Incontinence is the unintentional passing of bowel or urine. This can happen to anyone, but incontinence is part of the aging process and is, therefore, more prevalent among older adults, especially in female adults.
Fortunately, there are ways to mitigate incontinence, along with products available on the market that can help improve the quality of life for those who suffer from it.
Keep reading below as we'll cover everything there is to know about incontinence and answer some of the most frequently asked questions for older adults and their loved ones.
What Is Incontinence?
Incontinence can either be urinary or fecal. Both are pelvic floor disorders that result in an involuntary loss of control over your reflexes, leading to poor bladder control and possibly a urinary tract infection or the formation of pressure ulcers.
According to a report from the experts of the National Association for Continence, over 25 million Americans suffer from some form of this condition, be it stress incontinence or urge incontinence. Though it is common among older adults to experience bladder problems, it does not usually lead to major health conditions.
The four types of urinary incontinence are:
- Stress Incontinence - This happens when urine leaks when the bladder is under pressure (such as when you cough or laugh)
- Urge Incontinence - This happens when urine leaks immediately or after you feel the urge to pee
- Overflow Incontinence - This happens when you experience frequent urine leaks because you are unable to fully empty your bladder
- Total Incontinence - This happens when your overactive bladder is no longer capable of holding any urine at all, which causes frequent bathroom trips and leaking incidents
Fecal (or bowel) incontinence, on the other hand, can be classified into two main types:
- Urge Incontinence - This happens when people feel the need to go to the bathroom so suddenly that they don't get there on time
- Passive Incontinence - This happens when people are not aware that they need to pass stool
Both fecal and urinary incontinence are very common among older adults. Aside from the hassle these leakages bring, patients also suffer from embarrassment and loss of confidence as key side effects.
How Can You Mitigate Incontinence in Older Adults?
Incontinence in older adults is more than a physical problem. It can greatly disrupt one's quality of life if not managed well. Aside the urinary tract issues it can bring, patients may also experience anger, fear, and anxiety as side effects of the condition.
Managing Bladder or Urinary Incontinence
Depending on what's causing it, bladder incontinence can be either short or long-term. Patients with long-term incontinence typically find it difficult to perform their typical day-to-day activities.
Regardless of the types of urinary incontinence you suffer from, some treatment options and methods that may help alleviate their situation are:
1. Bladder control training is learning how to schedule certain times of the day to empty your bladder. This method can help manage how frequent you need to urinate throughout the day, and you may also want to keep a bladder diary to manage your fluid intake.
2. Pelvic floor muscle strengthening is done with the help of a physical therapist who specializes in exercises for the pelvic floor muscles. These exercises tighten and relax muscles that control urine flow to control bladder control and muscle strength.
3. Medicines work best with urge incontinence. These drugs work on the muscles to help relieve the pressure in your urinary tract, manage your bladder capacity, and potentially deal with urine loss.
4. Surgery may be a treatment option to help correct long-term incontinence, as long as your medical history allows it.
5. Incontinence products, such as adult undergarments, pads, and absorbent muscles may help alleviate some of the discomfort and keep the users more comfortable.
Managing Fecal Incontinence
Fecal incontinence is characterized by accidental gas or stool leakage. This condition is usually due to weak pelvic muscles because of surgery or other trauma that results in nerve damage and/or muscle injury.
Some treatment options to manage fecal incontinence are:
1. A bowel care plan is a training method done daily to regulate bowel movements by training the body to move bowels at the same time every day. Patients under this training usually see an improvement within a few weeks or months. As mentioned previously, a bladder diary may also help with this form of treatment.
2. Pelvic floor muscle strengthening may be suggested by a physical therapist who specializes in exercises for the pelvic floor muscles. These exercises work on tightening and relaxing the pelvic area, rectum and anus; which results in a bowel and gas control and improved muscle strength.
3. Diet changes may help keep track or identify what might be causing the symptoms and how to choose better food and drink options. A nutritionist or dietitian may be involved if needed, and you might be asked to take a few blood tests in order to update your medical history.
