Urinary incontinence, overactive bladder, or loss of bladder control, affects a wide variety of older adults of many different fitness levels, from the elderly who are confined to bed to seniors who are triathletes. People who are affected by incontinence may experience mild to severe symptoms. Unchecked, urinary incontinence has the potential to affect quality of life due to possible social isolation and has a high potential to cause physical complications. Incontinence can increase cost of care as well as making it more likely for a senior to be placed into a nursing home or other care facility.
Although incontinence is a common condition in older adults, it is not a normal change of aging. A thorough assessment by a healthcare professional can help a senior to determine the type of incontinence he or she is experiencing with a clear plan for how to treat it. Fortunately, some cases of incontinence may be reversible with appropriate assessment and specific actions to correct the situation.
Causes of Temporary Urinary Incontinence in Older Adults
When determining the cause of incontinence, it helps to know the person’s normal urinary habits and how they have changed since the incontinence began. Sometimes an overactive bladder can be traced to one event, such as childbirth or paralysis, while other types of incontinence may appear slowly with a gradual worsening of untreated symptoms, such as with a cystocele, chronic constipation, or enlarged prostate. Alcohol and obesity can also be contributing factors for incontinence. A knowledge of this history may greatly help a healthcare professional to discover which type of incontinence a senior is experiencing and which type of treatment(s) will be most effective.
Discovering the reason for incontinence is one of the most important steps in effectively resolving the problem. Simply dealing with the incontinence without considering the cause can result in more problems. For example, if a person’s car will not start, someone might begin by considering issues that are easy to fix, such as putting gasoline in the tank or charging the battery before looking at possible mechanical problems. If the car’s owner decided to immediately replace the engine, she could be left with a large bill and a car that still will not start if it simply ran out of gas.
Incontinence may be reversible and related to another condition. For example, a urinary tract infection (UTI) might cause a variety of symptoms in an older adult, including incontinence and even confusion. If the UTI is effectively treated, the incontinent episodes may completely disappear or improve drastically. Some medications may cause incontinence, and a physician can help determine if another medication might not cause undesirable side effects such as incontinence.
Simple Ways to Deal With Functional Urinary Incontinence
Some people experience functional urinary incontinence that is due to environmental factors. This might happen when an older person needs assistance getting to the toilet and no one responds to his calls for help. Perhaps he does not understand how to work the call signal, or maybe the call signal is out of his reach. The call bell may be ignored by caregivers or the person providing care does not recognize or hear that he needs assistance. Not having supplies such as a bedpan, bedside commode, or mechanical lift readily available can also result in wetting accidents. Ensuring that the senior can effectively use the call system and that caregivers will respond appropriately and in a timely manner with readily available supplies may be all that is needed to solve this problem.
Another example of environmental issues causing the loss of bladder control may be ineffective communication. Perhaps an older adult cannot effectively verbalize her need to use the toilet due to speech problems related to a stroke or mouth sores due to chemotherapy. Language barriers can also make it more difficult to determine a person’s needs. A communication board may prove to be beneficial in these instances.
Cultural issues may also affect a person’s ability to seek assistance with toileting. The person might fear “bothering” a caregiver and decide to wait until a later time. Someone might feel embarrassed to ask for assistance with toileting and feel as if he should be able to provide care for himself. Some cultures may have certain expectations related to caregivers providing personal hygienic care. Speaking candidly about these issues may help to determine a better caregiver/client relationship.
Many elders are embarrassed if they become incontinent. An older adult might feel uncomfortable seeking assistance with personal hygiene and may fear a lack of dignity or an invasion of privacy. People who experienced sexual abuse may be fearful of using the restroom or asking for help, particularly if they are experiencing symptoms of post-traumatic stress disorder (PTSD). Ensuring consistent, quality care that respects the person’s dignity can help in this situation.
Sometimes the way in which a caregiver offers help might make a difference. “Would you like for me to assist you to the bathroom?” might produce better results than asking “Are you doing OK?” and then moving down the hall when the elder nods yes. Many older adults, even some with dementia, may be helped by a bladder training program in which the person is offered voiding assistance on a regular schedule.
How to Overcome Urinary Incontinence
An older adult who becomes incontinent may assume that this condition is an inevitable change of aging that would require invasive surgery as the only treatment. He or she might immediately look for incontinence supplies to help conceal the problem. This may not be the most appropriate long-term approach and can potentially lead to complications.
Although loss of bladder control becomes more common with older age, it may be due to an infection, certain medications, environmental factors, communication breakdown, or other reversible issues. A healthcare professional can assess the situation and may be able to greatly help an older adult to achieve bladder control or at least take more control over his or her quality of life.
This article is for informational purposes only and should not be considered medical advice.
Sources:
- Dugan, Diana Successful Nursing Assistant Care 2nd Edition, 2008, Hartman Publishing
- National Institute on Aging article “Urinary Incontinence” last updated August 13, 2009
- “ Urinary Incontinence in the Elderly ” PowerPoint presentation by Bree Johnston, MD
- Western Journal of Medicine December 1981 article “Urinary Incontinence in the Elderly” by Joseph G, Ouslander, MD
Katrena Wells - Katrena Wells is a RN in NC with 17 1/2 years of experience in oncology, an educator since 1995, and has taught exercise classes since ...
