By Martha Swats, Owner/Administrator, Comfort Keepers
Bladder incontinence is a highly prevalent disease that not only affects a senior's health, but impacts their daily lives emotionally, socially, and economically. With a rapidly growing senior population, more people will experience incontinence − however, it is not an inevitable part of aging.
What happens: The body stores urine in the bladder, a hollow organ much like a balloon. During urination, muscles in the bladder tighten to move urine into a tube called the urethra, while the muscles around the urethra relax and let the urine pass out of the body. When the muscles in and around the bladder don't work properly, urine can leak. Incontinence can occur for short periods of time due to urinary tract infections, constipation, or as a side effect of a medication.
When leaking urine lasts longer, it may be due to:
• Urge Incontinence: The most common diagnosis, this involves an urgent need to urinate resulting in the loss of urine before arriving at the toilet, caused by involuntary contractions of the bladder that can't be stopped. Also called overactive bladder, it can be caused by strokes, dementia, Alzheimer's disease, multiple sclerosis, Parkinson's, or injuries. Conditions such as pelvic floor atrophy in women, prostate enlargement in men, or constipation in either sex can also lead to urge incontinence.
• Stress Incontinence: This occurs when an increase in abdominal pressure overcomes the closing pressure of the bladder. Abdominal pressure rises when you cough, sneeze, laugh, climb stairs, or lift objects. The bladder muscles of seniors may be so weak that leaking can occur just by getting up out of a chair. Stress incontinence is more common in women due to pregnancy and childbirth, and a lack of estrogen in postmenopausal women can also cause muscular atrophy that may lead to the condition. Men with enlarged prostates, have had prostate cancer treatments or surgery can also develop it.
• Overflow Incontinence: Rarely diagnosed, this occurs when one's bladder never completely empties. Sufferers frequently feel the need to go and often leak small amounts of urine. This condition is often caused by an obstruction in the urinary tract system or by a bladder that either has very weak contractions or is unable to contract at all. Causes include an enlarged prostate or damage from prostate surgery, constipation, fecal impaction, and nerve damage from stokes or diabetes.
• Functional Incontinence: This incontinence is caused by disabilities. Arthritis could make unzipping one's pants difficult, or a bad hip could make a trip to the facilities take longer than expected − and accidents might happen. Neurological disorders, stroke complications, Alzheimer's disease, dementia or multiple sclerosis are other causes. Often, the mind cannot plan or carry out a bathroom trip.
• Mixed Incontinence: People can have more than one type of incontinence. Usually there is a combination of stress and urge incontinence, especially in women. People with severe dementia, Parkinson's disease, neurological disorders, or who have had strokes can suffer from urge and functional incontinence.
Urinary incontinence diagnosis: Your loved one may feel embarrassed by accidents and the use of absorbent pads or protective underwear, which, in turn, could trigger a reluctance to visit the doctor. Or there could be some confusion about which specialist to see. But stress to your loved one that the best reason to see a doctor is that senior urinary incontinence is quite treatable. If your loved one feels comfortable with his or her primary care doctor, start there. Women can also find a urogynecologist, while men could visit a urologist; either can see a geriatrician, or a nurse practitioner who specializes in incontinence issues.
What to expect: A urinalysis to rule out infection or blood in the urine; blood tests to check on kidney function, calcium and glucose levels; a thorough discussion of one's medical history; and a complete physical exam, including a rectal exam and a pelvic exam for women, and a urological exam for men. The doctor may prescribe a medicine that calms muscles and nerves to treat an overactive bladder. If leakage is caused by weak muscles, the doctor or nurse can suggest exercises to strengthen the pelvic muscles. The doctor may fit a woman with a device worn in the vagina that helps lift the bladder. If other treatments fail, surgery may be suggested to improve bladder control.
What caregivers can do to help: Avoid giving drinks like caffeinated coffee, tea, and sodas that increase urination, but don't limit water; keep pathways clear and the bathroom clutter-free with a light on at all times; make sure there are regular bathroom breaks; if there is a tendency to leak urine at certain times of the day, trips to the bathroom ahead of time can help; supply underwear that is easy to get on and off; and use absorbent underclothes for trips away from home.
Discussing it with your loved one: Find a time when you and your loved one can be alone together, and discuss the subject with sensitivity and clarity. This is a dignity issue. Help your loved one understand that dignity is very important to both of you.
Comfort Keepers can help. Comfort Keepers' Interactive Caregiving keeps senior clients engaged physically, mentally, and emotionally while living independently at home. Call your local office today to find out more about all the ways we can help your loved one.
- Category: Health and Wellness
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