Incontinence might be one of the most difficult issues you will face when caring for an aging parent or loved one. And it certainly has the most impact on the quality of everyday life — for both caregiver and care receiver. It is likely to be a painful moment when you realize that your dignified elderly mother may no longer be able to control her bladder — painful for you and very painful for her.

Incontinence, the inability to control one's bodily functions, used to be seen as an inevitable and unavoidable part of growing older — something we just had to put up with. It is estimated to affect one out of every three Americans over the age of 65, women twice as often as men (due to loosening of the urethra through childbirth), and over half of all nursing home residents. However, these days, incontinence is more often seen as a symptom of some other related health problem, and can in most cases be treated and controlled, if not cured.

There is tremendous social stigma attached to incontinence. It is often referred to as the "silent affliction," due to the fact that most people are very uncomfortable talking about it. Many elderly people with incontinence withdraw in shame from their friends and family, while others are sometimes afraid to participate in normal daily activities that might take them too far from a toilet. More than just a physical problem, incontinence can affect your elder's emotional, psychological and social well-being.

Factors that Cause Incontinence

There is no one cause of incontinence, it can be brought on by many different factors including:

Neurological - linked to Parkinson's disease, stroke or muscle weakness
Medical - due to medication, obesity, poor mobility due to arthritis
Psychological - dementia, confusion, stress, depression
Environmental - difficulty getting in and out of bed, toilet too far away, clothing difficult to manipulate, cold air
Controlling Incontinence

The following are simple steps you and your aging parent can implement to help control incontinence:

Provide fluids. Make sure your elder drinks plenty of fluids, at least six and a half cups a day. Strange as it may sound, limiting fluid intake can actually make the problem worse as it results in more concentrated urine which can cause irritation and lead to serious illness.
Plan ahead. Schedule trips to the bathroom, particularly before going to bed.
Watch weight loss/gain. Weight loss can improve bladder control by reducing abdominal pressure. For more information about your aging parent's nutritional needs.
Encourage exercise. However light, exercise stimulates circulation and keeps the body from becoming too sluggish. 'Kegel' exercises help strengthen the muscles around the urethra and are very useful in helping control incontinence. Have your elder work on cutting off the flow while she is urinating, then practice these squeezes throughout the day while she's watching TV, or sitting reading. She should notice some changes within a month. Talk to your doctor for more information.
Dietary changes. Some foods and beverages are known to make incontinence worse. Avoid caffeine, spicy foods, alcohol and tomatoes.
Access to bathroom. Make sure the path to the toilet is well marked with lights and/or reflector tape for night time. If the toilet is too far away, buy a bedpan or a commode.
Check medications. Some medications can encourage or even cause incontinence. Have your doctor check your elder's drugs to see if this could be the problem. There are also medications available to control incontinence.
Consider a pessary. A pessary is a donut-shaped ring, inserted high up into the vagina that helps reposition the urethra and regulates and controls the urine flow. There is also a handy device called a plug, a tiny tampon inserted into the urethra and inflated to prevent urine leakage.
Surgery might help. As a last resort, surgery can help reposition the bladder or open the urethra when an enlarged prostate has closed it.
Coping with Incontinence

The pointers above may help control incontinence, but what if you and your elder are coping with it on a daily basis? The following may help you deal with the practical aspects of living with incontinence.

To reduce any odors from soiled clothing, provide easy access to a container with a lid containing a deodorizer such as baking soda.
Urinary incontinence can be coped with by using adult absorbency pads. Covering the pads with regular underwear helps a person feel less childlike. Be sure to change incontinence underwear often, keep skin clean and use lotions and powders (or cornstarch) to protect the skin.
By encouraging your aging parent to acknowledge her incontinence, the two of you can work together to ensure it causes as little disruption to her daily life as possible.