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.
Antibiotics are commonly prescribed to treat infections. Antispasmodic and anticholinergic drugs are also prescribed specifically for urge 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.
I am a Doctor of Physical Therapy and have been working with the 70+ age group for over a decade. I will share my knowledge and experience to give you ideas to care for your aging parents. Read more >>