Is your loved one experiencing incontinence?
This is a growing problem in our aging population, so it is a good idea to be aware even if this is not yet a concern.
It could be urinary frequency, urgency or accidental leakage with activity such as running, laughing or coughing.
Today, we will be discussing what incontinence in the elderly is and how we can better manage it.
Here we go.
So how do you know if an elder is suffering from incontinence? Geriatricians created a mnemonic for its symptoms called DIAPPERS.
DELIRIUM - The person experiences an abrupt change in thinking and alertness due to an acute medical illness. Most of the time, they can be too drowsy or confused to get to the toilet on time.
INFECTION - The person experiences burning sensations when peeing due to UTI. this can also be accompanied by pain, confusion, and frequent urination.
ATHROPIC URETHRITIS AND VAGINITIS - Shrinking of urinary and genital tissues in women can cause incontinence. This symptom can also get better through topical hormone therapy.
PHARMACEUTICALS - Incontinence can be caused by certain medications or diuretics which cause the person to have frequent urination.
PSYCHOLOGIC DISORDERS - A person’s current psychological disorder can also cause incontinence. In seniors, depression, delirium, and dementia can worsen incontinence.
EXCESSIVE URINE OUTPUT - This symptom can signal other underlying health problems like kidney problems, certain types of cancer, diabetes, and incontinence.
RESTRICTED MOBILITY - Problems in mobility can also cause a person to miss the bathroom. Musculoskeletal problems and other mobility restrictions can increase the chance of incontinence.
STOOL IMPACTION - Also known as constipation, this condition restricts the release of urine and can cause an uncontrollable overflow.
Get more information about senior incontinence here.
The good news is, that incontinence in the elderly is treatable. But like any other condition, you need to confirm the right diagnosis first.
The treatment your loved one will receive will depend on the type of incontinence they have.
The 5 types of incontinence are: stress, urge, overflow, functional and mixed. For a review of types and prevalence check out last weeks post here.
There are the non-surgical treatments you can do. And there are also surgeries and other procedures that may be required. As with anything, you should start with the least invasive option.
The first thing you need to do is get a medical appointment with your healthcare provider. Here, your loved one will go through several tests to check for potential issues.
Your loved one would likely go through urinalysis to rule out blood and other infections in the urine.
Blood tests may also be done to check the kidney functions, calcium, and blood sugar levels.
They will likely also undergo rectal, pelvic, and urological exams.
Your doctor may recommend lifestyle changes to improve the symptoms, like healthier food options, reducing caffeine intake, and increasing their daily water/fluid intake.
Maintaining a healthy weight can also improve incontinence symptoms.
Some seniors get referred to specialized physical therapists focused on pelvic floor muscle training.
Learn more about pelvic exercises here.
Some specialists can also recommend behavioral therapy if needed once a proper diagnosis is made.
For certain conditions, learning to delay urination can be helpful. In this case, elders are asked to gradually lengthen the time they spend between bathroom breaks.
Avoiding the "just in case" bathroom trips and paying attention to how full the bladder becomes will slowly train the bladder.
For patients with mobility issues, scheduled bathroom visits are encouraged every 2 to 3 hours.
Sometimes doctors may also recommend medications to help manage incontinence.
However, these drugs may have side effects like dry mouth, constipation, blurred vision, and confusion.
Encourage fluid intake especially water as seniors with incontinence issues often avoid fluids because of this and this can quickly lead to dehydration in the elderly.
There are also incontinence care products available in the market to help caregivers manage better.
Absorbent briefs, booster pads, and liners are available for purchase. There are also waterproof bed pads that you can get to lessen the burden of cleaning up.
It’s also important to clean up the mess as soon as possible to avoid potential fall risks.
And if all else fails, make sure to ask for help from your healthcare provider.
Incontinence in the elderly can be as challenging as any other condition.
It comes with its own perils and risks for the patient.
The good news is that there are ways to cope and treat it. The key is to get help as soon as possible.
Do you have any tips on how to manage incontinence in the elderly better? Share them with us below.
Is incontinence in the elderly a usual thing?
Most people would assume that, like memory loss, incontinence is common in seniors.
It can be embarrassing for the elder, and inconvenient for the caregiver.
One thing is for certain. Incontinence in the elderly isn’t something your loved one should just accept as normal.
So today, we will be discussing types and prevalence of incontinence in the elderly.
Let’s get started.
Incontinence is a condition where a person loses bladder control and causes occasional leaking of urine.