4. Medications may be prescribed as part of your treatment. Over-the-counter medicines such as loperamide, laxatives, stool softeners, and fiber supplements may help improve fecal incontinence. Stronger medications may also be prescribed as needed.
5. Surgery (sphincteroplasty) is another option to treat fecal incontinence. This procedure reconnects tears in the anal sphincter, which can then help with bladder control training. These tears are usually caused by vaginal childbirth or other injuries that may have damaged the genital or urinary area of both men and women.
Best Products to Prevent Incontinence Among Older People
Whether you have been dealing with incontinence for a while or just starting to experience it, one of the most important things that may help with your health issues is knowing which products to buy.
It may take a few trial and error purchases before you finally find the products that work best with your body and your lifestyle.
Indeed, some patients take more time testing and trying than others—this is perfectly fine, as your main goal is to reduce the pressure in your bladder by any means necessary.
Having the right products may not entirely solve all of your incontinence problems, but they will surely help bring back some of your lost peace of mind and confidence while also helping with urinary retention.
Here are the top 10 best incontinence products we chose, all with varying price points and features.
This brand comes highly recommended because it is four times more absorbent than other adult diapers in the market. It is considerably better than other reusable options and offers a whopping 4000ml leak-proof and reliable urinary retention.
The standard bladder capacity is at 400 ml-600 ml, which means the Abena Abri-Form Premium Briefs can hold up to six times more than your bladder can hold.
Aside from that, soft and breathable materials make up the non-woven side panels, making these diapers one of the most comfortable incontinence briefs available.
Other people prefer pull-on pants over the usual diapers because of the additional protection bring.
We recommend the Waterproof Vinyl Pull-on Pant because it is roomy, soft, comfortable, and offers both leak and odor protection. It is designed for use on top of either disposable and reusable diapers, and will remain soft even after several washes.
For older adults who need dryness and protection for an extended period of time, these extended wear briefs from Medline are one of your best options.
Its anti-leak guards hold liquid very well and keeps you dry for a longer period of time. These briefs even have a wetness indicator that lets you know when your briefs are soiled.
The manufacturers of this underwear have included a changing schedule to make it easier for patients and caregivers to use. What's more, they're are made to keep you confident and comfortable anywhere between 8 to 12 hours.
These diapers rely on NASA-inspired IconTek technology to give multiple layers of protection, similar to what astronauts use on lang flights. And because fewer changes are needed, this means you get to save on cost as well.
Bed Pads and Bedsheets
Not everyone wants to keep on washing sheets due to urinary inconteinence, which is where this product comes in. The Peelaway Disposable Bedsheets absorbs any of your body liquids while protecting your mattress at the same time.
It features a breathable design to keep you cool in bed and also peels away quickly revealing the fresh sheet underneath. It is an excellent product that will give you a good night sleep while making sure your bladder stays in check.
These waterproof pads are made to absorb up to 8 ounces of liquid. They are available in five different sizes which makes them highly adaptable to older women and men alike. On top of that, these pads are latex-free, machine-washable, and have non-slip backing to give you comfort at all times of the day.
This product is very high-absorbent and durable, making it one of the must-have incontinence products in the market.
Anyone experiencing incontinence problems knows what having a good-quality and high-absorbent pad is a must.
These bed pads from UltraSorbs are great because they quickly draw moisture away from your skin, and its AquaShield oil provides an additional layer of protection so that frequent change in beddings and linens are no longer needed. These pads also help prevent rashes and skin breakdown because of its air-permeability feature.
Wipes and Washcloths
Aloe vera is known for its gentle soothing effects and is widely used to treat burns, rashes, and clean snesitive skin. That's why these hypoallergenic Aloetouch wipes is a great addition to your incontinence product must-haves.
They are alcohol-free, easy to pack, and lightweight. You can use these wipes at home or bring with you when you go out so you have something to use in case of an emergency.
