Learning to treat & manage incontinence with aging adults
with guest author, Mollie Hammer, PT, DPT
Urinary Incontinence (UI) is the loss of bladder control due to the inability to control when and how urination happens. Not only can this be an overwhelming issue for aging adults and caregivers, it can also be an embarrassing issue that seniors find difficult to talk about. Studies suggest up to 60% of aging adults may experience incontinence episodes. These episodes vary from a small annoyance to a major disruption in a seniors life that may keep them from being less active for fear of leaking. The increase in urgency and frequency to urinate causes seniors to rush to the bathroom at all hours of the day which interrupts their preferred activities. Moreover, this is an important fiscal concern as many seniors and their families report spending as much as $200-300 per month on disposable incontinence products.
Incontinence can have more severe health outcomes including increasing fall risk, depressive symptoms leading to decreased quality of life, and decreased skin health. When older adults have a strong sense to urinate and are worried they won’t make it to the bathroom in time they may hurry to the restroom and are more likely to fall. Older adults may experience depressive symptoms and decreased perceived health that comes with losing independence and control when they do and do not urinate. Lastly, when older adults continue to have leaking this can affect skin integrity leading to skin breakdown.
There are a myriad of reasons from musculoskeletal to neurological conditions that may contribute to urinary incontinence. For this reason, it’s best to start with your primary care provider to determine if there is an underlying medical cause for incontinence. They will screen you for common issues such as urinary tract infection and benign prostatic hyperplasia. Once you’ve met with your doctor to rule out medical causes, there are a few things that you can do at home.
- Start Journaling
- Record when and where you feel the urge to urinate.
- Write down any habits or triggers that may contribute to the urgency.
- Include what you’re eating and drinking – caffeine, soda, and seltzer water are bladder irritants.
- When You Feel the Urge to Urinate:
- Stop in place (calms the nervous system).
- Abdominal breathing (abdominals connected to pelvic floor).
- 3 quick squeezes of the pelvic floor muscles.
- Calmly walk to the bathroom.
- Toileting
- Urinating should be a passive process.
- Abdominal breathing helps to relax the pelvic floor muscles so you can void. everything in your bladder all at once.
- DO NOT push or bear down to urinate.
- Reduce Fall Risk
- Declutter the path to the bathroom, remove any trip hazards including area rugs and throw rugs.
- Consider adding night lights to make mid-night bathroom trips safer.
Incontinence is more prevalent in those with dementia or Alzheimer’s Disease. A decline in cognition can result in higher instances of incontinence due to stress, decreased interoception (the ability to understand and feel what is going on inside of your body), or difficulty locating the restroom. If you’re managing incontinence as a family member or caregiver, here are some additional tips:
Journal
Use the guidelines above, including tracking frequency, food, and drink.
Include what time accidents happen, and how often.
Create a Toileting Schedule & Stick To It!
Use the journal to determine how frequently your loved one is needing to use the restroom.
Use reminders to encourage your loved one to use the restroom prior to the urge.
Written reminders, phone alarms or voice assistants are great tools.
Deep Breathing Exercises
Practice deep abdominal or belly breathing with your loved one to help relax the pelvic muscles during urination.
Check out the Environment
Is the bathroom easy to find? Is the path to the bathroom cluttered? Is the toilet accessible? Is it easy for your loved one to get on and off the toilet?
Toileting at Night
Is your loved one able to safely walk to the bathroom at night? Would they benefit from additional lighting or a bedside urinal or commode?
Consider Your Words
Urinary incontinence is embarrassing and stressful. Remind your loved ones that accidents happen.
If you or a loved one is struggling with urinary incontinence, seek the advice of a professional. Incontinence is a multifaceted issue often requiring creative solutions. A professional can help you to identify specific strategies to help manage incontinence in your situation.
Prior to purchasing any equipment, it is always best to consult a professional to provide specialized recommendations to your situation. A professional may suggest multiple pieces of equipment to help manage you or a loved one’s incontinence. Common recommendations may include:
About Mollie Hammer, PT, DPT
Mollie is a physical therapist in the Des Moines metropolitan area. She received her Doctor of Physical Therapy from Washington University School of Medicine in St. Louis and has training for urinary incontinence from the Academy of Pelvic Health Physical Therapy. Her interests include pelvic, maternal, and social determinants of health throughout the lifespan with a strong emphasis on public health and improving access to care. In her free time she enjoys walking her rescue Boston Terrier, reading with a cup of coffee, and running. Check out her blog here.