Dealing with Urinary Incontinence
Urinary incontinence is the uncontrollable loss of urine. It can occur at any age, with the causes tending to be different for each age group. The likelihood of urinary incontinence increases with age. About one out of every three seniors over 60 has some type of bladder control problem.
When June Lockhart of Lassie fame starred in an adult briefs commercial, urinary incontinence officially came out of the closet. Even though it's refreshing to see this condition out in the open, it has also portrayed incontinence as normal for old age. It gives the impression that you simply treat this yourself by grabbing for the adult briefs at the grocery store or have them discreetly sent to you through the mail. It also makes people think that there's really nothing that can be done about it. They are wrong on both counts.
Incontinence, though it affects at least 13 million Americans, is not normal. It's definitely a sisterhood thing: 85 percent of people affected by incontinence are women. Before Mom resigns herself to adult briefs, she needs to be seen by her family doctor or urologist to determine the cause of the disorder. Medications, an acute illness, a urinary tract infection, or endocrine problems can all cause incontinence. It could also be the symptom of an underlying disease, and that's why she needs a physician to do the detective work to find out what's really going on. There also might be a weakening of the muscles supporting the urinary tract.
There are three major types of incontinence:
- Stress incontinence. The muscles of the pelvic floor, which have been dutifully supporting the bladder for all these years, become weakened—mostly due to the wear and tear of childbirth and menopause's hormonal changes. The bladder slips down without the muscle support and now the abdominal muscles can squeeze the bladder. So whenever Mom coughs, lifts something, strains, or sneezes, those abs put enough stress on the bladder to leak out urine.
- Overflow incontinence. Urine in the bladder builds up to a point where the muscle that controls the flow (urinary sphincter) can't hold it. Urine leaks out throughout the day. Men who have enlarged prostrates are especially vulnerable because the prostrate blocks the normal flow of urine causing it to hold up in the bladder until it overflows. Usually, there's no bladder sensation involved.
- Urge incontinence. Your parent will feel an urgent need to urinate and just not be able to hold it. There's hardly any time between feeling the need to void and actually urinating. This may be caused by an infection or medications. In this case, it can be reversed. But if Mom has had a stroke or suffers from dementia or another neurologic disorder, it can mean that the brain is no longer able to send the “hold off” signals to the bladder.
Chances are Mom won't be inclined to tell you about her incontinence. It's still a taboo topic for many people. Even physicians! Studies have found that many docs don't ask their older patients during exams about possible incontinence. And far too many doctors haven't had any training on how to treat it. So you really have to push on this one. Just letting your parents know how lots of their friends are probably going through the same thing, that it can be reversible, and that it could be a sign of something they don't want to ignore can help them get past the embarrassment factor.
Incontinence can be very isolating. Your mom or dad might stop going on trips, the movies, and outings with you or their friends because one of them lives in constant fear of having an accident. If you see a real drop in your parents' social activity, incontinence could be the reason. Gently explore it as a possibility.
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Excerpted from The Complete Idiot's Guide to Caring for Aging Parents Â© 2001 by Linda Colvin Rhodes, Ed.D. All rights reserved including the right of reproduction in whole or in part in any form. Used by arrangement with Alpha Books, a member of Penguin Group (USA) Inc.
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