Coping With Urinary Incontinence

Millions of adults in the United States have urinary incontinence. It is most common in people over 50 years of age, especially women.

Urinary incontinence is the loss of bladder control. It can range from leaking a small amount of urine to having very strong urges to urinate that are difficult to control. Incontinence may be a chronic or temporary problem. Although prevalence and incidence of urinary incontinence increases with advancing age in both men and woman, it should NOT be considered part of the normal aging process. As a person ages, the body's changes can reduce how much urine the bladder can hold. The stream can become weaker and can cause one to feel the urge to urinate more often. Some people suffer from overactive bladder, which is characterized by urinary urgency and frequency. This may or may not be combined with incontinence.

Types of Incontinence

• Stress Incontinence: This involves leakage associated with physical activity that increases abdominal pressure – sneezing, coughing, laughing, and lifting.

• Urge Incontinence: This is the sudden sensation of the need to urinate, most common in older adults, often associated with underlying neurological disorders—like Parkinson's, multiple sclerosis or stroke.

• Overflow: A blockage has occurred that is preventing the bladder from emptying completely.

• Functional incontinence: This type occurs when you have normal urine control but cannot urinate normally because of a disease or condition. For instance, you may not be able to get to the bathroom in time because of arthritis or another disease that makes it hard to move around. An individual with dementia may have trouble recognizing the need to go to the bathroom.

Causes of Urinary Incontinence

An older adult experiencing urinary incontinence needs to talk to their doctor and have an exam. The doctor will also need to know about the patient's medical history to determine the cause of the urinary incontinence.

Women may experience drying and thinning of the skin in the vagina or urethra, especially after menopause. They also may have weakened and stretched pelvic muscles after childbirth. Men may have an enlarged prostate gland or have had prostate surgery that is causing the condition. Being overweight increases pressure on the bladder and may lead to incontinence. Other factors that may cause urinary incontinence are certain medications, constipation, urinary tract infections, vascular diseases, and diseases such as diabetes, Alzheimer's, and multiple sclerosis.

Effects of Urinary Incontinence

Urinary incontinence can have a negative impact on the older adult's quality of life. The older adult may become depressed and retreat socially, as he or she worries about having an accident in a public setting. Many adults with incontinence refrain from sexual activity. Physically, the person may experience painful rashes. The condition can also be a stressful situation for the caregiver.

Non-Surgical Treatments for Urinary Incontinence

• Timed voiding: Some people who have urinary incontinence can learn to lengthen the time between urges to go to the bathroom. They start by urinating at set intervals, such as every 30 minutes to 2 hours (whether they feel the need to go or not). Then gradually lengthen the time between urinating (for example, by 30 minutes) until they're urinating every 3 to 4 hours.
• Kegel exercises: These consist of contracting and relaxing the muscles that form part of the pelvic floor. A person who makes these muscles stronger can hold the urine in the bladder longer. This is often thought of an exercise for women to do after childbirth, but men can benefit from it as well.
• Lifestyle changes: An older adult can alleviate the symptoms of urinary incontinence through weight loss and use of a proper diet—one that avoids foods that irritate the bladder, like caffeine, alcohol, and spicy foods.
• Absorbent pads and protective garments: These products can help manage the situation and make it easier for the older adult to have social interaction and confidence. They can also assist with odor control.

Medical Treatments

The doctor may also treat urinary incontinence with medicine or medical devises, such as a catheter, depending on the type of type of urinary incontinence. Finally, if other treatments haven't worked or the incontinence is severe, the doctor may recommend surgery.

Conversations about Urinary Incontinence

Incontinence can be an embarrassing subject, but it doesn't have to be. Older adults and their caregivers need to talk to their doctor about it. It can be treated. Many older adults with urinary incontinence often do not seek evaluation or treatment because they are embarrassed or think that nothing can be done to help. Many are also afraid that surgery is the only option. Caregivers should suggest the older adult speak to the doctor about it – to find the cause and learn about their options.

References: University of Kansas Medical Center Mayo Clinic National Institute on Aging