Incontinence In The Elderly: A Guide to Providing Support
Incontinence, the inability to control urination or bowel movements, is a common yet often overlooked issue among the elderly. Although it can be distressing and sometimes embarrassing, it is important to recognise that incontinence is not a normal part of ageing and can often be managed or treated effectively. In fact, many older adults live with incontinence due to a variety of factors, ranging from age-related physical changes to medical conditions such as diabetes, stroke or dementia.
Despite its prevalence, incontinence in the elderly often carries a stigma, leading some people to suffer in silence. This can result in emotional distress, social isolation and a decreased quality of life. Understanding the causes, types and available treatments for incontinence can help reduce the stigma, encourage open conversation and empower individuals and caregivers to seek appropriate support and solutions.
Types of incontinence
Incontinence in the elderly can take several forms, each with its own set of causes and treatment options. Understanding the different types is important in identifying the most effective way to manage the condition.
Urinary incontinence
Urinary incontinence is the most common type of incontinence among older adults. It can be further broken down into several subtypes:
- Stress incontinence: This occurs when physical activities such as coughing, sneezing, laughing or lifting cause leakage of urine. It is often due to weakened pelvic floor muscles or damaged sphincter muscles.
- Urge incontinence: This type of urinary incontinence in the elderly involves a sudden, intense urge to urinate, often followed by an inability to reach the bathroom in time. It is commonly caused by bladder muscle spasms or overactivity.
- Overflow incontinence: This happens when the bladder doesn’t empty fully, leading to frequent dribbling or leakage. It is typically a result of blocked urinary flow or weakened bladder muscles.
- Functional incontinence: In this case, the individual has the physical ability to control urination but experiences difficulty reaching the bathroom due to mobility or cognitive issues. It is often seen in individuals with dementia or physical disabilities.
Faecal incontinence
Faecal incontinence refers to the inability to control bowel movements. It can range from occasional leakage to complete loss of bowel control. Causes can include weakened muscles, nerve damage or conditions like constipation, neurological disorders or inflammatory bowel disease.
Mixed incontinence
Mixed incontinence involves a combination of both urinary and faecal incontinence, and it can be challenging to manage. The causes are typically multifactorial, with both physical and medical conditions contributing to the issue.
What causes incontinence in the elderly?
Incontinence in the elderly can be caused by several factors, including age-related changes, medical conditions, medications and lifestyle influences.
- Age-related changes:
- Weakened muscles and nerves responsible for bladder and bowel control
- Reduced bladder capacity and increased urgency
- Medical conditions:
- Diabetes: Nerve damage affecting bladder control
- Stroke: Impaired brain function affecting bladder and bowel control
- Dementia: Cognitive decline making bathroom management difficult
- Parkinson’s disease: Disrupted bladder control due to muscle stiffness
- Arthritis: Mobility issues limiting bathroom access, leading to functional incontinence
- Medications:
- Diuretics: Increased urine production
- Sedatives: Reduced ability to sense urgency or reach the bathroom in time
- Mobility and environmental factors:
- Physical disabilities or poorly designed spaces that make bathroom access difficult
- Psychological factors:
- Stress, anxiety and depression worsen incontinence symptoms
How common is incontinence in the elderly?
Incontinence in older people is common, with many older adults experiencing some form of bladder or bowel control problems. As individuals age, physical changes, medical conditions, medications and mobility issues can all contribute to incontinence. It can affect both men and women, though it is more common in women due to factors like childbirth and hormonal changes.
How to treat incontinence in the elderly
There are various solutions for incontinence in the elderly available to help manage incontinence. The approach depends on the type and cause of the incontinence, as well as the individual’s specific needs and preferences.
- Lifestyle changes
- Diet: Avoiding bladder irritants like caffeine, alcohol and spicy foods can help reduce symptoms. A high-fibre diet can also prevent constipation, which may contribute to incontinence.
- Fluid management: Monitoring fluid intake and adjusting it according to individual needs can help reduce frequent urges or leaks.
- Medications and medical devices
- Medications: For conditions like overactive bladder, anticholinergic drugs may help control urgency. For those with stress incontinence, medications that help strengthen the bladder muscles may be prescribed.
- Medical devices: Devices like pessaries for women or penile clamps for men can help manage incontinence by applying pressure to prevent leaks.
- Behavioural therapies
- Bladder training: Encouraging individuals to gradually increase the time between bathroom visits helps train the bladder to hold urine for longer periods.
- Pelvic floor exercises: Kegel exercises strengthen the muscles responsible for bladder control and can significantly improve symptoms of stress incontinence.
- Incontinence products
- Pads and adult nappies: Specially designed for incontinence, these products can help manage leakage while maintaining comfort and dignity.
In cases where other treatments are ineffective, surgical options such as bladder lifts or the implantation of artificial sphincters may be considered. These interventions aim to provide more permanent solutions for managing incontinence.
Supporting someone with incontinence
Supporting an elderly person with incontinence involves practical care, emotional support and preserving their dignity. Caregivers can play a crucial role in helping manage incontinence effectively and compassionately.
- Practical assistance with incontinence care
- Help with accessing the bathroom and using incontinence products
- Ensure regular hygiene routines to prevent skin irritation and infections
- Adapt the home environment by installing grab bars, improving lighting and removing hazards to make the bathroom more accessible
- Emotional support and reassurance
- Offer emotional support to reduce embarrassment and help manage the psychological impact of incontinence
- Encourage open conversations, reassuring them that incontinence is common and manageable
- Promoting independence in managing incontinence
- Empower the individual to maintain their dignity by involving them in their care and decision-making
- Provide guidance on managing incontinence while fostering independence
Help for incontinence in the elderly
At Trinity Homecare, we understand that incontinence can be a challenging condition for elderly individuals and their families. Our compassionate and experienced care teams are here to provide the support needed to manage incontinence with dignity and comfort. Whether it’s through personal care, assistance with daily tasks or offering emotional support, we are committed to ensuring your loved one receives the best care possible.
Arrange homecare
Trinity Homecare is a fully managed care agency with an ‘Outstanding’ CQC rating, placing Trinity amongst the top 4% of all nationwide care companies in England. With this in mind, you can rest assured that your loved one will receive the highest standard of care and specialist support.
If you have any questions about arranging live-in or visiting care, simply get in touch with our helpful and knowledgeable care team.
Arranging home care with Trinity is straightforward. Simply follow these five steps:
- Call our care team
- Undergo a free, no-obligation consultation to discuss your care needs and arrange a care assessment
- After the assessment, a plan of care is created
- A well suited carer is found and placed
- Care can be adapted at any time