Disposable cleansing wipes make it easy for you to clean up when you're on the go. These wipes from Tranquility are pre-moistened to ensure better cleansing and skin protection.
They are also very comfortable to use as they are made of very soft and hypoallergenic materials. Lastly, these wipes are alcohol-free and infused with aloe that brings a gentle yet soothing relief.
These washcloths from ProCare are durable, soft, disposable, alcohol-free, and latex-free. They come in packs of 50 that are specially made with spun-lace fabric to ensure that they are gentle when used in the most sensitive areas of your body.
Each washcloth is 12 inches by 8 inches, making it the perfect size to clean large areas of your skin effectively, comfortably, and efficiently.
Frequently Asked Questions About Incontinence
1. What is incontinence?
Simply put, incontinence is the loss of a person’s ability to control bladder and bowel movement. It results in accidental discharge of urine, feces, or gas.
The severity of urinary incontinence can range from minimal leakages and slight pressure to total inability to control bladder and bowel movements.
2. What are the types of incontinence?
Incontinence can be classified into two types: fecal/bowel and urinary incontinence.
As discussed in the first part of this article, urinary incontinence in older patients is the involuntary discharge of urine from the bladder, and fecal incontinence is the involuntary discharge of feces or gas from the bowel.
Urinary incontinence can be classified as
- Stress incontinence
- Urge incontinence
- Overflow incontinence
- Total incontinence.
On the other hand, fecal incontinence can be further classified into:
- Urge incontinence
- Passive incontinence
3. Can Incontinence in the Elderly Be Cured? Will It Go Away?
As discussed above, there are several methods to manage and treat incontinence. As far as treatment goes, we have bladder training, pelvic floor muscle strengthening, medicines, and surgery.
Most patients try exercises and medications first before they decide to go under the knife. The incontinence products mentioned above can complement these treatments and work well in alleviating the discomfort that urinary incontinence in older adults can bring.
4. What Lifestyle Changes Can Help Decrease Urine Leakage?
The first step in knowing which lifestyle changes can help you is knowing which food, drinks, and activities make your symptoms worse. For some people, alcohol, coffee, and citrus worsen their incontinence problems. Once you identify your bladder irritants, make sure to avoid them at all costs.
For people who are obese or overweight, losing the excess weight can help relieve the pressure in your bladder. This is because extra weight puts more pressure on the bladder, so losing it will help reduce episodes of stress incontinence.
Another tip is to schedule your fluid intake. Just keep in mind that it takes around two to three hours for fluids you drink to reach your bladder, so it’s best to schedule your intake to hours when you’ll have a restroom nearby.
Use collectors and pads that catch urine. Refer to our list above to see some of the best absorbent pads, adult diapers, bed pads, and undergarment covers that can help you control and manage leakage.
Lastly, know your medicines. There are some medications that urge you to pass urine more until they wear off. It’s best to ask your doctor about this so you can plan ahead and know when is the best time to take the medicines.
5. What Incontinence Products Do I Need?
Our top 10 list of best incontinence products in this article can give you a good starting reference. These products will help you manage and control leaks so you feel more confident and comfortable doing your usual day-to-day activities.
Depending on the severity of incontinence, some people may only need liners, while others feel more secure wearing adult diapers or pull-on pants. Bed pads are also great to protect your mattress when you sleep at night.
6. Who Is at Risk for Incontinence?
Incontinence is prevalent among older adults. But contrary to popular belief, it does not necessarily mean that it is a normal part of aging. Younger and middle aged people can experience incontinence as well depending on their medical history and lifestyle.
It's also worth noting that incontinence is more common for women than men. Some factors that cause this condition among women are pregnancy, childbirth, and menopause. Reproductive events like those mentioned affect the urethra, bladder, and organs that support these muscles.
Women across all ages can experience incontinence, but it is most common among older women. This can be attributed to the hormonal changes that happen during menopause. As of 2014, more than four out of 10 women 65 years old and above were experiencing urinary incontinence.
