Is your elderly parent reluctant to talk to his/her doctor about their bladder control problem? It is a common issue among people who are taking care of elderly parents.
To overcome the reluctance, help your elderly parent educate themselves on the condition, know that it’s common as people grow older — and assure them that doctors have seen it all before!
Information about incontinence in the elderly
Loss of bladder control is called urinary incontinence. It can happen to anyone, but is very common in older people. At least 1 in 10 people age 65 or older has this problem. Symptoms can range from mild leaking to uncontrollable wetting. Women are more likely than men to have incontinence.
Aging does not cause incontinence. It can occur for many reasons. For example, urinary tract infections, vaginal infection or irritation, constipation, and certain medicines can cause bladder control problems that last a short time. Sometimes incontinence lasts longer. This might be due to problems such as:
•Weak bladder muscles
•Overactive bladder muscles
•Blockage from an enlarged prostate
•Damage to nerves that control the bladder from diseases such as multiple sclerosis or Parkinson’s disease
•Diseases such as arthritis that can make walking painful and slow
Many people with bladder control problems hide the problem from everyone, even from their doctor. There is no need to do that. In most cases urinary incontinence can be treated and controlled, if not cured. If you are having bladder control problems, don’t suffer in silence. Talk to your doctor.
Bladder Control
The body stores urine in the bladder. During urination, muscles in the bladder contract or tighten. This forces urine out of the bladder and into a tube called the urethra that carries urine out of the body. At the same time, muscles surrounding the urethra relax and let the urine pass through. Spinal nerves control how these muscles move. Incontinence occurs if the bladder muscles contract or the muscles surrounding the urethra relax without warning.
Diagnosis
The first step in treating a bladder control problem is to see a doctor. He or she will give your aging parent a physical exam and take their medical history. The doctor will ask about your elder’s symptoms and the medicines he/she uses. The doctor will want to know if your elderly parent has been sick recently or had surgery. Your doctor also may do a number of tests. These might include urine and blood tests and tests that measure how well your mom or dad empties the bladder. In addition, your doctor may ask you to keep a daily diary of when your parent urinates and when they leak urine. Their pattern of urinating and urine leakage may suggest which type of incontinence your elderly parent has.
Types of Incontinence
There are several different types of urinary incontinence:
Stress incontinence happens when urine leaks during exercise, coughing, sneezing, laughing, lifting heavy objects, or other body movements that put pressure on the bladder. It is the most common type of bladder control problem in younger and middle-age women. In some cases it is related to childbirth. It may also begin around the time of menopause.
Urge incontinence happens when people can’t hold their urine long enough to get to the toilet in time. Healthy people can have urge incontinence, but it is often found in people who have diabetes, stroke, Alzheimer’s disease, Parkinson’s disease, or multiple sclerosis. It is also sometimes an early sign of bladder cancer.
Overflow incontinence happens when small amounts of urine leak from a bladder that is always full. A man can have trouble emptying his bladder if an enlarged prostate is blocking the urethra. Diabetes and spinal cord injury can also cause this type of incontinence.
Functional incontinence happens in many older people who have normal bladder control. They just have a hard time getting to the toilet in time because of arthritis or other disorders that make moving quickly difficult.
There are several methods that doctors suggest aging seniors and their caregivers try to control incontinence.
Bladder Control Training
Your doctor may suggest that your aging parent try to get back control of their bladder through training. With bladder training your mom or dad can change how the bladder stores and empties urine. There are several ways to do this.
Pelvic muscle exercises (also known as Kegel exercises) work the muscles that you use to stop urinating. Making these muscles stronger helps your elderly parent hold urine in their bladder longer. These exercises are easy to do. They can lessen or get rid of stress and urge incontinence.
Kegel exercises. The muscles your parents needs to exercise are the pelvic floor muscles. These are the ones used to stop the flow of urine or to keep from passing gas. Often doctors suggest that your aging parent squeeze and hold these muscles for a certain count, and then relax them. Then repeat this a number of times. Your parent will probably do this several times a day. Your doctor will give you exact directions.
Biofeedback helps your elderly become more aware of signals from their body. This may help him/her regain control over the muscles in the bladder and urethra. Biofeedback can be used to help teach pelvic muscle exercises.
Timed voiding and bladder training also can help your aging parent control their bladder. In timed voiding, the caregiver keeps a chart of urination and leaking to determine the pattern. Once you see a pattern, help your parent to the bathroom at those times to empty the bladder before they might leak. When combined with biofeedback and pelvic muscle exercises, these methods may help your parent control urge and overflow incontinence.
Managing incontinence
Besides bladder control training, there are several other ways to help manage incontinence:
Sometimes doctors suggest a small, throwaway patch; a small, tampon-like urethral plug; or a vaginal insert called a pessary for women with stress incontinence.
A doctor can prescribe medicines to treat incontinence. Some drugs prevent unwanted bladder contractions. Some relax muscles, helping the bladder to empty more fully during urination. Others tighten muscles in the bladder and urethra to cut down leakage. These drugs can sometimes cause side effects such as dry mouth, eye problems, or urine buildup. Vaginal estrogen may be helpful in women after menopause. Talk with your doctor about the benefits and side effects of using any of these medicines for a long time.
A doctor can inject an implant into the area around the urethra. The implant adds bulk. This helps close the urethra to reduce stress incontinence. Injections may have to be repeated after a time because your body slowly gets rid of these substances.
Sometimes surgery can improve or cure incontinence if it is caused by a problem such as a change in the position of the bladder or blockage due to an enlarged prostate. Common surgery for stress incontinence involves pulling the bladder up and securing it. When stress incontinence is serious, the surgeon may use a wide sling. This holds up the bladder and narrows the urethra to prevent leakage.
Under a doctor’s care, incontinence can be treated and often cured. Today there are more treatments for urinary incontinence than ever before. The choice of treatment depends on the type of bladder control problem your parent has, how serious it is, and what best fits their lifestyle. As a general rule, the simplest and safest treatments should be tried first.