How To Care: Incontinence
How to Care: Incontinence
Things to Look For
Bladder and bowel control is dependent on having a properly functioning bladder, urethra, bowel and
digestive system; a sound neurological system; efficient urine and stool production and elimination; and
the desire and capability to go to the toilet alone or with personal assistance. A change in one or more
of these factors could result in incontinence. Incontinence may also be caused or aggravated by medications,
illness or environmental factors, such as the location of the bathroom.
- Sudden changes in bladder or bowel habits
Sudden changes: increased frequency, increased urgency and pain
may indicate transient or short-term incontinence. The incontinence
may be a result of infection, especially urinary tract infections;
injury, such as a hip fracture; surgery, particularly prostate
surgery; chronic illness, such as diabetes and heart disease.
Or it may be a bad reaction to medication.
- Persistent changes in bladder or bowel habits
Straining to urinate, urinating in trickles and spurts, producing
a weak stream of urine, not emptying the bladder completely and
dribbling are symptoms of incontinence that may be caused by an
obstruction in the bladder, medications, constipation and neurological
disorders. "Accidents" or urine loss when a person laughs, coughs,
sneezes or engages in physical activity may be related to pelvic
or sphincter muscle weakness.
- Urine Retention
Urine retention occurs when a large amount of urine stays in the
bladder after a person has urinated. This build-up of urine can
put a person at increased risk for urinary tract infections. Urine
retention occurs in over half of all elderly people who have just
had surgery for a fractured hip or stroke. It can also be a side
effect of illness or medication.
- Excessive production of urine
Diuretics: foods and medications that cause the body to
shed water may increase a person's frequency and urgency to urinate
and lead to incontinence.
Caffeine: found in coffee, tea, cola, cocoa, beer, chocolate and soft
drinks is a known diuretic.
Several medications have a diuretic effect. Illnesses,
such as diabetes and heart disease may cause people to urinate
excessively or build up large amounts of urine in the bladder.
- Bladder or urinary tract infection/cystitis
Irritation from a bladder or urinary tract infection can cause
or aggravate incontinence.
Constipation is a major cause of urinary incontinence in elderly
people. A bowel filled with stool can block the flow of urine
or cause urine to stay in the bladder. People with constipation
may also exhibit bowel incontinence.
Dark, strong-smelling urine can be a sign of dehydration. If a
person is not getting enough liquids (about six cups) daily, the
urine may become so concentrated that it irritates the bladder
and lays the groundwork for bladder or urinary tract infections.
Signs of dehydration include having a dry mouth, cracked lips,
or sunken eyes.
- Restricted mobility/physical disability/access
Restricted mobility and immobility may make it difficult or impossible
for people to control their bladder or bowels or get to the bathroom
in time. Mobility restrictions caused by illnesses, such as arthritis
or Parkinson's Disease can prevent people from undoing their own
clothing. Poor eyesight, speech, hearing and other communication
problems may affect a person's ability to seek help from a caregiver.
The location or ease of access to the bathroom may hinder a person
from using the toilet effectively.
- Cognitive impairment
Confusion may occur as a side-effect of medication. Neurological
disorders such as Parkinson's Disease, stroke, and spinal cord
injury may affect the brain so that it does not give a person
enough warning time to get to the toilet before the bladder or
bowel is emptied. Brain tumours may affect people's ability to empty
their bladder or bowels without help. People in the early stages
of Alzheimer Disease and other dementia may forget where the bathroom
is or how to use it. In the middle and later stages of dementia,
people lose the interest and ability to look after themselves
and forget how to urinate or move their bowels.