Incontinence in Older Adults

FACTS

• Incontinence means a person cannot control the bladder and/or bowels.

CAUSES

• Constipation
• Urinary tract infections
• Weak bladder muscles
• Overactive bladder
• Nerve damage from diabetes, Parkinson’s disease, and other diseases
• Enlarged prostate in men
• Injury, or damage to nerves and muscles from prostate surgery
• Balance or gait problems that cause difficulty getting to the bathroom fast enough
• Pelvic organ prolapse, displacing the bladder and urethra
• Loss of ability to sense the need to urinate
• Forgetting to go the physical bathroom
• Inability to find the toilet

STRATEGIES

Urinary incontinence 

• Decrease or eliminate caffeine intake.
• Avoid alcohol.
• Drink a cup of fluid all at one time rather than sipping a beverage over a longer period of time.
• Keep pathways and bathroom well-lit, clear, and clutter-free.
• Mark the bathroom with a big sign that reads “Toilet” or “Bathroom.”
• Provide regular bathroom breaks, every 2-3 hours.
• Supply easy-to-remove underwear and clothing.
• Use disposable underwear, especially away from home.
• Utilize waterproof mattress pads and other protective covers for bed linens.
• Gentle-but-thorough cleaning and drying of the private area is essential for keeping the skin healthy.
• Application of a skin barrier ointment can further protect the private area from moisture and irritation.

Bowel incontinence

• Eat 20-30 grams of fiber per day. This can make stool more bulky and easier to control.
• Avoid caffeine and alcohol to help prevent diarrhea.
• Drink several glasses of water each day to prevent constipation.
• To minimize accidents, schedule bowel movements at the same times each day, especially after meals.
• Gentle-but-thorough cleaning and drying of the private area is essential for keeping the skin healthy.
• Application of a skin barrier ointment can further protect the private area from moisture and irritation.

Disposable underwear

• Many factors are considered when choosing the right incontinence product. Some trial and error is usually required.
• Separate daytime and nighttime products may be needed.
• Features to consider:
  • Absorbency
  • Flexibility that supports activity level
  • Gender-specific or unisex
  • Sizing – Proper sizing is essential to prevent leakage
  • Style – Tab-style, pull-ons, slimmer profile for daytime outings
  • Cost – Inquire about free samples and manufacturers coupons while considering which product works best
  • Products that trap and wick moisture away from the skin and feature a soft breathable lining
• In some states, Medicaid covers the cost of adult disposable briefs. Some private insurance providers may cover the cost. Medicare does not cover the cost.
• If a medical diagnosis supports the use of disposable underwear, the cost may be deducted as a medical expense on an annual tax return.