How To Deal With Elderly Incontinence
Let’s have an open and honest conversation about incontinence. In the UK, it’s thought that over 5m people are living with some form of incontinence yet it’s not something we openly discuss. Whilst it can be an issue at any age, bladder and bowel problems are become more common as we get older so we thought it was important to look at how to deal with elderly incontinence.
People living with incontinence may be embarrassed, or start to worry about going out. We’re writing this article because it’s important to raise awareness of elderly incontinence, providing education and solutions to improve quality of life for anyone suffering. Read on to find out everything from what incontinece is, to how to get rid of smells from clothing, bedding and furniture.
What Is Incontinence?
It’s the inability to control your bladder (so you may pee unintentionally – this is called urinary incontinence) or bowel (where you don’t have control over bowel movements, known as bowel incontinence).
More women than men experience incontinence – as well as pregnancy and childbirth, hormonal changes during the menopause can cause it (which is why more older women suffer).
However, elderly men are also susceptible and bladder problems can indicate an underlying prostate problem so it’s important to see a doctor and get checked out.
A Healthy Bladder
The bladder stores urine and is supported by pelvic floor muscles. The brain controls the bladder, letting it know when to hold or empty urine (these signals are what give you time to find a toilet).
The amount we all wee depends on the individual, but largely a healthy bladder empties completely every three to four hours.
If your elderly parent (or yourself) is experiencing some form of accidental bladder leakage, then it’s time to understand some more about incontinence and effective treatments.
Different Types Of Bladder Incontinence
Over a third of people aged over 65 experience some form of bladder leakage, but it’s not one size fits all as there are different kinds of incontinence.
Stress incontinence is when urine leaks when you cough, sneeze, laugh or sometimes even during walking and other light exercise. The name ‘stress’ comes about as it’s caused by the weakening of the muscles used to prevent urination (the pelvic floor muscles). People living with stress incontinence won’t always feel the need to wee before leaks happen.
As the name suggests, urge incontinence is caused by an overactive bladder – you suddenly need to go to the toilet and can’t always get there in time.
People recovering from a stroke or living with Parkinson’s disease may experience this, if the nerves linked to the bladder are affected. It’s also possible to have a mix of stress and urge incontinence.
This type of bladder leakage happens when you can’t completely empty your bladder when passing urine, and end up leaking urine later. Overflow can also be marked by trouble starting to wee and having a weak flow once it starts.
Functional incontinence is when you are physically unable to get to the toilet in time. Things such as mobility problems, or arthritic hands meaning it’s harder to undo clothing at speed may result in bladder leakage.
Nocturia is frequent nighttime urination (usually having to get up twice or more). If your elderly parent is getting up to go to the bathroom at night, make sure that they have a clear path to the toilet to reduce the fall risk.
We’ve written about the most useful products for older adults, where we list a number of helpful inexpensive living aids that can help prevent falls.
Most of us experience bowel problems such as constipation or diarrhoea every now and then, but bowel incontinence is different.
Caused by weak bowel muscles or changes to the nerves controlling the bowel (this could be from chronic constipation or a stroke for example), symptoms include bowel leakage and an urgent need to go to the toilet (urge incontinence).
Bowel incontinence is often symptomatic of an underlying physical or neurological condition, so our advice would be go and see a doctor.
Make sure your loved one is eating plenty of fibre in their diet to encourage regular bowel movements and minimise the risk of constipation. Brown bread and warming stews with pulses are delicious ways to drive up fibre consumption.
Some people are doubly incontinent, when bowel and bladder incontinence occur together. It in itself is not a disease, but a symptom of other problems including lifestyle, medical and physical factors.
Caring For Someone With Incontinence
Going to see a doctor should be the first step if your elderly parent is experiencing incontinence. It may also be that they can identify a short term reason for the cause such as a UTI.
It’s likely they will ask the following questions, so run through them with your parent in advance:
- How long have they been living with incontinence?
- How often do they have bladder or bowel leakages?
- How much is lost?
- How is it making them feel?
- How much, what and when are they drinking?
- Do they know when they need to go to the toilet?
- What medication are they taking?
- Are there any other symptoms?
It’s a good idea to keep an incontinence diary for a few days before seeing the doctor. Keeping track of:
- How often they go to the bathroom (day and night)
- How urgent the need to go to the bathroom was
- The time they go to bed and get up in the morning
- How often and what they are eating and drinking
- Any leakage and what they did
- Incontinence products used
At the GP appointment, it is also likely the doctor will perform a physical examination and ask for a bladder or stool sample.
The NHS has a local continence service – your parents doctor can refer them. There, expert nurses and physiotherapists can help your elderly parents treat and manage their incontinence. Or, if they don’t want to wait for a referral there’s the Bladder and Bowel continence clinic.
Getting On With Life
Adaptive clothing, daily living aids and home adaptations can all help people live well with incontinence – it just takes a little bit of planning, and knowing what solutions are available!
It could be an idea for women with bladder leakage and difficulty getting to the toilet in time to wear skirts and dresses with pull up stockings instead of trousers.
For men, loose boxer shorts are easier to get off quickly than Y-fronts.
Equipment And Living Aids
Improving access to the toilet is important too. Walking aids improve mobility – it could be an idea to have a walking frame at the end of the bed so it can easily be used at night for example.
