How to Talk about Incontinence with an Aging Parent

Just broaching the subject of incontinence with another person is enough to make most people squirm, but when a family member is facing the issue alone, it can be a crucial conversation for maintaining their well-being.  As the founder and CEO of Because Market, I’ve had conversations with thousands of families who have had to address this sensitive topic. In this guide, we’ll explore how to deal with incontinence in elderly family members and loved ones - and what they need to live at their best. 

Whether it's urinary incontinence or some other type, recognizing the specific type of incontinence a person is experiencing is crucial for tailoring appropriate interventions and enhancing their quality of life. Whether through strengthening exercises, medications, or other targeted approaches, understanding the nature of the condition guides effective care and support. The first step in addressing incontinence with an aging parent is educating yourself about the condition. Learning more about the potential causes of incontinence can help you understand the issue more effectively and in many cases, get you up to speed on what your loved one may already know about their own condition. 

• Stress incontinence: Stress incontinence is characterized by the involuntary leakage of urine during activities that exert pressure on the abdomen, such as coughing, sneezing, laughing, or physical exercise. Stress urinary incontinence commonly arises from weakened pelvic floor muscles or sphincter, leading to a diminished ability to support the bladder and control urine flow during moments of increased intra-abdominal pressure.
• Urge incontinence: Urge incontinence involves the sudden and overwhelming urge to urinate, often accompanied by an inability to reach a restroom in time. This condition is primarily attributed to overactive bladder muscles, leading to involuntary contractions and a heightened sense of urgency to empty the bladder, resulting in episodes of unexpected urinary leakage.
• Overflow incontinence: Overflow incontinence is characterized by the inability to empty the bladder fully, resulting in a persistent dribbling of urine. This condition occurs when the bladder doesn't contract effectively or when there is an obstruction in the urinary tract, leading to an overfilled bladder and continuous leakage of urine, often accompanied by a sensation of incomplete voiding.
• Functional incontinence: Functional incontinence is marked by the challenge of reaching a restroom in a timely manner due to physical or cognitive impairments. Individuals experiencing functional incontinence may have difficulty accessing toilet facilities, not necessarily because of a problem with bladder control, but due to limitations in mobility, cognitive function, or other health conditions that hinder their ability to reach the restroom independently.
• Mixed incontinence: Mixed incontinence is characterized by the coexistence of symptoms from different types of incontinence, often involving a combination of stress and urge incontinence. Individuals with mixed incontinence may experience urinary leakage during activities that increase abdominal pressure, such as coughing or sneezing (stress incontinence), as well as an intense and sudden urge to urinate with little time to reach a restroom (urge incontinence). This combination of symptoms requires a tailored approach for effective management and treatment.

Common causes of incontinence

While incontinence is a fairly normal condition in older adults, it is important to understand the root causes of any specific type of incontinence. From weakened pelvic floor muscles to neurological conditions, there are various factors can contribute to the development of urinary incontinence, impacting individuals across different age groups and lifestyles. Some of the most common causes include:

• Weak Pelvic Floor Muscles: Weakened pelvic floor muscles, often due to factors like pregnancy, childbirth, hormonal changes aging, or obesity, can lead to insufficient support for the bladder and result in stress incontinence.
• Overactive Bladder Muscles: Overactivity of the bladder muscles, often associated with conditions such as bladder irritation, neurological disorders, or urinary tract infections, can cause a sudden and intense urge to urinate, characterizing urge incontinence.
• Prostate Issues: In men, an enlarged prostate (benign prostatic hyperplasia) can obstruct the urethra, leading to difficulties in bladder emptying and overflow incontinence.
• Nerve Damage: Conditions like diabetes, multiple sclerosis, or spinal cord injuries can damage the nerves controlling bladder function, resulting in various types of incontinence.
• Medications: Certain medications, such as diuretics, alpha-blockers, or sedatives, may affect bladder function and contribute to urinary incontinence.
• Genetic Factors: Some individuals may be predisposed to a higher risk of incontinence due to genetic factors that influence bladder and pelvic floor function.

Understanding the underlying cause of incontinence is crucial for developing an effective treatment plan. Individuals experiencing symptoms of incontinence should seek medical evaluation to identify the specific factors contributing to their condition.

How does incontinence impact older adults?

Incontinence can be a taboo subject in our culture, and the impacts of incontience have both physical and psychological impacts. The most common effects include:

• Reduced quality of life: Incontinence can significantly impact an individual's overall quality of life, limiting daily activities and affecting personal relationships.
• Social isolation: Fear of embarrassment or stigma related to incontinence may lead to social withdrawal and isolation, as individuals may avoid social gatherings or events.
• Skin issues: Continuous exposure to moisture from urine or feces can cause skin irritation, rashes, and even more severe conditions like dermatitis or pressure sores.
• Sleep disruption: Individuals with incontinence may experience sleep disturbances due to the need to wake up frequently during the night to use the bathroom.
• Urinary tract infection: Incontinence can contribute to an increased risk of urinary tract infection (UTIs), adding another layer of health concerns to individuals experiencing involuntary urine loss.

It's important to note that the impacts of incontinence can vary widely among individuals, and the extent of these effects depends on factors such as the severity of the condition, the presence of underlying health issues, and the availability of supportive resources and interventions. Seeking professional guidance and adopting effective management strategies can help mitigate the impact of incontinence on a person's life.

