How to Stop Urinary Incontinence in an Old Age Person?

According to the National Institute on Aging, more than one in five seniors in Canada experiences some form of bladder control issues. Learning how to stop urinary incontinence in an old age person can significantly improve quality of life and is often a manageable condition rather than an inevitable part of aging.

Quick Summary

This guide provides an overview of effective strategies for managing and stopping urinary incontinence in older adults, detailing behavioral changes, pelvic floor exercises, medical treatments, and environmental modifications to restore bladder control.

Key Points

• Start with behavioral changes: Implement bladder training, timed voiding, and strategic fluid and dietary management as a first-line approach to manage symptoms.

• Strengthen your pelvic floor: Regular Kegel exercises and other core-strengthening activities are crucial for supporting the bladder and reducing leaks.

• Explore medical options: If lifestyle changes are insufficient, a healthcare provider can recommend medications, such as anticholinergics or newer alternatives, to help control an overactive bladder.

• Consider procedural interventions: For more severe cases or specific types of incontinence, procedures like bulking agent injections, nerve stimulation, or sling surgery may be necessary.

• Address environmental factors: For those with mobility or cognitive issues, making the home environment safer and more accessible is essential to prevent functional incontinence.

• Don't rely solely on products: Absorbent products are a valuable tool for management but should be used in conjunction with other treatments, not as the only solution.

• Consult a healthcare professional: A proper diagnosis from a doctor or specialist is vital to determine the specific type of incontinence and create the most effective, personalized treatment plan.

Understanding the Types and Causes

Urinary incontinence (UI) is not a single condition but a symptom with various underlying causes. In older adults, it is often a result of age-related changes in the urinary tract, compounded by other health issues.

• Stress Incontinence: Leakage occurs from physical pressure on the bladder, such as coughing, sneezing, or lifting. This is often due to weakened pelvic floor muscles, which can happen after childbirth in women or prostate surgery in men.
• Urge Incontinence: This is a sudden, intense urge to urinate, often followed by involuntary leakage. It's caused by an overactive bladder muscle that contracts at the wrong times. Common in older adults, it can be exacerbated by bladder irritants like caffeine and alcohol.
• Overflow Incontinence: This happens when the bladder doesn't empty completely, causing frequent or constant dribbling. Obstructions, like an enlarged prostate in men, or weak bladder muscles can cause this.
• Functional Incontinence: Leakage occurs when a person has a fully functional bladder but cannot make it to the toilet in time due to physical or cognitive limitations. Conditions like arthritis, dementia, or mobility issues are contributing factors.

Behavioral and Lifestyle Modifications

For many older adults, the first and most effective line of treatment involves simple, non-invasive changes to daily habits. These methods focus on training the bladder and reducing irritants.

Practical tips for lifestyle changes

• Bladder Training: This involves scheduling regular bathroom breaks, also known as timed voiding, and gradually increasing the time between them. It helps to retrain the bladder to hold urine for longer periods.
• Fluid Management: While it may seem counterintuitive, adequate hydration is crucial. Limiting fluids can make urine more concentrated and irritate the bladder. The key is strategic fluid intake—avoiding excessive amounts, especially before bedtime or long outings.
• Dietary Adjustments: Certain foods and drinks are known bladder irritants. Limiting or eliminating these from the diet can reduce urgency and frequency. Common culprits include caffeine, alcohol, artificial sweeteners, and spicy or acidic foods.
• Weight Management: Excess weight puts added pressure on the bladder and pelvic floor muscles. Losing weight can significantly reduce symptoms, especially for stress incontinence.
• Constipation Prevention: Straining during bowel movements can weaken the pelvic floor. A diet rich in fiber and sufficient fluid intake can help prevent constipation.

Exercises for Pelvic Floor Strengthening

Kegel exercises are a cornerstone of incontinence treatment, helping to strengthen the muscles that control the bladder.