In the bathroom, grab rails placed strategically and expertly fitted can provide support and help your elderly parent on and off the toilet. There’s lots of other toilet frame and living aid ideas in our ‘assisted toileting’ article.
Going Out And About
Some people don’t stray far from home in case of a bladder or bowel accident. It’s important physically and mentally to keep up with activities and stay active as we age, so try and encourage your parent to leave home.
A solution could be to take a different set of clothing and pads, along with a bag (even scented with lavender) to put dirty clothes in.
In addition to seeing a doctor, here are some helpful ideas when caring for someone with incontinence.
Talk To Your Parents
Show your parents that you’re there for them. Speak about their feelings (being conscious that this may be a difficult conversation for them). It’s possible to live well with incontinence, and talking about their experience will help you all plan and work out how to deal with it.
Both you and your parents may feel embarrassed by the situation, having to care for them in this personal way. It could be that a carer could help when it’s too hard for you to.
Pads, pull ups, bed sheets – there’s a real range of incontinence products available now to improve quality of life so try them out and see which your parent likes. We’ve written a big article on products to manage incontinence here.
Remind your parent that incontinence is nothing to be ashamed of. Taking control of the situation (by seeing a doctor or following any of these strategies) will help them cope.
Watch your reactions too. If you’re the main caregiver, it can be hard to deal with incontinence on a daily basis. Admit your discomfort and remember that they don’t have control over the situation. Look for help from like-minded individuals in forums, or get private care support.
Some people with bladder leakage may be tempted to stop drinking as much. This can lead to dehydration, so check that they’re still drinking at least 1.5 litres daily. Reducing diuretics (in coffee and tea) can also help as this makes people need to pee.
Keep A Diary
Encourage your parent to take note of when they need the bathroom, and get into a routine (for example making a herbal tea at 11am and then going to the bathroom). This could help to avoid leakage.
Pelvic Floor Exercises
Your parent’s doctor or physiotherapist can recommend pelvic floor exercises to strengthen their bladder muscles.
Dementia And Incontinence
Almost a million people in the UK are living with dementia, the majority of whom are over 75 years old.
When we think of dementia we often just think about how it affects someone’s memory, but helping them maintain their physical habits including going to the toilet, are just as important to consider.
Dementia Bathroom Issues
Functional incontinence is common with dementia. Your parent’s memory may mean that they’re unable to remember what the toilet is used for, or they may get lost and not find or ask for the bathroom.
Dementia mobility loss means they may not get there in time, or they have trouble removing clothing. Their medication may also be a factor, relaxing the bladder muscles.
Help a loved one with dementia to maintain their dignity with these incontinence tips:
- They may not remember the word for toilet, replacing it with something else or a non-verbal cue. Look to see if there’s a pattern of them using this cue, it could be their way of telling you they need to go to the bathroom.
- Keep a diary of when accidents happen. If they happen every few hours, plan for it and make a schedule to take them to the toilet. Asking them if they need the toilet may also help.
- Help them relax and give them plenty of time. Check the toilet before leaving to make sure they have emptied their bladder or bowels.
- If your elderly parent gets lost on the way to the toilet, consider getting a dementia-friendly toilet seat which is bright in colour or a sign for the bathroom door.
Incontinence Odor Eliminator
If you’re concerned about the smell from elderly incontinence, try these hacks:
- Try and encourage your parent to wash daily. If this is easier said then done, then try a flannel or wipe.
- Wash the laundry as soon as possible so that the stale smell of urine can’t linger. Look for anti-bacterial washing products or even bleach on sheets to really eliminate odours (but make sure it won’t affect their skin).
- Ventilate! Open windows and doors and bring fresh air in.
- This is a cost-effective tip for cleaning furniture. Mix white vinegar and water in a spray bottle – great for spraying chairs and mattresses.
- Put some essential oils onto cotton wool and place around the home.
- If the laundry can’t be washed straightaway (for example if your parent is out), use lavender to scent the bag. This will take the edge off the urine.
If they’re living with senior incontinence then your parent may be eligible to Attendance Allowance. It’s not means tested and is for people aged over 65 who need help with personal care, such as changing your incontinence pad. It’s always worth applying for as could help to pay for hourly or live in care at home.
I hope this article has shown you that living with elderly incontinence is manageable. It’s important that your parent accepts they are incontinent and helps you look for solutions. It may be a case of trial and error to see what they like – good luck!
Elderly incontinence isn’t something to be embarrassed about – lots of people live with it. Talk to your parents, go to the doctor, keep an incontinence diary, invest in adaptive clothes and living aids – this can all help.
– Try and encourage your parent to wash daily. If this is easier said then done, then try a flannel or wipe.
– Wash the laundry as soon as possible so that the stale smell of urine can’t linger. Look for anti-bacterial washing products or even bleach on sheets to really eliminate odours (but make sure it won’t affect their skin).
– Ventilate! Open windows and doors and bring fresh air in.
– This is a cost-effective tip for cleaning furniture. Mix white vinegar and water in a spray bottle – great for spraying chairs and mattresses.
– Put some essential oils onto cotton wool and place around the home.
– If the laundry can’t be washed straightaway (for example if your parent is out), use lavender to scent the bag. This will take the edge off the urine.