Elderly Incontinence: Tips for Care and Treatment Options

For over 3.3 million Canadians who experience incontinence (bladder leakage) putting off a trip to the bathroom is not an option.

Urinary incontinence isn’t something your loved one should live with. Due to embarrassment, many people do not seek help and therefore are unaware of the many treatment options that are available.

Is urinary incontinence a normal part of aging?

Incontinence can happen at any age, however, it’s generally more common in seniors.

As you age, changes in the body can make incontinence more likely. It can be caused by aging, lifestyle choices, or a range of health conditions.

Elderly urinary incontinence can take on a few forms:

• only leak urine occasionally
• constantly dribble urine
• complete lack of both bladder and bowel control

Causes

Not drinking enough water, childbirth, a health condition such as diabetes, may be the causes. Many people slow down their water intake, however, this can cause strong urine that irritates the bladder wanting to release more often.

The following health issues can cause urinary incontinence in both women and men:

• Multiple sclerosis
• Alzheimer’s disease
• Stroke
• Parkinson’s disease
• Constipation
• Obesity

Common urinary incontinence causes in women are prior pregnancies, childbirth, menopause, pelvic floor dysfunction.

For men, prostate problems are a common cause of urinary incontinence.

Types of urinary incontinence

There are six common types of urinary incontinence:

• Urge incontinence is the most common diagnosis, often referred to as an overactive bladder.
• Total incontinence indicates your sphincter muscle is no longer working. 
• Stress incontinence occurs when an increase in abdominal pressure overcomes the closing pressure of the bladder. You may feel abdominal pain when you cough, sneeze, laugh, climb stairs, or lift objects.
• Overflow incontinence occurs when your bladder never completely empties. Sufferers frequently feel the need to go and often leak small amounts of urine.
• Functional incontinence is incontinence caused by other disabilities. Neurological disorders, stroke complications, or arthritis can prevent someone from unzipping their pants quickly enough, resulting in an accident.
• Mixed incontinence is a combination of more than one type of incontinence. People with severe dementia, Parkinson’s disease, or neurological disorders, as well as people who have had strokes, can have both urge and functional incontinence.

What can we do?

Your loved one may feel embarrassed and avoid scheduling a doctor’s appointment. They may be using absorbent pads or protective underwear to help, but urinary incontinence is very treatable with medical assistance.

They may not be sure what kind of doctor to see.  A primary care doctor, geriatrician, nurse practitioner, or urinary specialist are viable options. If your loved one feels comfortable with their primary care doctor, it’s generally good to start there. Women can also find a urogynecologist, while men can visit a urologist.

At your medical appointment, you’ll likely have:

• A urinalysis to rule out infection or blood in the urine
• Blood tests to check on kidney function, calcium, and glucose levels
• A thorough discussion of your medical history
• A complete physical exam, including a rectal and pelvic exam for women, or a urological exam for men

A patient may also be asked to bring a bladder diary to their first visit or create one before the second appointment.

In this journal, they will likely record:

• Types of drinks they consume
• Times they urinate throughout the day
• How much they urinate by placing a cup over the toilet to record the volume
• A description and frequency of their accidents

If the previous tests and exams don’t point to a diagnosis, the patient could undergo one of these procedures:

• Bladder ultrasound and post-void residual (PVR)
• Cystography
• Urodynamic testing
• Cystoscopy

Behavioural therapy is generally the first treatment for urinary incontinence in the elderly. This may involve:

• Learning to delay urination – You can do this by gradually lengthening the time between bathroom trips.
• Scheduled bathroom visits – This is often effective for people with mobility issues or neurological disorders, even if this means a caregiver is in charge of taking you to the restroom.
• Pelvic floor muscle exercises – Kegel exercises strengthen the muscles that help regulate urination. You should practice these a few times a day, every day. Learning how to contract the right muscles can be confusing, but a pelvic floor physiotherapist can teach the correct way.
• Fluid and diet management – Although diet alone can’t cure urinary incontinence, it can improve bladder control. Certain beverages like carbonated drinks and alcohol can cause your bladder stress. Even drinking coffee or tea while taking prescribed medication can aggravate it. Additional bladder irritants to avoid include milk, tea, honey, soda, and very spicy foods.

Incontinence care tips for families

If your elderly loved one suffers from urinary incontinence, self-care can help avoid complications such as skin rashes, urine odours, and accidents. For cleaning, use a mild soap. Petroleum jelly or cocoa butter can protect the skin. Make sure to pat the skin dry.

Having the right products on hand will provide you and your loved one some peace of mind in urgent moments and ease the stress of incontinence care.

Avoid falls – If they frequently run to the restroom, slip-and-fall accidents can happen more easily. Try to make the bathroom as accessible as possible at home. Use pads and protective garments or washable underwear until you find a successful solution.

Ask for help

If elderly incontinence is keeping your loved one isolated and unable to enjoy their favourite pastimes, talk to them about treatment options and encourage them to see a doctor. With the proper and appropriate treatment, your loved one could soon be enjoying life more fully.

Your independence, safety & dignity are our highest priorities. We provide nurse-managed and home support services in the comfort of your home. Designed to meet your individual preferences and personal needs, our care plans are customized for you and delivered by compassionate, friendly, professional caregivers.