It can range from small leaks when coughing or sneezing. Or it can also be an uncontrollable urge to pee at any time.
Urinary incontinence usually occurs as people get older. But to set the record straight, it is not an inevitable consequence of aging.
Different types of incontinence can affect a person at any age. Here are some of them.
Stress incontinence happens when pressure or stress is applied to your bladder.
Urine leaks when coughing or sneezing, laughing, exercising, or lifting heavy items.
Urge incontinence is often caused by infections, severe conditions like a neurological disorder, or diabetes.
This type of incontinence feels like a sudden, intense urge to urinate, especially through the night.
Some experience the need to go more than eight times a day or night. Others get triggered even when hearing or touching running water.
There’s also the dry form of urge incontinence, where you feel the urge to go even if the bladder is empty.
Overflow incontinence is a more common condition in men especially those with benign prostatic hyperplasia.
It happens when the person can’t empty the bladder. This leads to an overflow and can leak out any time of the day.
Leftover urine in the bladder can become a breeding ground for bacteria. Thus causing the person to become more prone to repeated urinary tract infections.
Many factors may affect a person suffering from functional incontinence. But the main identifier of this type is the ability of the person to reach the toilet when the need arises.
Medications such as sedatives can also cause functional incontinence. And for seniors, it can be as simple as not getting to the toilet on time.
Mixed incontinence is a combination of stress and urge incontinence.
It is mainly caused by weakened muscles that support and control the bladder. Increased pressure on the bladder can also cause leakages to happen.
Pregnant women or those who recently gave birth experience this most often.
It can also happen to people who have gone through surgery. Medical conditions like thyroid issues and certain diuretics can also cause mixed incontinence.
This brings us back to the question, what makes the elderly more prone to incontinence? And is it something that you should expect when caring for the elderly?
Aging increases the risk for incontinence. The bladder’s ability and capacity are reduced, thus the uncontrollable leakage.
Elderly postmenopausal women also lose volume and tone in their pelvic muscles. Ligaments and connective tissues that support the pelvic area also gradually fail.
Weakened pelvic floor and muscles also increase the risk of prolapse and eventually cause incontinence.
Dementia patients are often diagnosed with a type of incontinence. Some even experience a complete lack of control for both bladder and bowel movements.
Because of any of these many factors, patients are at an increased risk of falls and fractures. Rushing to the commode or an accident that results in a wet floor can significantly increase the danger at home.
They also have higher risks for ulcers and urinary tract infections.
CDC reports that 51% of people aged 65 and older reported problems with incontinence. 44% of those had bladder incontinence. While 17% are said to suffer from bowel incontinence.
Women make up about 50% of that number, while 25% are men. It is also said that women receiving home health care were 1.7 times more likely to have bladder incontinence compared to men.
Incontinence also has its social and financial implications. It can even cause a huge shift in a person’s life.
Some conditions are so severe that they can lead to social anxiety and even withdrawal. Others even experience depression and loss of independent functions.
These factors also play a role in increased risk of decreasing cognition and worsening dementia.
In fact, 6-10% of nursing home admissions are due to urinary incontinence.
Unfortunately, incontinence is common and becoming more likely as our loved ones age.
Click here for the best ways to manage incontinence and warning signs to look out for.
If you liked the shorter post this week let me know in the comments below.
That's all for today.
Take care, keep mom safe and have a great day!
Home inspectors have an important role in the success of aging in place.
They make sure that the houses our elders live in are safe enough for them to function on their own.
On top of that, they also make sure that the house is maintained as an asset instead of a liability.
So today, we’ll go deeper into what home inspectors do to keep our loved ones safe at home.
We are speaking with Mark Caffiers, Director for Property Inspections at D.S. Murphy Inspections. He is a InterNachi C.P.I. (Certified Professional Inspector) and also a Certified Aging-in-Place Specialist (CAPS) as designated by NAHB.
We will also be discussing what inspections are needed and why we need to have regular inspections done for our aging parents’ home.
Let’s get started.
Glad to be here.
I am Mark Cafiiers, and I’m the Director for Property Inspections at D.S. Murphy Inspections. We are a multigenerational company that is a leader in appraisals in the southeast.
D.S. Murphy Inspections have been in the residential and commercial appraisal industry for more than 30 years.
As home inspectors, we are known for our diligence in our inspection process and our exceptional customer service.
Our services include full home inspections, microbial assessment, radon measurement, four points inspection, wind mitigation inspections, drone services, pool and spa, and aging-in-place inspection.
