Urinary Incontinence Management for The Elderly
Urinary Incontinence Management
For a lot of people, a trip to the bathroom isn’t something to stress about, and can easily be put off for a while. However, for some people—namely, the33 million Americans who suffer from an overactive bladder (OAB), it’s not that simple.
Urinary incontinence is a topic that some people find difficult to discuss, but it’s important to remember that it’s not something your loved one should hide or try to live with. Since incontinence is more likely to develop with age, it’s likely that seniors will experience it in some form. Keep reading to find out about urinary incontinence and how you can help your loved ones manage it.
What Is Urinary Incontinence?
According to theNational Association for Continence (NAFC), urinary incontinence is the involuntary loss of urine that can range from occasional light wetness to heavy bladder leakage and even bedwetting. While urinary incontinence can happen at any age, it’s more commonly seen in seniors, especially women.
Why Does It Happen?
Urinary incontinence is a result of an uncontrollable bladder, resulting in leaking urine when you cough or sneeze, or urgently needing to go to the bathroom with no warning. Remember, urinary incontinence is a symptom of a problem in yoururinary system and not just a problem in and of itself.
Your urinary system is made up of your kidneys, bladder, ureters, and urethra, which all function to filter, store, and remove waste from your body. When this system works smoothly, you will find that you have enough time to get to a bathroom before needing to urinate, and won’t experience any leakage. When the parts in the system aren’t working as well as they should, you can experience urinary incontinence.
What Causes Urinary Incontinence in Seniors?
As people age, their body goes through a lot of changes, including changes in their urinary system. According to theUrology Care Foundation, one in two women above the age of 65 will experience bladder leakage.
The muscles around the bladder and urethra are responsible for letting urine pass out of the body. Aging can cause these muscles to become weaker, which results in urinary incontinence.
Apart from aging, urinary incontinence can also be caused by lifestyle changes (like not drinking enough water), or certain health conditions. These include:
● Alzheimer’s disease
● Parkinson’s disease
● Stroke
● Multiple sclerosis
● Urinary tract infection
● Constipation
● Diabetes
● Arthritis
● Obesity
In the case of older women, urinary incontinence can be caused by:
● Past pregnancies
● Childbirth
● Menopause
For older men, prostate problems are found to be a common cause of urinary incontinence.
Types of Urinary Incontinence
There are several different types of incontinence, all of which have different causes, characteristics, and triggers. Finding out the exact type of incontinence your loved one experiences will be helpful in figuring out a treatment plan.
1. Stress Incontinence
Stress incontinence occurs when urine leaks as a result of pressure being put on the bladder. Exercising, coughing, sneezing, laughing, or lifting heavy objects can cause stress incontinence. This type of incontinence is caused when the pelvic floor muscles become too weak to support the pelvic organs—so it is most commonly found in women who have gone through childbirth and menopause. However, men who have had prostate surgery can also develop stress incontinence.
2. Urge Incontinence
Urge incontinence is when people have an intense need to urinate immediately and usually happens too quickly for the person to reach a bathroom in time, resulting in urine leakage. Urge incontinence is caused due to anoveractive bladder (OAB), which can be caused by a variety of reasons including weak pelvic muscles, infection, nerve damage, a drop in estrogen levels after menopause, or obesity. OAB can also be caused by alcohol, caffeine, and certain medications. OAB also typically affects people with diabetes, Alzheimer’s disease, Parkinson’s disease, and some other conditions.
3. Overflow Incontinence
Overflow incontinence occurs when your bladder is always full, leading to small amounts of leakage. If you find that your bladder doesn’t completely empty when urinating, it’s likely a sign of overflow incontinence. Rather than a lot of leakage, this causes minor leakage over time. This type of incontinence is commonly found in people with chronic conditions like diabetes, multiple sclerosis (MS), and stroke. Spinal cord injuries can also result in overflow incontinence. In the case of men, having an enlarged prostate can block the urethra, resulting in this type of incontinence.
4. Mixed Incontinence
As the name suggests, mixed incontinence is a combination of several types of incontinence, which all cause leakage issues. Mixed incontinence is typically a combination of stress and urge incontinence, and is most likely found in women. Of the 45% of women who experience urinary incontinence,14.5% of women showed the prevalence of mixed urinary incontinence (MUI).
The symptoms of mixed incontinence are typically the same as those of stress and urge incontinence, although the symptoms of one type can be stronger than the other. It is caused by the same factors that cause urge and stress incontinence.
