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Living with Incontinence

A senior man with bladder control problemIt’s true that urinary incontinence is more common in the elderly. Up to 35 percent of the total population over the age of 60 years is estimated to be incontinent, with women twice as likely as men to suffer from it. One in three women over the age of 60 years are estimated to have bladder control problems. The National Institutes of Health (NIH) suggests that 17 percent of men over age 60 experience urinary incontinence, with this percentage increasing with age. However, it is also true that urinary incontinence almost always results from an underlying treatable medical condition and is often curable at all ages, but it is under-reported to medical practitioners.

Urinary incontinence, or the involuntary leakage of urine, is a depressing problem that may have a huge impact on a person’s quality of life and activity at any age. Patients or loved ones with incontinence should be referred to a medical practitioner specializing in this field. Family physicians and internists see patients for all kinds of complaints, and are well trained to diagnose and treat this common problem. These primary care specialists can refer patients to urology specialists if needed. Keeping a history of voiding and leakage is helpful as it can indicate the type of incontinence and the related treatment. Other things to report to your doctor are straining and discomfort, use of drugs, recent surgery and illness.

Incontinence is expensive both to individuals in the form of bladder control products and to the health care system and nursing home industry. Injury related to incontinence is a leading cause of admission to assisted living and nursing care facilities. More than 50 percent of nursing facility admissions are related to incontinence.

How to Manage a Urinary Incontinent Patient or Loved One

Many caregivers will deal with people who suffer from incontinence. The problem causes embarrassment and distress, and it’s important that a good caregiver treat them with tact and sensitivity. They need to be aware of some of the common causes of incontinence, such as muscle weakness, neurological damage, infection, other medical conditions or confusion. Among the most common types of urinary incontinence are stress incontinence, which can cause leaking urine when you laugh, cough, or sneeze, and urge incontinence, in which a sudden urge to urinate often makes it difficult to make it to the bathroom in time.

Urinary incontinence contributes to skin problems, when not managed properly. Bedsores are aggravated by constant contact of the skin to urine. Patients and family members who are urinary incontinent must be kept clean and dry for their comfort and health. There are different aids that can help the patient, including pads &/or adult diapers, catheters and regular use of the toilet. Sometimes the caregiver can help a confused elderly person to not have accidents by regularly prompting them to use the toilet and not continue to wear wet pads or undergarments.

Use perineal pads if you or the patient is only mildly incontinent. These are pads that are placed in the underwear with an adhesive side or an elastic belt. Consider diet changes to induce weight loss if the person is overweight. Extra weight causes pressure on the bladder, reducing bladder control in some individuals. Add sturdy handrails beside toilets for in-home patients who are mobile and independent.

For those with no bladder control, use diaper-style absorbent underwear with the proper absorbency level. Measure the patient around the waist and hips to determine the correct size of underwear needed. Prevent leakage by using the exact size recommended; larger underwear may be easier put on but will leak around the leg openings. Clean the perineal area after an incontinent episode. Wipe the soiled area downward, away from the pubic bone or stomach area. Special perineal wipes can be used in place of washcloths, water and soap.

Place absorbent bed pads directly under the hips of an incontinent patient. Remove and replace with a clean, dry pad in the morning for the mildly incontinent or as soon as soiled for the fully incontinent. Check catheters on an hourly basis for patients who use them. To ensure a clean leg or bed bag, empty when half full. Wearing gloves, place the drain tube of the catheter bag into a urine collection container. Wipe the end of the catheter bag drain with an alcohol pad before replacing cap or sliding into its holder. Empty the collection container into the toilet.

Additional Tips 

  • Offer instructions on pelvic floor exercises (Kegel exercises), if the person is able to do them.
  • Avoid foods and drinks that can irritate the bladder, such as coffee, citrus juices and colas.
  • Teach your patient or family member how to use incontinent supplies themselves to increase a sense of dignity.
  • Check the patient’s skin often. Contact with urine can cause rashes and other skin breakdowns.
  • Remove any absorbent padding that causes skin irritation and replace it with cloth products.
  • Barrier creams are not a substitute for frequent changes of underwear and may even cause skin reactions for some sensitive patients.

Check Out Treatment Options for Urinary Incontinence

There are many treatment options for urinary incontinence. About 80 percent of those who are affected by urinary incontinence can get better with treatment. But, to make living with urinary incontinence easier, you must seek help. For more severe urinary incontinence, your doctor may recommend prescription medication or a surgical procedure, such as an operation designed to support the bladder and prevent leakage of urine.

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