It’s better for home inspectors to have a certification for Aging in Place. Sadly, I was surprised to hear that I was only the third inspector to take the certification classes in twenty years.
But if you ask me, there is a huge demand for home inspectors in the geriatric population. And there is a huge hole in the process of making sure that homes are safe enough for the elderly to navigate on their own.
As a licensed professional, my role is to give you proper advice on how to make the home safe for the elderly. My expertise also lets me connect you with the best people for the job.
It actually depends on the kind of property we’re inspecting.
Most would think that inspections require tearing things apart. But in reality, most of what we do are visual and not technically exhaustive.
Our purpose is to educate the clients about conditions that exist regardless of what type of inspections we’re doing.
Most of the time home inspections for property buyers and sellers deal with meeting standards. Our services tend to be in commercial and residential areas. And we check on such things as radon measurements, mold inspections, and others, especially for new buildings.
Some things are more important than others. But for the most part, we’re trying to avoid curveballs and figure out unusual situations that might affect a property.
Even though we’re hired to do general inspections, we’re also looking for potential issues that need urgent action.
These types of home buyers, they’re more concerned about protecting their assets, pricing, report turnarounds, and honesty in reporting.
Not every house is going to fit elder people’s needs. And if they’re the ones buying the house, they would need to know what type of changes they need to get done.
This is where our synergy exists. We as home inspectors can make assessments for them. We point out the parts of the house that need adjustments, especially for safety standards.
The most common issues we find are smoke detectors and carbon monoxide detectors.
More often these alarms are not in their proper place. Anything that’s ten years or older needs to be replaced for it to be effective.
Some detectors are placed too near the kitchen and are triggered way too often. And people say they don’t like hearing the alarm going off thus the batteries are removed.
Current safety standards call for all households to have a smoke detector in every bedroom, on every floor, and in any room with a fireplace.
Carbon monoxide detectors, on the other hand, are required for every floor of the house.
There’s also the problem of high water temperatures at homes. Anything that’s above 125°F is already considered scalding, especially for the elderly and small children.
I’ve added these things to our inspection checklist because I see them all the time. The problem is, that not all inspection lists have these things in order.
While some institutions and groups are giving general guidelines for inspections, most of these things are things I’ve learned through experience.
There are design considerations, but I’ve prioritized these seemingly simple things.
I have a 93-year-old mom who also lives on her own. And I’ve done my best to help her stay in her own home for as long as possible.
Recently we organized an in-law apartment for her when she was ready.
As family members, we also need to consider the things a loved one needs when they move in with us.
The goal is for them to still have a sense of independence even if they’re in a family member’s home.
So it is also helpful to get the services of aging-in-place home inspectors to guide them on building additional dwellings or renovations that need to be completed.
Take care of trip hazards and other causes of falls.
Make sure grab rails are available around the home for easier access and safer mobility.
We also see a lot of fall hazards like uneven flooring and stairs, bad lighting, and clutter in homes. So make sure you’re keeping things clean, safe, and clutter-free.
I recently checked on a house that had an unusual staircase. The ideal measurements should be at least 11-inch wide treads and 8-inch stair height, but this one was uneven.
These measurements are hazardous for the elderly and should be addressed as soon as possible.
It’s all about understanding what the immediate concerns are. If the conditions are too tedious to fix like the staircase I mentioned, then you can think of other ways to go.
One example is to keep all the things your elders need on one floor. This way you’re removing the need for them to move up and down the stairs and risk getting into accidents.
You can also move around the house and see things from their perspective.
It’s also necessary for you to schedule a professional home inspection regularly.
Keep in mind that everything has a life expectancy. Regular checks can ensure that things are working as they should.
Consult with an expert home inspector.
I’ve been through it with my mom, who is also part of the reason why I took the certification for aging-in-place inspections.
There are a lot of resources available for aging-in-place design, but it’s easier to focus on what your elders need.
It can be something as simple as adding some lighting on the stairs or switching from door knobs to levers.
The key is to get proper guidance from professional home inspectors so you’d know what to prioritize.
Changes don’t have to be drastic to keep your elders safe. Remember that the goal is for them to keep on living independently for as long as they can.
Read more about home inspections here.
Mark Caffiers is the Director of Property inspections for D.S. Murphy Inspections.
With 35 years of experience in the industry, Mark has extensive experience in construction trades. He has also done consultations with clients on rental property purchases and maintenance programs.
Mark has also planned and executed many complex projects from complete guts and remodels of residential and commercial buildings. He and his team of experts have also worked with renovations and resurrecting properties with multiple buildings on the historic register.
