Managing Incontinence

Incontinence is an extremely personal and delicate subject to approach, especially with your own family members.

Here, we will tell you about incontinence and the issues it creates, its causes, how to manage it and finally, how to broach the subject.

What is incontinence and how does it impact?

You probably already know that incontinence is the inability of someone to control their own bodily functions. Involuntary urination and excretion, however, is extremely common. It affects between 15% and 35% of the British adult population, so really ought to be looked at as just a normal part of growing old.

Having said that, it is also extremely embarrassing for those that suffer from it and can lead to a number of undesirable consequences:

• Social: Incontinence sufferers are often unwilling to take part in prolonged social activities, so, as a result, can socially isolate themselves
• Physical: Rashes and sores can develop if the incontinence is not proactively managed and the areas kept dry. These issues can quickly develop as areas as skin become infected.
• Environmental: Bad smells and damage to furnishings can also be an issue, on most would rather not address.
• Financial: Pads, treatments and other requirements can be very expensive, especially when issues get worse.

What causes incontinence?

The causes of incontinence range from the simple and avoidable, to the complex and manageable.

• Diuretics: Substances that promote urine production, for example, Alcohol, Caffeine, Artificial Sweetener, Spicey foods, and many medications
• Urinary tract infection (UTI): UTIs can cause bladder irritation, creating the urge to urinate
• Ageing: As people age, the muscles controlling their bladder functions deteriorate.
• Menopause: The loss of estrogen can cause the lining of the bladder and urethra to break down
• Enlarged Prostate: Common in men, as they age the prostate can enlarge, resulting in is stress on the urethra
• Neurological disorders: Disease that intefers with the nervous system, such as Parkinson’s, and MS, can also cause loss of control
•  Pregnancy and Child Birth: Hormonal changes and the stress of childbirth can weaken the pelvic floor

How to manage incontinence:

Depending on its physical cause, incontinence can be experienced in different ways. It can be successfully managed with the right products. The most common types are Stress Incontinence and Urge Incontinence, and it can also quite often be a combination of the two:

• Stress Urinary Incontinence (SUI): The bladder unexpectedly leaks due to pressure from physical exertion such as coughing, sneezing, laughing, heavy lifting or exercising. This is most common in women. There are exercises that can be done to try and encourage bladder and urinary tract muscle strength. Known as pelvic floor or even as kegel exercises these are recommended for both men and women and are as simple as drawing up the lower pelvic muscle toward the abdomen and holding for 5-10 seconds before releasing. These are simple exercises that can be done at any time, anywhere. By strengthening these muscles there can be an improvement in bladder control as well as a reduction in prolapses and even improved sexual health outcomes.  
• Urge Urinary Incontinence (UUI). Urge incontinence occurs when the bladder tries to empty despite best efforts to restrain leaking. This can result in quite large losses of urine and increased frequency of urination. This most common in men and is commonly linked to an enlarged prostate or prostate surgery. However, it can be quite common for women as well, particularly if they have suffered nerve damage.
• Functional incontinence: The inability to reach the toilet in time due to lack of mobility or mental illness such as dementia or Alzheimer’s.
• Bowel incontinence: Often referred to as fecal incontinence, is the inability to control bowel movements, causing stool (feces) to leak unexpectedly. This can range from an occasional leakage of stool while passing gas, to a complete loss of bowel control, and can be managed with the advice of a GP.

How to approach the subject:

The first thing you should note before you broach the subject is that they are almost certainly aware of the issue and may fee very uncomfortable about it. They may even be relieved you have brought up the subject, however, they may also respond in quite a threatened and/or aggressive manner. 

It is important not to pressure them to talk, so if you do get a negative reaction, it may be best to leave some information with them, to read in their own time and approach the subject again on a different day.

It is also a good idea to involve the GP, at some point, who will be able to arrange for them to be referred to the incontinence team or district nurse to help. This will help with some of the financial costs as they may arrange for equipment and supplies to be sent out to you.

In summary:

With the right support, these are often temporary conditions that can be rectified in a short time allowing the person to regain their independence and confidence to get on with their lives.

There is plenty of information and advice out there, alongside many products that can be used to protect help manage the issue. Here is just a small selection of links to further information:

• http://www.whentheygetolder.co.uk/helping-your-parents-with-toilet-problems-and-incontinence/
• https://www.nhs.uk/conditions/bowel-incontinence/
• https://www.nhs.uk/conditions/urinary-incontinence/
• https://www.ageukincontinence.co.uk/

Incontinence products are expensive so it’s important you find the right ones that you feel confident and comfortable in and do the correct job. You need then to shop around for the best prices. In some cases, though this can be a difficult process, these can be obtained free through your local social services. These products are not only for personal use, but there is also a wide range of products that can be put on beds and chairs for protection such as waterproof sheets, seat covers and mattress protectors. 

The Just Can’t Wait card is also a good way to go, as it allows you to pop into shop bathrooms with less resistance than you might normally get:

You can find more information on these products here:

• www.ageukincontinence.co.uk
• www.amazon.co.uk
• www.depend.co.uk

You can also get alot of free samples, here are a few sites to try:

• www.depend.co.uk/sample
• www.coloplast.co.uk
• www.tena.co.uk
• www.allaboutincontinence.co.uk/sample-packs
• https://www.bladderandbowel.org/bowel/bowel-problems/faecal-incontinence/