Incontinence is a subject that can be uncomfortable to acknowledge or discuss. After all, it can be embarrassing to admit a struggle with getting to the bathroom on time or that clothing has been soiled. However, a reluctance to address it openly can hinder people from getting the advice and care that they need. Out of all activities of daily living (ADL), maintaining independent toileting is a key to determining if someone can remain at home or outside assistance is needed.
Fortunately, it’s possible for older people to successfully manage incontinence and retain as much independence as possible. This condition isn’t a reason to be inactive or homebound!
You’re Not Alone in the Struggle
Older people who deal with incontinence should feel heartened to know that they are not alone. In fact, a range of health conditions, including pregnancy, constipation, blockages and infections, can cause bladder or bowel leakage in a person of any age. Older people can be more susceptible to incontinence because as the bladder muscle ages, it can decrease its capacity for storing urine and may experience involuntary contractions. Menopause and prostate changes can also exacerbate incontinence.
While it can be difficult to start a conversation about incontinence, a patient need not worry about talking to their doctors about it. Doctors see and treat a variety of conditions, and they are trained to help patients manage issues with bodily functions. “I can’t imagine anything that would shock me after almost 40 years. Nothing surprises me anymore,” Dr. Suzanne Salamon, associate chief of gerontology at Harvard-affiliated Beth Israel Deaconess Medical Center, told Harvard Health.
Your doctor is your partner. It’s helpful to remember that physicians want to know what’s truly going on with their patients so that they can provide the best care and advice possible. Experts often recommend a combination of lifestyle, behavioral and medical interventions that can help keep incontinence under control.
Lifestyle Changes that Help Manage Incontinence
Using disposable products such as shields, pads and other protective products can increase an older person’s confidence about staying active and being able to leave the house. In addition, absorbent underclothing that mimics normal underwear can be worn easily under everyday clothing. But there are other steps – from what you eat and drink to exercise – that help tackle the issue at the source.
- Avoid foods that irritate the bladder. Known bladder irritants include artificial sweeteners, chocolate, spicy foods, acidic foods, and citrus fruits.
- Cut out caffeine, alcohol, and carbonated beverages. Alcoholic drinks, coffee, tea, soda, and carbonated drinks act as diuretics.
- Stop smoking and maintain a healthy weight. Smoking is bad for overall health, and it can cause chronic coughing, which puts pressure on the bladder. Excessive weight also puts pressure on the organs.
- Emphasize healthy food with fiber. Constipation often goes hand in hand with incontinence because of the strain it puts on the structures involved with elimination. Eating fiber-rich food helps address constipation.
Safety measures also play an important part in supporting an independent lifestyle. Being able to get to the bathroom quickly and safely reduces the chances of having an accident, or worse – risking a fall. It’s wise to remove things from the path to the bathroom and consider installing safety devices like nightlights, a raised toilet seat and grab bars.
Strategies for Alleviating Incontinence
- Try pelvic floor exercises. Exercising the pelvic floor can improve muscle tone in the urogenital area. Exercises include squeezing and releasing the muscles that stop the flow of urine. A doctor can provide advice on how such exercises could support improved continence.
- Follow a toileting schedule. Following a schedule for going to the bathroom can be helpful for people who cognitively may not realize that they need to go until it is too late.
- Retrain the brain. Sometimes, there can be a sense of urgency to go to the bathroom even when the bladder isn’t full. Bladder training involves increasing the time between bathroom visits by recognizing the urge to go and delaying response time.
If behavioral approaches are not effective, medical approaches can be considered. Several medications treat urge incontinence and urgency, including antimuscarinics and alpha-blockers. Medical devices can be inserted that address symptoms of prolapse, and nerve stimulators can improve bladder muscles. There are also surgical interventions available if necessary.
Supportive Care for Staying Active with Incontinence
Kadan Homecare, a family owned business with more than 40 years of experience serving Metro Atlanta families, is an award-winning provider of in-home personal care and companion care. In addition to providing care that supports an older person’s need for modesty with regard to incontinence and following an appropriate toileting strategy, Kadan’s highly trained caregivers can help with medication oversight, healthy eating and food choices, and advice on home safety measures.
For more information or to talk with our team about care at home in the Atlanta area, call 770-396-8997 or email info@kadan.org.