How to perform Kegel exercises

1. Identify the muscles: Squeeze the muscles you would use to stop the flow of urine. You should feel a tightening and lifting sensation.
2. Perform repetitions: Contract these muscles and hold for 3 to 5 seconds. Relax for the same amount of time. Repeat 10 times.
3. Do multiple sessions: Aim for three sets of 10 repetitions each day. You can perform these while sitting, standing, or lying down.
4. Incorporate other exercises: Incorporating exercises like pelvic tilts, squats, and bridge poses can further strengthen the pelvic region and core, providing additional support.

Medical and Surgical Treatments

If conservative approaches aren't enough, several medical interventions are available after a consultation with a healthcare provider.

Comparison of Common Treatments

Treatment Method	Type of Incontinence	How It Works	Best For...
Medications	Urge, Overflow	Anticholinergics relax the bladder muscle; Mirabegron increases bladder capacity; Alpha-blockers help empty the bladder in men.	Patients whose symptoms are not controlled by behavioral therapies alone.
Bulking Agents	Stress	Injected material thickens the area around the urethra to help it close.	Women with stress incontinence; can be temporary and may need repeat injections.
Nerve Stimulation	Urge	Electrical pulses are sent to the nerves controlling the bladder to retrain its reflexes.	Patients with overactive bladder unresponsive to other treatments.
Sling Procedures	Stress	A sling made from body tissue or synthetic material supports the urethra.	Women with significant stress incontinence.
Artificial Sphincter	Severe Stress	An inflatable device is placed around the bladder neck to control urine flow.	Men, often after prostate surgery, with severe stress incontinence.

Environmental and Support Strategies

Making the environment safer and using supportive products can make a significant difference for older individuals with incontinence, particularly functional incontinence.

• Make the Bathroom Accessible: Ensure clear pathways to the bathroom. Install grab bars, raised toilet seats, and adequate lighting to prevent falls and speed up access.
• Use Incontinence Products: Absorbent pads, briefs, and protective bed pads offer a sense of security and manage leaks, especially during treatment or for those with cognitive impairment.
• Simplify Clothing: Choose clothing with easy-to-manage fasteners, like elastic waistbands, to reduce the time it takes to undress.

Conclusion

While urinary incontinence can be a distressing issue, it is not an inevitable consequence of aging. With a multi-faceted approach, combining behavioral modifications, targeted exercises, and—when necessary—medical treatments, older adults can effectively manage and often resolve their symptoms. Open communication with a healthcare provider is the first and most critical step towards a tailored treatment plan that can restore control, dignity, and a better quality of life. The journey toward continence is a manageable one, with many proven strategies to explore.

Frequently Asked Questions

What is the primary cause of urinary incontinence in older adults?

There are several causes, but common factors include weakened pelvic floor muscles, an overactive bladder, and issues like an enlarged prostate in men or pelvic organ prolapse in women.

Are Kegel exercises effective for both men and women?

Yes, Kegel exercises are effective for both men and women by strengthening the pelvic floor muscles. For men, this is especially helpful after prostate surgery.

Should I stop drinking water if I have incontinence?

No, you should not stop drinking water. Limiting water can make urine more concentrated, which irritates the bladder and can worsen symptoms. Proper hydration is important, but fluid intake should be managed strategically.

What dietary changes can help manage incontinence?

Avoiding or limiting bladder irritants such as caffeine, alcohol, artificial sweeteners, and spicy or acidic foods can help manage symptoms. Eating a high-fiber diet to prevent constipation is also recommended.

When should I see a doctor about incontinence?

You should see a doctor if incontinence is bothering you, affecting your quality of life, or if you've tried behavioral changes without success. A doctor can help diagnose the specific type of incontinence and recommend a tailored treatment plan.

Can medications cure urinary incontinence?

Medications can effectively manage and reduce symptoms, especially for urge incontinence by relaxing bladder muscles. However, they may not be a permanent cure and often have side effects, particularly for older adults.

Is surgery a common treatment option for seniors?

Surgery is typically reserved for severe cases where conservative methods have failed, and the patient is in suitable health. It can be very effective for specific issues like stress incontinence or an enlarged prostate.