Aging & incontinence

What happens when they get older?

What’s the first thing to do if your elderly loved one loses control of their bladder and/or bowels? Try not to panic. It may be awkward and embarrassing for both of you at first. But be assured: incontinence is an often-faced problem and there are ways you can help her or him to deal with it.

If you’ve watched a loved one get older, you’ve probably noticed changes to their physical condition. Maybe they’re not as fit or trim as they once were. Maybe their eyesight and hearing aren’t so good these days. It’s natural.

And they might have a similar problem with their urinary system. With age, it works less effectively than when they were younger. As a result they lose some or all control over their bladder and bowels. It’s a common condition called incontinence.

Incontinence can be embarrassing and frustrating for your loved one. Going to the bathroom, a private function they once took for granted, is suddenly beyond their control.

You can help by being understanding. By trying not to be embarrassed or judgmental about their situation. Learn more about incontinence, and the practical things you can do for your loved one. Care for them in a loving manner, and it could bring the two of you closer together.

To understand your loved one’s condition better, consider what’s happening in their aging body.

Why is your loved one becoming incontinent?

As they’ve grown older, their organs, muscles and nerves might stop working effectively together.

To be able to keep continent we need support from the pelvic floor muscles and sphincter muscles. These important muscles assist in urinary and fecal continence. When we get older, these muscles might weaken for different reasons and therefore cause urinary leakage. It can also be that nerves connecting the brain and bladder could be sending the wrong signals.

In addition, also as a result of age, our kidneys and bladder might not work as effectively as when we were younger. (Generally, in a healthy aging person, kidney function remains normal. But illness, medicines, and other conditions can impair kidney function.)

The following changes could be contributing to incontinence:

What happens with kidneys as we age?

The renal function is also at increased risk of declining as we age. This is seen as a reduced blood flow to the kidneys and reduced production of anti-diuretic hormone (ADH). This hormone concentrates the urine (recovering water into the body). When this hormone level is reduced, more urine is produced, especially at night. This is also a reason why it is normal for an elderly person to need to use the bathroom 1-2 times per night.

What happens with our bladder as we age?

The bladder is a muscle sac. With aging, the bladder muscles are at increased risk of starting to lose tone and function. This leads to a reduced ability to contract and squeeze. As a result, the bladder takes a longer time to empty and might not totally empty, leaving some urine in the bladder.

The bladder also becomes less stretchy and cannot hold as much urine as before. The emptying reflex is triggered later when the bladder is almost full. This gives an elderly person less warning time to get to the bathroom to empty their bladder.

The urethra can become blocked. In women, this can be due to weakened muscles that cause the bladder or vagina to fall out of position (prolapse). In men, the urethra can become blocked by an enlarged prostate gland. These conditions are important to detect early in order to get the right treatment.

Symptoms can include:

difficulty in starting to urinate
feeling that the bladder is not emptied after urinating
an interrupted or weak urine stream
a frequent urge to urinate and frequent nighttime urination.

Not being able to empty the bladder completely can cause the bladder to be filled with residual urine which causes overflow urinary incontinence and is also a risk for urinary tract infections.

If your loved one has become less mobile with age, they might not find it easy to reach the bathroom. The result is, when they need to go, they can’t get there in time. Then they depend on a caregiver like you to help them with their incontinence.

Learn more

To be a good caregiver, it’s important to understand the aging process and how it affects mobility and cognitive ability. Learn more about age-related changes and how you can help your loved one in the following articles:

> Aging and our minds

> Aging and mobility

> Home safety

> What is incontinence?

> Find the right incontinence products