Dealing effectively with incontinence

Posted Feb. 03, 2014, at 2:18 p.m.

We’ve all seen bladder-control TV commercials with a frustrated-looking woman constantly in need of a restroom. A miserable existence, to be sure, and yet one shared by many. As I have met many seniors with this affliction, I offer this column as an apology to my aunt.

My cousin and I were hateful children. My aunt — my cousin’s mother — had a problem with incontinence. If she laughed too hard she would tinkle a bit. Once discovered, my cousin and I would compete to see who could make her laugh hardest. Fortunately my aunt was good-natured about it all, although I am sure quite embarrassed.

As an adult, I realize that incontinence is no laughing matter. It can actually be a life-altering burden. But there are some things that can be done to help the situation.

The causes of incontinence are varied and include multiple childbirth, urinary-tract infection, illness, side effects from certain medications, and, for men, an enlarged prostate. While incontinence is more often diagnosed in older people, this is not a necessary consequence of aging.

And not all incontinence is created equally but the outcomes are about the same:

• Stress incontinence, which occurs mostly in women, is the leakage of urine during exercise, coughing, sneezing, laughing, lifting heavy objects, or other body movements that put pressure on the bladder.

• Urge incontinence is the inability to hold urine long enough to reach a bathroom. When a strong need to use the restroom arises or when even a small amount of liquid, especially with caffeine, is consumed, leakage occurs. Caffeine is a potent bladder irritant.

• Overflow incontinence is the leakage of small amounts urine, day and night, from a bladder that always feels full. Getting up frequently during the night to use the restroom is a common symptom.

The prevalence of pads and absorbent undergarments on the market may keep people dry in the short run but they are often hard on self-esteem and the use of these products can cause patients to prolong seeking treatment. People often start with pads and then graduate to adult incontinence briefs.

Treatments for incontinence are as varied as the causes and include behavioral techniques, medications, and surgery. Bladder drills and Kegel exercises are two non-invasive and very successful techniques with proven results.

Bladder drills involve emptying the bladder by clock rather than by desire, so that it is prevented from reaching the volume where leakage occurs. The goal is to reach two and a half to three hours between voids without leakage or accidents.

Kegel exercises rehabilitate the pelvic floor muscles, which can improve bladder support. Various devices can be used to ensure that the correct muscles are being used during the exercises. I have heard from happy seniors that, with dedication and a little time, these muscles will strengthen, and incontinence, for the most part, becomes a thing of the past.

Imagine not having to plan your life around whether or not a bathroom is nearby. Life is too short to be afraid to give a belly laugh, pick up a baby, or sneeze during allergy season.

Don’t be embarrassed. If you are suffering from incontinence, talk to your doctor. New treatments are invented every day. Tremendous isolation can come with incontinence and people give up activities that they enjoy out of fear. Don’t let this treatable condition govern your life.

Carol Higgins Taylor is director of communications at Eastern Area Agency on Aging. For information on EAAA, call 941-2865, toll-free 800-432-7812, or visit www.eaaa.org.

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