For men, incontinence can be cause by almost anything relating to the prostate gland, Parkinson's disease, and diabetes.
7. How Do You Treat Elderly Incontinence?
Treatments for incontinence among older adults can vary from medications, surgeries, behavioral therapy, and bladder or bowel therapy.
The treatment methods for you will usually depend on the prescription of a urogynecologist, urologist, physical therapist, nutritionist, and/or dietitian.
At-home incontinence management methods are also available but will of course need the assistance of family members or caregivers and nurse practitioners.
8. Is Incontinence Normal in the Elderly?
It is a common misconception to consider incontinence as a normal part of aging. It can happen to anyone at any age.
Incontinence becomes increasingly complex among the elderly because functional impairment, cognitive impairment, and comorbidities—but it is not something that all older adults must go through and deal with.
No matter the patients' age, effective treatments are available to manage and cure incontinence problems.
9. How Can I Help Someone With Incontinence?
It can be tough for caregivers of patients with incontinence. As such, you should know that help is available and there are several resources which can make life easier for you and for the person you are caring for.
First, try to understand their condition as much as you can. Read about it, talk to the doctor, do your research. Remember that this medical condition is very sensitive and most patients feel embarrassed to even ask for help.
Understanding what they are going through will help you offer sympathy, care, and compassion even during the most difficult days.
Second, understand the emotional challenges they are going through. Incontinence can cause embarrassment, loss of confidence, anxiety, stress, and even depression to those who are going through it.
Avoid making jokes and simply let them know that you are there to help and support them whenever they need you.
Third, remember to be patient. Going to the toilet five times within thirty minutes can be frustrating, especially if you are on the road or trying to spend time and relax. Just imagine how even more frustrating it is for them to feel uncomfortable and worried all the time.
It will greatly help if you reassure them that you are happy to wait for a few minutes while they take a quick trip to the bathroom—this is a small gesture that will do wonders for managing urinary incontinence in older patients with grace.
Fourth, be prepared. People with incontinence usually bring tons of supplies with them just in case an emergency occurs. They would appreciate it if you offer to be in charge of the supplies or bring spare products for them.
Lastly, be willing to change plans. It is almost impossible to perfectly schedule bathroom breaks; after all, the urge can hit at any time. If you have long trips, choose a route that has more options for toilet stops. Also choose a destination that has a good number of public bathrooms.
When the plan gets cancelled or the itinerary gets totally shuffled, your loved one will most likely feel guilty and sorry. Again, try to be sensitive and offer assurance that you understand their situation.
In caring for patients with incontinence, it is usually the small things that matter most. Your constant reassurance will mean so much to them more than you’ll ever know and is part and parcel of the health care process.
National Association for Continence
The National Association for Continence (NAFC) is a national, private, non-profit organization that aims to improve the quality of life of people with incontinence, pelvic floor disorders, and voiding dysfunction. Their main purpose is to be the leading source of public information and advocacy on everything about the mentioned medical conditions.
National Institute on Aging
The National Institute on Aging (NIA) conducts broad scientific efforts and research to better understand the nature of aging and help extend the active, healthy years of a person’s life. Experts publish articles and guides on elderly incontinence in this site.
International Continence Society
The International Continence Society (ICS) is a registered charity that aims to improve the quality of life of people with urinary, pelvic floor, and bowel disorders through education, research, and advocacy. The ICS is composed of urologists, urogynecologists, basic scientists, nurses, and researchers.
Association for Continence Advice
The Association for Continence Advice (ACA) is a registered charity that aims to improve the quality of life of people with urinary, bowel, and pelvic floor disorders through education, research, and advocacy. The ICS is composed of urologists, urogynecologists, basic scientists, nurses, and researchers.
Nathan Justice manages community outreach programs and forums that help many senior citizens. He completed a counseling program at the University of Maryland’s Department of Psychology.