What is Incontinence?

Incontinence is the inability to control either urine or fecal elimination. What this means in simple terms its that the affected individual may excrete urine or bowel movements when they do not want to.

There are 5 types of incontinence. Let's look at each of them.

Stress Incontinence: this often occurs when an affected individual coughs, laughs or takes exercise. The pressure put on the bladder by the stomach muscles by these activities can cause an involuntary loss of small amounts of urine. Stress incontinence can be caused by excessive stretching of the vagina during childbirth, loss of pelvic muscle control and enlarged prostate.

Urge Incontinence: this is often caused by Alzheimer's, Parkinsons, enlarged prostate, spinal cord injuries or urinary tract infections. The affects are an inability to control the urge to urinate for defecate. In practice this means that the affected individual never reaches the toilet in time.

Reflex Incontinence: This is due to spinal cord injuries, brain tumors or strokes. Reflex incontinence means that urine and bowel movements seep from the body at any time.

Overflow Incontinence: Basically, this is leaking urine when the bladder is full. It is often caused by diseases cause blockages of the urinary tract..

Bowel incontinence: is the inability to contain or "hold" a bowel movement. It can be caused by constipation that goes on for an extended period of time or diarrhea.

Incontinence in the elderly

People of all ages can suffer from incontinence, but the majority of those who suffer from this embarrassing condition are over the age of sixty. It is also much more commonly found in women than it is in men. This is because childbirth affects the muscles that control urination and defecation.

Elderly people are especially prone to incontinence because of weakened pelvic muscles, urinary tract infections, an enlarged prostate gland in men, diabetes, high calcium levels in the body, a thinning of the vagina wall or simply an inability to move fast enough to get to the toilet in time.

Why is incontinence so distressing?

Visiting the toilet is an essential action that most of us take for granted. But for an old person, incontinence can make them feel that are losing control. Obviously, this can have serious effects on an elderly person's dignity and self esteem, especially when they are still mentally active. Many people find it totally embarrassing to have to accept help from other people, especially if the carer is a relative.

How can it affect people with dementia?

If the person you are caring for suffers from dementia, incontinence can bring additional care problems. Some sufferers seem to accept it, whereas others find it highly distressing and humiliating. As a result, they make take actions to conceal their difficulties including such as the evidence. For example, they may take take off clothes soaked in urine and try to hide them or they may put faeces in the bin. Confusion may result in the elderly person going to the toilet in the wrong place such as a wardrobe or waste paper bin.

What can you do to help as a carer?

There are three golden rules to remember when you are dealing with an elderly person with incontinence:

-Try not to feel embarrassed or disgusted about the condition.

-Don't get angry or upset.

- Be dignified and remember that the person concerned will be embarrassed and upset themselves.

Of course, these rules are easier said than done. Caring for an elderly person is a huge stress on the carer and incontinence can only add the stress. If you feel you are having difficult with dealing with incontinent, is would be worth talking to a medical professional for some advice.

Some practical tips for dealing with incontinence

For most people, going to the toilet is a routine part of their day - something you hardly notice. But for an elderly person, they may want to use the toilet but be unable to use it, or even to find it. Here are some tips:

* Make sure the person in your care knows where the toilet is - a sign on the door can help.
* Make sure that access to the toilet is clear and there is no furniture, clutter or junk which will prevent easy access to the toilet for an elderly person.
* Leave the toilet door open when it is not in use. If it is always closed, an elderly person may think that someone is in there.
* Make sure the toilet is easy to use. Handrails can be installed - seek the advice of an occupational therapist, who can offer advice on how to make a toilet easy to use.
* Make sure the elderly person's clothes can be quickly removed and unfastened. Velcro is often easier for old people to manage rather than zips or buttons.
* If getting to a toilet becomes impossible, a commode may be the answer. Ask your occupational therapist or community nurse for advice.

Incontinence aids

There may come a stage where the elderly person in your care cannot use the toilet at all. In this case, you need to take action to deal with the consequences. There are ways to help them feel more comfortable at the same time as protecting items such as clothes and bedding. There are various products available to deal with incontinence including:

Waterproof bedding Mattresses are difficult to clean that the best of times, but you can protect the mattress with a waterproof cover. You can also buy protective duvet covers and pillowcases. You should make sure that the elderly person's skin does not come in contact with the mattress protector as this can cause sores.
Absorbent undersheets Special undersheets are available for beds and chair beds which enable an elderly person to lie or sit on a dry surface.
Incontinence pads and pants These pad are a bit like nappies and can be worn day and night, or during the night only. They will keep the elderly person's skin dry, but they are also highly absorbent. You need to watch for chaffing and change the pads regularly.

Incontinence and personal hygiene

If the elderly person in your care has had an accident, it is important to deal with it as soon as possible as it can be very uncomfortable and lead to unpleasant smells. Also, dampness next to the skin can cause sores. (See our article an washing an elderly person) Here is some advice on what to do:

* If an elderly person has had an accident, cleanse the area using mild soap and warm water. Make sure you dry the area properly before putting on fresh pads and clothes.
* Moist hand wipes can be used for minor accidents.
* Wash any soiled clothes or bedding immediately. It's often a good idea to give them a good soaking.
* Dispose of used pads hygienically.

Incontinence is an unfortunate and embarrassing problem for many elderly people. It serves as a very real reminder that the body not working properly and you need to deal with it in an efficient and dignified way so as not to cause extra distress.