Managing the incontinence that can come with ageing
Bladder and bowel weakness are often associated with ageing but they are not inevitable and there are ways to manage the problem.
The issue can affect both men and women but is more common among women. It is also something of a hidden problem as embarrassment can make it difficult to discuss.
The causes of incontinence can vary, but in men an enlarged prostate gland can trigger bladder and continence issues later in life while women can suffer from urinary incontinence due to a weakened pelvic floor muscle, often as a result of pregnancy and birth.
There are different types of bladder incontinence. Stress incontinence occurs when the muscles that hold the urine in the bladder are too weak to stop accidental leakage of urine, perhaps as a result of a cough, sneeze or laugh. Urge incontinence is when the lining of the bladder is irritated, constantly sending signals to the brain to empty.
Another common cause of bladder incontinence is a urinary tract infection, where bacteria get into the urethra. The condition is often accompanied by a burning sensation when passing urine.
Bowel incontinence can be the result of prolonged bouts of constipation, as a side effect of medication or as a result of another medical condition or illness.
There are a number of ways to mitigate or eliminate incontinence simply by making changes to the diet and habits.
They include pelvic floor exercises, bladder retraining (making visits to the toilet at set times), drinking more water to flush out an irritated bladder, taking antibiotics for urinary tract infections, and cutting down on some foods or drink such as alcohol and heavily spiced food.
Probably the most common form of incontinence in people with dementia is an overactive bladder, with feelings of a sudden and intense need to go, and frequent urination. There is a greater likelihood of “accidents” for a number of reasons including:
- not being able to react quickly enough to the sensation of needing to use the toilet
- failing to get to the toilet in time – for example, because of mobility problems
- not being able to tell someone that they need to go to the toilet because of problems communicating
- not being able to find, recognise, or use the toilet. If someone becomes confused about their surroundings, they may urinate in an inappropriate place (such as a wastepaper basket) because they have mistaken it for a toilet
- not understanding a prompt from someone to use the toilet
not being able to, or forgetting how to, perform the activities of using the toilet, such as undoing clothing and personal hygiene