When nature won’t stop calling: urinary incontinence

Urinary incontinence (also known as bladder leakage) is a common issue that arises as people age. The good news is that there are ways to lessen the impact of bladder leakage and there are products to keep the worry of leakage from affecting a person’s quality of life.

As a caregiver, it’s good to be informed about bladder leakage so that if the person you are caring for experiences incontinence, you’ll know how to help. Also, nothing makes a taboo topic easier to discuss than being armed with all of the information – so we’re here to help!

Understanding bladder function:

The bladder is a small muscle in the lower abdomen. It expands like a balloon as it fills with urine from the kidneys. Unlike a balloon, there is no pressure. It just expands until it has reached capacity. Normal bladder capacity is about two cups of urine but the bladder of a senior often holds less. For someone to void (pass urine) they must relax the sphincter (ring of muscle) or valve at the base of the bladder and then contract the bladder. We feel like we have to void (or pass urine) when our bladder starts contracting. However, we don’t urinate at that moment because we are able to keep the sphincter or muscle at the base of the bladder tight. When we go to the bathroom and relax the sphincter, the bladder contracts and we pass urine.

Why are people incontinent of urine?

There are many reasons why someone may experience bladder leakage:

The bladder may not contract well and as a result it doesn’t empty completely.
The sphincter or the pelvic floor muscles may be weak making it more difficult to hold the urine in.
The bladder and sphincter may not work together and the person experiences either leakage of urine or the inability to void.
Some medications can make it more difficult to empty the bladder. This can mean that there is always some urine present in the bladder and the person needs to void (or pass urine) often.
Bladder infections may cause a person to leak urine.
There are several illnesses that can contribute to incontinence such as Multiple Sclerosis, Parkinson’s disease, stroke, and dementia to name a few.

Are there any strategies to help regain bladder control?

Drink at least eight glasses of water a day (unless otherwise instructed by a health care professional). Some people limit their fluid intake to reduce the leakage. However, this is not a good idea because the bladder does not like concentrated urine so it tries to get rid of it. This means frequent trips to the bathroom with not much urine passed each time.
Limit the amount of caffeine that is ingested. Coffee, tea, colas, chocolate, and some other soft drinks have caffeine in them. The bladder does not like caffeine and it tries to get rid of it. Also, the caffeine acts as a diuretic so it makes more urine and a need to pass urine more often.
Limit the amount of citrus juices as these also irritate the bladder.
Make sure bowels are moved every day or every other day.
Empty the bladder every 2-4 hours or as soon as the urge is felt. Urination should not be put off.
Learn to do Kegel exercises.

Products to help manage the bladder leakage

Use disposable incontinence products that are made to hold urine. Sanitary pads are not designed for urine leakage and will not be useful. There are several brands of incontinence products. It is best to ask for samples rather than buy a whole package. The better products have material inside the pad that absorbs the urine and turns it into a gel. These products help prevent both leakage and odour.

Below are links to the websites of some popular brands of incontinence products in Canada. You will be able to see some of the products that are available and each site has some helpful resources as well.

http://www.attends.com/products-for-all

http://www.poise.com/

http://www.tena.ca/

Men can wear condom catheters if needed. These are applied in a similar way to a condom but allow for a catheter bag to be attached for collecting urine.

There are several types and brands of condom catheters so it is important to discuss the options with a health care professional to ensure a correct fit. The following is an example of condom catheters that are available.

https://www.hollister.com/en/products/continence-care-products/male-external-catheters

Reusable bladder leakage products including pads and pants can be purchased from a home health store.
A catheter is a last resort (unless it is an intermittent catheter used for urine retention).

Visit The Canadian Continence Foundation’s website for more information and resources.

Speak to a health care professional about seeing a Nurse Continence Advisor (NCA) or an Enterostomal Therapy Nurse (ETN) for a thorough assessment to help determine the cause of the bladder leakage and an appropriate management plan.