5. Functional Incontinence
Functional incontinence usually occurs in older people who have normal bladder function and control, but experience other disorders like arthritis or a mental condition that makes it difficult to move. This condition can either prevent the person from feeling the urge to urinate or can make it difficult for them to reach the bathroom in time.
6. Total Incontinence
Total incontinence is caused by a total loss of urinary control, causing continuous leakage. It can be a result of either a physical or mental condition. Aneurogenic bladder, for example, is a neurological condition that prevents the bladder from emptying properly. Other problems affecting the nerves like spinal cord injuries and multiple sclerosis can also cause total incontinence.
Symptoms of Urinary Incontinence
The symptoms of urinary incontinence depend on the type of incontinence, but the main symptom is a leakage of urine. It can be consistent or occasional leakage. Depending on the type of incontinence, you might leak urine when:
● Coughing
● Sneezing
● Exercising
● Laughing
People with urinary incontinence can also experience leakage when they need to urinate but can’t make it to the toilet on time. Additionally, getting up repeatedly in the middle of the night to urinate is a common symptom of urinary incontinence (nocturia).
Urinary Incontinence Treatment
There are several treatments available for urinary incontinence, and the right treatment depends on the type of incontinence and how serious it is. Treatment and management of urinary incontinence include making lifestyle changes, taking medicine, and surgery.
Lifestyle Changes
Making some changes in your daily habits—also called behavioral changes—can be very useful for people dealing with stress and urge incontinence. These include:
Bladder training: Bladder training involves being conscious of when and how you use the bathroom so you can control it. For example, take down details of how much you drink, the sensations you feel before leakage, and how often you use the bathroom. This information can help your doctor prepare a schedule so you can practice going longer between bathroom visits, allowing your bladder to stretch more.
2.Pelvic floor exercises: Strengthening your pelvic floor, throughKegel exercises, for example, can help your muscles become stronger, which will give you more control.
3.Quitting smoking: Smoking can make you cough, which can trigger stress incontinence.
Medication
Medication to treat incontinence commonly includes anticholinergics (to calm overactive bladders), mirabegron, and alpha-blockers (relaxes the bladder muscles to increase the amount of urine it can hold and to help empty it more thoroughly), and topical estrogen (which helps rejuvenate tissues in the urethra and vagina).
Surgery
If urinary incontinence is caused by a change in bladder position or an enlarged prostate, then surgery can be used to treat and even cure the incontinence.
Therapy
Urinary incontinence therapy is another avenue for treatment. Occupational therapy sessions focus on strengthening the bladder and pelvic floor muscles. Each of Brookfield Senior Living’s communities are partnered locally with Home Healths and each have an Out Patient Therapy solution.
How to Manage Minor Incontinence
For people with minor incontinence, following some self-help and lifestyle tips can help manage and relieve symptoms. These include:
● Doing daily pelvic floor exercises like Kegels and pilates. Avoid high-impact exercise as it can put pressure on your pelvic floor muscles and increase leaks.
● Avoid lifting heavy items.
● Lose excess weight.
● Reduce alcohol and caffeine consumption.
● Drink lots of water.
How to Manage Major Incontinence
Major incontinence can be harder to manage. Most experts recommend medical treatment before considering surgical treatment, however, if the incontinence is severe and can be treated by surgery, prior medical treatment may not be mandatory.
Typically, major incontinence comes with comorbidities like asthma, or chronic constipation. Treating these comorbidities can help minimize incontinence. If medical treatments cannot alleviate the incontinence, there are products to help ease the discomfort:
● Pads or protective garments. These products are not bulky and can easily be worn under everyday clothes.
● Catheter. If you have overflow incontinence, your doctor may recommend learning how to use a catheter to drain your bladder.
How to Help Your Elderly Loved Ones with Urinary Incontinence
Your loved ones may feel embarrassed by their incontinence and may avoid discussing it or scheduling a doctor’s appointment. If urinary incontinence is keeping your loved ones from enjoying their favorite activities, talk to them about treatment and encourage them to ask for help. Remember to be kind and compassionate while doing so, and show them that urinary incontinence is very treatable with the right medical assistance.
AtBrookfield Assisted Living, we believe in helping the seniors under our care live full and enriching lives. Your loved ones will receivecomplete care and support for their incontinence issues, as well as any other assistance they may need. To learn more about how we can help,contact us today.