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Issues Affecting Urinary Continence in Older Adults

We've all seen the ads on television about bladder problems and the challenges they present, especially to much older adults. Leaking bladders (or urinary incontinence) is an embarrassing problem for anyone of any age. But in older adults with thining and sensitive skin, it can cause skin breakdown where the urine stays in contact with the skin and subsequent challenges keeping the area clean and free of sores.

It also causes extra housework (needing to wash the bed linens and clothes more frequently), and even causes social isolation for people who don’t want to chance leaving the house in case of an “accident.”

But while urinary incontinence affects approximately 25 million Americans, the condition rarely gets the attention and discussion it deserves. Due to this lack of open communication about the disorder, many older adults feel like they just have to live with the problem rather than bringing it to the attention of their doctor or family caregiver.

One of the more important things to understand is that incontinence is not inevitable as people age. Many seniors do find that their bladders may become “weak” as they age, causing occasional leakage. But sometimes the problem may be as simple as having a condition called a UTI.

One of the most common causes of urinary incontinence that is usually easily treated is a UTI or urinary tract infection. Also called cystitis or bladder infection, UTIs cause an intense need to void, or pass urine. In younger people, this sensation is obvious, but it isn’t always as noticeable among the elderly. If you are finding that your loved one has suddenly begun to experience incontinence and this was never a problem before, look for other signs that indicate there may be an infection, such as:

  • New onset of confusion or agitation

  • Hallucinations

  • Other behavioral changes

  • Poor motor skills

  • Falls

You may also notice:

  • Strong smelling urine

  • Cloudy urine, or blood in the urine

  • Fever (not always)

  • Complaints of pain when urinating

  • Complaints of pressure or pain in the abdomen

  • Night sweats

If you suspect an infection, your loved one should be seen as soon as possible by their medical provider who will have the urine tested. Once the infection is confirmed and treated, the incontinence should resolve or at least be largely minimized.

Other factors adding to the problem of incontinence:

1.) Poor mobility

If frailty and mobility is a problem, incontinence can often happen as a result of the fact that the older individual is unable to get to the bathroom quickly enough. The need to urinate may come on very suddenly and the loved one simply can't move fast enough to make it to a bathroom before leakage occurs.

This may also be an issue at night. Older individuals often take a bit longer to get out of bed to go to the bathroom because of muscle loss and weakness in the legs. Further, waking in the middle of the night can also cause some confusion in those elders with dementias. If mobility is an issue, an in-home assessment by a trained nurse or caregiver may help provide solutions.

2.) Medicines

Certain medicines, such as diuretics (so-called “water pills”), increase the amount of urine produced, causing more need to urinate. If a loved one is on a medication that does this, it is important to keep this in mind if he or she must leave the house or is not near a readily accessible bathroom. To reduce the chances of night time incontinence from medications, ask the pharmacist if they may be taken earlier in the day, so the diuretic effect isn’t as strong when your loved one is trying to sleep.

The staff and caregivers at AAging Better In-Home Care frequently deal with the problem of incontinence among its clients. We understand this type of issue can negatively affect the quality of life of a loved one and their families. Every member of our staff is trained to recognize many of the signs and symptoms of incontinence and to provide a variety of home care services that assist clients in managing the challenges of such a diagnosis. Feel free to contact us today to discuss options or to schedule an in-home meeting, where we can assess what level of care and services will help make your loved one’s life easier within his or her own home.

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