As an expert in the construction industry, Mark and his team have always prioritized high-quality services and excellent experiences for their clients.
Mark also has the following certifications and licenses:
We are also working together on a new combined Aging in place home inspection and mobility assessment by me as a Doctor of Physical Therapy to keep mom safe at home. Let me know if you have any thoughts or questions!
That's all for today.
Take care, keep mom safe and have a great day!
This is a re-post of an article from a couple years ago, but I feel it is as important if not more important now as Covid has drastically increased the need for our older loved ones to age in place.
Are you worried about the sheer volume of things in your aging mother’s house?
This is a common problem for those with aging parents.
Most of the time we don't understand why they keep trinkets and things around. But in reality, it might be their way of keeping the memories alive.
This article will discuss why it is important to start a minimalist lifestyle as soon as possible.
This is not a solution for significant hoarders.
If your parent falls into the category 2-5 of hoarding listed here, professional help is needed.
See if her primary care physician can refer to someone who specializes in dealing with that. We can help reduce the normal accumulation of items over a lifetime to improve her safety within the home.
So, is a minimalist lifestyle the best for our aging moms?
Truth is, she doesn’t need to free herself of all worldly possessions and completely change who she is.
But it's always a good idea to declutter and clear away what she doesn't need. Stuff, junk, clutter, knickknacks, and heirlooms tend to accumulate as we age.
It is usually due to one feeling that an item is valuable or will be needed in the future.
And most of the time, getting rid of them is also an emotional process.
As we age, we begin to outlive relatives. Many of whom have left their heirlooms and trinkets to us. This may be when you see items within the home becoming excessive.
Often your mother will feel a responsibility to her family to keep the items they felt were important or worth saving. This is the time to step in. If Mom’s home is already full of furniture, suggesting a one piece in, one piece out (donated) is a good policy.
A quick story first.
I was working with a man one time who was in need of physical therapy before returning to his home.
Due to his significant COPD, he was unable to walk around his home without being very short of breath.
Because there was so much clutter in the home, he was unable to use a walker or a wheelchair.
He bought a “shop stool” and was using this to scoot around his home. This very unsafe behavior eventually resulted in a fall off the stool and a broken hip.
Try not to let the clutter reach the point of significant danger.
There are many reasons to reduce the amount of items in one’s home.
As furniture begins to take more and more floor space, the pathways for walking become more narrow.
While mom can navigate these narrowing pathways now, what happens when she steps off a curb wrong, twists her ankle, and requires a walker to get around.
If she can't use the walker at home, she is likely to try cruising (touching the walls and furniture for support) which increases her chance of another fall and more significant injury.
As furniture blocks wall space, electrical outlets are more difficult to access. The fix often used is an extension cord.
While this will solve the issue of inaccessible outlets, it creates a separate risk of tripping.
In addition, more furniture and more stuff leads to more lamps and electronics each needing to route cords across the narrowing walkways
If she is hesitant but not outright resistant, suggest starting with one item she can find that she thought she might need months or years ago, but no longer needs this item. Give it away.
There are many organizations such as Goodwill or the Salvation Army that gladly accept donations. Give her a day to reflect on the “loss”. Once she realizes, it was not really that difficult, suggest finding 5 things to donate.
If this goes well, suggest a room to clear and declutter. Maybe a small guest bedroom or dining room. Let her know you appreciate the effort it takes, and encourage her that personal safety is a top priority.
Point out how nice the room looks and how free and open it feels. Give her time to begin to adjust. Change is uncomfortable and even more so as we age. Once she has adjusted, help her move to the next room.
If she is unwilling to participate in improving the safety of her home by starting to declutter, it may be necessary to remove visible fall/fire risks without permission.
Unplug one cord to an appliance or lamp that is seldom used.
If there is one that crosses a walkway, move the cord to behind the piece of furniture it was sitting on, don’t plug it back in. See if this is noticed. If it is not, try another one or remove the item altogether.
If she does notice, express your concern regarding her safety and see if y'all can find a compromise where another item is removed or a pathway is cleared.
Be sure to be understanding during this process, and to give time for the benefits to become apparent. She may feel attacked and hurt if the situation is not described in a way she will see the need for change.
In the long run, a minimalist lifestyle will benefit your mother and yourself. Make the effort.
Change is difficult, but when we choose to change it becomes empowering.
That's all for today.
Need more tips on how to keep mom safe at home? Check out the full guide for aging in place here.
Take care, keep mom safe and have a great day!