Incontinence in the active elderly is a sensitive issue and can be an embarrassment for sufferer and carer as neither may find it easy to talk about this very personal problem, resulting in the help needed not being forthcoming.

Many people are unaware that certain forms of incontinence are treatable.


What is urinary incontinence?

Urinary incontinence is the inability to hold urine in the bladder. It is most common among older women, but it can happen to younger women after the birth of one or more children. It can also occur as a result of an accident. Sometimes the loss of urine is only a small amount but there can also be a complete loss of control. For the sufferer, the fear of having an accident can severely change their life style, in that they may feel anxious about going out of the house in case they are unable to find a toilet.

Urinary incontinence may also be the result of a change in a mental or physical condition. These changes can sometimes result in an involuntary loss of urine.


Treatments for urinary incontinence in the elderly

There are several ways that urinary incontinence can be treated or controlled.
If there is a urinary tract infection, the symptoms are ‘the feeling’ of wanting to pass urine every few minutes although usually, only very small amounts of urine are passed. This is accompanied by a burning pain in the urethra and a feeling that one still wants to pass more urine. Other symptoms that can accompany a urinary tract infection are backache, fever and sometimes blood in the urine. A GP would need a urine sample for testing to see if there is an infection present and then, depending on the result, antibiotics would possibly be prescribed.

There are remedies that can be purchased at the local chemist for cystitis but these are only for mild symptoms and after 48 hours, if there is no improvement, a doctor should be consulted.


Stress incontinence

In older women this is very common, although not all older women suffer from this type of incontinence. It can happen when a person laughs, coughs, runs, exercises or does anything strenuous. It is then that a small amount of urine is lost due to the fact that the pelvic muscles have weakened over time.


Treating stress incontinence

If the incontinence is not too severe, performing pelvic floor exercises can help the problem by strengthening the muscles which hold back the urine flow.

For the sufferer to know which muscles these are, perform this exercise while sitting on the toilet every time urine is passed. Try stopping the flow of urine in midstream and holding it back while counting for four or five seconds, then pass more urine, stopping again for a few more seconds and so on until the bladder is empty. Do ths every time there is a visit to the toilet and over time, the muscles will get stronger and the incontinence should improve.


Urge incontinence

Is the sudden need to go to the toilet and pass urine several times a day (more than is usual). Even though the bladder may only contain a small amount of urine this signals the bladder to contract and the need to go to the toilet arises. Common complaints from the sufferer are, having to go to the toilet several times day and night. Occasionally, there will be bed wetting as the bladder overflows.


Treating urge incontinence with behaviour therapy

This can be achieved by the person themselves by going to the toilet before they feel the need to. This could mean every hour, more or less. Then over the days and weeks following they should allow a longer time span between each toilet visit by gradually working up from say 1 hour to 1.5 hours then to 2 hours and so on until the length of time between each visit is lengthened and the person is happy with the result.

The individual person will soon get to know how long they can go between toilet visits. If they find that they begin to leak urine before the allotted time is up, then the time span needs to be shortened back to a time when there was no leakage. If control improves with change, then a longer period of time can be tried again.

The aim of this exercise is to be able to hold more urine in the bladder for a longer period of time without the fear of having an accident. This treatment takes time and needs patience but in the long run is well worth the effort.
If after having performed the above regime for several months with no improvement a visit to a GP would be worthwhile to discuss the possibility of other kinds of treatments.


Overflow incontinence

Overflow incontinece is mostly found in older men. The bladder overfills and never empties completely resulting in constant leakage. This is usually due to a blockage, possibly an enlarged prostate.


Treatment for overflow incontinence

This type of urinary incontinence depends on what is causing the overflow of urine. If it is an enlarged prostate then surgery may be needed.

A urinary catheter can be inserted into the penis by a health care professional to collect the urine, and the wearer or carer can be taught to look after the catheter at home.

Penile sheaths are another option. This looks a bit like a large condom, called a sheath, which is secured by surgical tape to the penis. A tube runs from the sheath to a bag that is fastened onto the leg into which the urine is collected and then emptied several times a day. The draw back with this method is that very often the sheath may come off the penis.


Mobility and urinary incontinence

Other types of incontinence can occur if the person is less mobile than they used to be and find it more difficult to get to the toilet in time. one answer is to be near a toilet or have a commode near to where they are sitting.


Dementia and Alzheimer’s

Incontinence can occur here as often the sufferer cannot say when they need to go the toilet. The carer can help by reminding them and possibly helping them to the toilet


Drugs

Certain drugs can cause urinary incontinence especially diuretics, which cause the kidneys to work harder by collecting excess fluid from around the body and filling the bladder more frequently.


For help on this sensitive issue see the Further information and Support Group page for Urinary incontinence