Helping the person in your care deal with incontinence
Some of your caregiver responsibilities may involve assisting the person in your care with toileting, which can be an awkward issue for you, as the caregiver, and for your care recipient.
As a caregiver, it helps if you approach incontinence in a clinical manner. This can help to take away some of the discomfort you are both experiencing.
What should you do if the person in your care is incontinent?
As a caregiver, it helps if you approach incontinence in a clinical manner. This can help to take away some of the discomfort you are both experiencing. It also helps to understand the causes of bladder leakage in order to manage incontinence.
There are several approaches one can take to manage incontinence including:
- Incontinence products
- Exercises that strengthen the muscles to help control continence
Kegel exercises (pronounced kee-gell) were first developed by Dr. Kegel and are often called pelvic floor exercises and have proven to be a very effective way of managing incontinence.
Pelvic floor muscles
You can see from the pictures below that the pelvic floor muscle in both men and women is like a large hammock that supports all the pelvic organs by holding them up in the correct position.
As we age, gain weight, experience pregnancies, strain with bowel movements, and generally decondition, the pelvic floor muscle loses its tone and strength, and it sags, causing the organs to drop from their correct position. A sagging pelvic muscle can also cause a lack of bladder control, or incontinence.
Although these changes happen as we age, and incontinence is more common as we age, it is not a normal part of aging and it can be prevented.
Strengthening the pelvic muscle with Kegels
As a caregiver, you may want to suggest trying Kegel exercises to help strengthen the pelvic floor if the person you’re caring for is experiencing incontinence. Kegel exercises help to lift the pelvic organs back up to where they should be and therefore reduce the symptoms of incontinence.
How to do Kegel exercises
How do I find the pelvic floor muscles to know I am doing it right?
Front and back Kegels can be done to strengthen the muscle in both the front and back of your pelvic floor:
- Front Kegels: Imagine needing to go to the bathroom and “holding it” or stopping the stream. By doing front Kegels like this you will be using the muscles at the front of your pelvic floor.
- Back Kegels: Think about passing gas in a public place and “holding it.” By doing back Kegels like this you are using muscles at the back of your pelvic floor.
- In both front and back Kegels you should notice that your rectum rises slightly, your anus tightens, but your buttocks (gluteus, or bum muscles) do not move, they should be still. Nobody can see you doing a Kegel exercise. Do not tighten your abdomen or buttocks, squeeze your legs together, or pull up on your shoulders. This will not help you to do a Kegel exercise.
Now that you have found the pelvic floor muscle, you are going to exercise it by doing Kegels.
How do I do the Kegel exercise?
The Kegel instructions below apply to both men and women suffering from incontinence.
- Pull up on your pelvic floor as if you were in an elevator. Slowly pull it up to the top floor and hold it there for five full seconds (full seconds can be counted as 1001, 1002, 1003, etc.).
- If you lose the contraction when you get to 1003, and the pelvic floor has slid back down, then only hold for three seconds until it gets easy. Once it is easier, try holding for five seconds. It is important to hold as tight as you can for the total time.
- Release slowly, like the elevator is moving back to the ground floor. If you just drop your pelvic floor muscle it is not nearly as effective. The goal is to develop muscle control.
- Keep at it! You need to repeat this hold and relax cycle of the Kegel exercise to strengthen your pelvic muscle, the same as with any muscle exercise.
How often do I need to do Kegel exercises?
- You can do Kegel exercises while you are driving, standing in line at the grocery store, watching TV...practically anytime.
- Do your Kegel exercises during each commercial break of your favourite TV show, every day. Do them for the whole commercial break. You will be amazed at the difference.
- If you are unable to do Kegel exercises while you watch TV then do a set of 10 Kegel exercises five times every day: morning, lunch, supper, after dinner, and bedtime.
When will I notice an improvement?
By doing Kegel exercises regularly you should notice an improvement within 4-6 weeks.
IF YOU DON’T USE IT, YOU WILL LOSE IT
The pelvic floor is no different from any other muscle group and as such, it needs to be consistently exercised to stay in optimal condition. As with any exercise, consult your doctor before you begin, to make sure it’s the right exercise for you.
Continence Series Part 3: Dementia and Incontinence