Providing care to elders with urinary incontinence can be one of the greatest challenges that caregivers can face. You might feel frustrated, overwhelmed, or uncomfortable helping your parent go to the bathroom. Your parent might feel helpless, embarrassed, and might even try to hide the fact that they are having accidents.
The good news is, there are many remedies that can help make it easier for your parent to stay dry – and they don’t all involve extra pills! The strategies to use depend on what type of incontinence your parent has.
- Stress incontinence is when someone has leaks that occur when they sneeze, cough, laugh, or otherwise squeeze their belly muscles. People with stress incontinence often only leak small amounts of urine.
- People with stress incontinence can help control leaks by doing exercises to strengthen the muscles that keep their bladder closed. These exercises are called “Kegels.” To practice, tell your parent the next time they pee, to squeeze the muscles to try and stop the flow of urine. This helps them know which muscles to squeeze. Then, practice squeezing these muscles several times throughout the day. If this is too hard, tell your parent to imagine that they are trying to stop themselves from passing gas. Do the same thing – practice squeezing these muscles a few times a day.
- In the meantime while these muscles are getting stronger, most people end up wearing a pad in their underwear. If one type of pad doesn’t work, try a different brand – it can take a few tries to find one that feels comfortable and protects clothing.
- Urge incontinence is that “gotta go gotta go” feeling - when the person feels a very sudden and powerful urge to pee that they cannot hold back for very long, and they lose control before they make it to the bathroom.
- People with urge incontinence should try to go to the bathroom “early and often” – before the urge comes. Many people find that having a bathroom schedule helps. Start by bringing your parent to the toilet once every hour while they are awake, whether they think they have to go or not. If that keeps your parent dry, then you know you have found a successful strategy. Then, start spreading the toilet visits out farther – every hour and a half, then every two hours, then every three hours – until you figure out how long they can go without needing to “go”. Some people find that they only need to visit the toilet after meals and before bedtime to stay dry.
Certain foods and drinks can make urge incontinence worse. Avoid these, or at least cut down on them:
- Caffeine such as coffee, tea, and sodas
- Alcohol including beer, wine and liquor
- High-acid foods such as citrus fruits and tomatoes
- Carbonated drinks
Some medications can also make urge incontinence worse. Common culprits include diuretics (water pills) and certain blood pressure medications. If your parent is constipated, that can also make urge incontinence worse. Talk to your parent’s doctor about whether any of their medicines might be worsening the problem.
If none of these strategies help, there may medication to help control bladder urges, and you can ask your parent’s doctor about these. These should be used with caution, as they have many side effects. In people with memory or thinking problems, they can cause worsening confusion. They also frequently cause constipation – and that can make incontinence worse! Many people find that these medicines are not worth the trouble.
- Functional incontinence happens when a person would be able to keep control of their urine, but they can’t make it to the bathroom in time for other reasons. Some examples include bad arthritis that makes it hard to walk, lung problems that make them too out of breath before they get to the bathroom, or memory problems so they don’t remember to go to the bathroom.
- The same strategies that work for urge incontinence will work here. Additionally, you might find that a commode placed closer to the chair or bed where your parent spends their time will make it easier than going back and forth to the bathroom.
- Overflow incontinence happens in patients with nerve or spinal cord damage who can’t feel when their bladder is full, and the urine just pours out of them. People with overflow incontinence usually leak very large amounts of urine without any warning.
- If your parent can control when they pee, but just don’t feel the need to, try using the toilet schedule strategy. If your parent can’t pee on their own, their doctor might suggest using a catheter to help drain the bladder of urine before it drains itself.
- If you think your parent has overflow incontinence and you don’t know that they have nerve or spinal cord damage, call their doctor right away. This could be a sign of a serious problem.
- Nighttime-only incontinence might be a sign of an untreated medical problem or a medication side effect. If your parent has this, it’s time for a visit to the doctor.
Many elders with urinary incontinence have mixed incontinence – with features of more than one type of incontinence. In these cases, a blend of different strategies often works best.
Even with the best strategies, not all elders with urinary incontinence will stay dry. It’s normal to feel upset or frustrated. It’s also normal to feel that you don’t want to be the one changing your parent’s diaper. If this is how you feel, remember that it’s okay to reach out and ask for help.