Coping with incontinence

Facing the loss of or a reduction in bladder control can be difficult for a person. They may experience embarrassment or depression for needing assistance with a deeply personal issue. Known as urinary incontinence, this condition is the accidental leaking of urine from the bladder. It is a common problem among older adults; however, it should not be considered a normal part of aging. Involuntary loss or leakage of urine is the sign of a problem. There can be several reasons for temporary incontinence including urinary tract infections, constipation and taking certain medications. However, according to the National Institute on Aging, long-term incontinence can be caused by:

  • Weak bladder muscles
  • Overactive bladder muscles
  • Weak pelvic floor muscles
  • Damage to nerves that control the bladder from diseases such as multiple sclerosis, diabetes, or Parkinson’s disease
  • Blockage from an enlarged prostate in men
  • Diseases such as arthritis that may make it difficult to get to the bathroom in time
  • Pelvic organ prolapse, which is when pelvic organs (such as the bladder, rectum, or uterus) shift out of their normal place into the vagina. When pelvic organs are out of place, the bladder and urethra are not able to work normally, which may cause urine to leak.

Types of incontinence

  • Stress incontinence occurs when urine leaks as pressure is put on the bladder, for example, during exercise, coughing, sneezing, laughing or lifting heavy objects.
  • Urge incontinence happens when people have a sudden need to urinate and cannot hold their urine long enough to get to the toilet. It may be a problem for people with diabetes, Alzheimer’s disease, Parkinson’s disease, multiple sclerosis or who have suffered a stroke.
  • Mixed incontinence is a combination of stress and urge incontinence.
  • Overflow incontinence happens when small amounts of urine leak from a bladder that is always full. Men with enlarged prostates can experience this problem. Diabetes and spinal cord injuries can also cause this type of incontinence.
  • Functional incontinence occurs in many older people who have normal bladder control. They just have a problem getting to the toilet because of arthritis or other disorders that make it hard to move quickly.
  • Transient incontinence is a temporary type of incontinence caused by reversible problems such as constipation, medications or inflammation.

Managing incontinence

There are several options for managing incontinence including exercise, medication, toileting devices, lifestyle changes, surgery and using personal care supplies such as incontinence pads and briefs. When choosing options for treatment, a person must consider factors such as their overall health, level of activity and lifestyle. It is recommended by the National Institute on Aging that the simplest and safest treatments are tried first. Some simple options include:

  • Pelvic muscle exercises (Kegel exercises). This involves strengthening the muscles that start and stop the flow of urine.
  • Scheduled urination to help control the bladder.
  • Lifestyle changes such avoiding caffeinated drinks and drinking less alcohol, which causes the muscles around the bladder to relax.
  • For functional incontinence, a person can try modifying their environment to make using the bathroom easier, such as installing adaptive equipment like grip bars and raised toilet seats.

If you are experiencing problems with bladder control, consult your healthcare provider to seek treatment options.

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