Common treatments for urinary incontinence

It's important to remember that for most individuals, there is no treatment that will cure urinary incontinence. Several treatment options are available to treat urge incontinence, urinary incontinence, as well as other types of incontinence, and the choice of intervention depends on the type and severity of the condition. Common treatment options include:

• Pelvic floor muscle exercises (Kegel Exercises): Pelvic floor muscles have a lot to do with how we regulate, and pelvic floor exercises involve contracting and relaxing the muscles that support the bladder muscle and urethra. Regular practice strengthens these muscles, improving bladder control and reducing the symptoms of stress incontinence.
• Behavioral therapies: Behavioral interventions focus on modifying habits and patterns related to bladder function. Techniques such as bladder training, scheduled voiding, and fluid management can help individuals regain control over their bladder and reduce urgency and frequency associated with urge incontinence.
• Medications: Medications may be prescribed to address specific causes of incontinence. For example, anticholinergic medications can help calm overactive bladder muscles in cases of urge incontinence, while estrogen therapy may be recommended for postmenopausal women with stress incontinence.
• Surgery: Surgical interventions may be considered for certain types of incontinence that do not respond adequately to conservative treatments. Procedures such as sling surgery or bladder neck suspension aim to provide additional support to the urethra and restore continence.

It's important for individuals experiencing urinary incontinence or bladder control issues to consult with a healthcare professional for a comprehensive evaluation and personalized treatment plan. The effectiveness of treatment options can vary, and a tailored approach addressing the specific needs and characteristics of the individual is key to successful management.

After you’ve done your own research about incontinence, you’ll be in a mindset to approach the topic with more empathy. Bladder control issues can be about so much more than a functional issue; for many older adults it signifies a loss of freedom, independence and agency. It can be embarrassing- be gentle but direct in broaching the subject of incontinence. Use concrete examples of what you’ve observed in your home or in your time together to help express your concern in plain terms. For example, a statement like, “I saw that when we went to the store together, you had a visible leak on your clothes” or "it seems like you've been using the bathroom a lot, are you worried about having an accident?" can help keep the conversation on the right track. Sharing an observation or asking a question may help your parent or loved one be less defensive so you can work together to find a solution. 

Many people are surprised to hear that over 25 million adults experience incontinence and roughly half of adults 65+ experience some form of bladder leaks. Letting your parent know that this is a very common issue can help reduce feelings of shame or embarrassment. Even Hollywood stars like Katy Perry and NFL quarterback, Tony Romo, have publicly addressed their struggles with incontinence.

In a recent survey Because Market conducted of 150+ adults aged 65+, only 19% were willing to discuss their bladder leaks with a friend or family member. Starting the conversation about incontinence can be a first step in reducing the stigma so your loved one can get the products and help they need. 

After you've worked with your doctor to rule out any medical or pharmaceutical issues, work on bringing practical ideas or solutions. For most adults, the answer will lie in learning how to better manage incontinence, and fortunately there is a host of products that can help families in this respect. Highlight the benefits of these options, emphasizing how they can prevent urine leakage and contribute to a more comfortable and confident daily life for your parent. Remember to be patient - adopting a new hygiene product or routine can be a deeply personal choice for some individuals.

How to manage urinary continence:

Here are some helpful tips from our staff on how to get your aging parent to consider using a new product: 

• Stock their bathroom: Admitting that you need incontinence pads or underwear can be difficult, and making that first purchase can be even harder. Make this transition easier by buying a few different types of pads and planting them in a hidden drawer or cabinet in their bathroom. Letting them know “I got a great deal on these pads, I’ll leave them in your bathroom if you’d like to try them” can be a low risk way for your parent to try a new product. 
• Pay attention to vocabulary: Words carry weight, and ensuring that your parent maintains a sense of dignity throughout the conversation is crucial. When referring to incontinence products, avoid words like “adult diaper” or “accident” that may make an older adult feel child-like. Instead, use words like, “disposable underwear”, “pads”, or “guards” to refer to incontinence products. Paying attention to the words you use may make it easier emotionally for your parent to embrace these products. 
• Help them stay discreet: When it comes to using incontinence pads or underwear, there are several reasons your parent or loved one may be hesitant to try them. One often overlooked issue is how they can discreetly store and dispose of their products without creating unwanted odors. Finding a portable zipper pouch can help them carry products with them without embarrassment. Disposable opaque bags with tie handles can help keep used products discreet and odorless in the household trash. 

Selecting incontinence pads and underwear can be confusing for many, given the variety of options. Depending on the level of your parent’s bladder leaks, you may consider the following products: 

Disposable pads and guards: When it comes to managing light to moderate incontinence, disposable pads for women and guards for men offer protection that is easy to change in and out of throughout the day. Make sure you look for pads designed for incontinence instead of menstrual pads, which are designed to absorb less liquid than incontinence pads. 

• Disposable underwear: For more substantial leak protection, consider disposable underwear, often referred to as “adult diapers”. Because Market’s Overnight Underwear holds up to 6 cups of liquid, which is 37% more than the leading brand. Made with cloth-like material and the latest technological designs, the underwear is streamlined and discreet under clothing. Consult a size chart to ensure the most comfortable and leak-proof fit. 
• Bed and chair protectors: Protecting your home and car from unwanted leaks can save you time and money in the long run. Consider disposable pads that can be used in your home or car to help make cleaning up easy. 
• Skin care products: Maintaining skin health can help your parent feel comfortable and prevent chafing or adult diaper rash. Follow the 2 step process: 1. Cleanse 2. Protect to help prevent skin breakdown. Disposable wet wipes are a convenient way to keep skin clean between changes, and adult barrier creams can help soothe and protect delicate areas to prevent chafing. 
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