Incontinence in Elderly Adults: Causes, Treatments, and Solutions
If you or a loved one experiences uncontrolled urinary leakage or constant urges to pee, you're not alone. Researchers of a review published on PubMed Central report that urinary incontinence in elderly adults is prevalent, with 9% to 39% of women 60+ experiencing it daily and 2% to 11% of senior men reporting the same thing.
Although prevalent, incontinence isn't a natural part of aging, often signifying an underlying condition. The good news is that it is treatable, with many solutions available for its management.
So, join us today at St. Andrew's Village, our senior living community in Aurora, CO, as we delve into the causes and treatments of incontinence in seniors.
Causes of Incontinence in Elderly Adults
Urinary incontinence (UI), also called involuntary urination, leads to a sudden, forceful urge to urinate and, in many cases, an uncontrolled leakage of urine. It's a distressing, sometimes even debilitating problem, often caused by many factors, from infections to muscle disorders.
Let's examine the top causes of UI in more detail.
Urinary Tract Infections (UTIs)
UTIs are infections often affecting the lower urinary tract, including the bladder and urethra. They frequently occur when bacteria pass the urinary tract via the urethra and spread in the bladder. Escherichia coli (E. coli), a bacteria found in the large intestine, is the leading cause of bladder infections, accounting for over 90% of cases, as reported by Cleveland Clinic.
UTIs can cause bladder control issues by irritating and inflaming the bladder. The bladder becomes more sensitive when this happens, resulting in strong, sudden urges to pee.
Constipation
Constipation, another of the most common elder health concerns, is a gastrointestinal disorder characterized by:
- Infrequent bowel movements (e.g., less than three a week)
- Hard stool that is difficult to pass and requires excessive, uncomfortable straining
- Incomplete bowel movement
According to an article in Geriatric Nursing, constipation affects 17% to 27% of the overall geriatric (older adult) population. It also becomes more common with age, especially in hospitalized older adults.
Constipation can contribute to urinary incontinence by causing the rectum (the chamber that stores stool) to fill with impacted stool. As a result, the over-full rectum puts direct pressure on the bladder, limiting its capacity to hold urine.
Pelvic Floor Disorders
The pelvic floor is a group of muscles at the bottom of the pelvis. Its primary job is to support the pelvic organs, including:
- The bladder
- The bowel
- The uterus or womb in women
Pelvic floor disorders (PFDs) occur when the pelvic floor muscles weaken or tear. The weakened or damaged muscles can't support the pelvic organs, resulting in bladder and bowel problems.
Women are at a higher risk of PFDs, particularly female seniors. Data from the American Urogynecologic Society shows that over 50% of women 55 and older experience problems caused by PFDs, including UI.
Benign Prostatic Hyperplasia (BPH)
BPH, commonly known as "enlarged prostate," is a non-cancerous condition that occurs when the prostate gland expands. It can lead to UI because an enlarged prostate can:
- Compress the urethra
- Prevent the bladder from emptying completely
- Cause overflow incontinence, an involuntary urine discharge due to the bladder not having emptied completely
The pressure placed by an enlarged prostate on the bladder can also cause an overactive bladder (OAB). OAB leads to urge incontinence, wherein the bladder contracts involuntarily, allowing urine to leak.
Treating and Managing Incontinence in Older Adults
Since incontinence is typically a symptom of an underlying health condition, the priority is to address the root cause. Then, as seniors undergo treatment, they can use incontinence products, such as specialized underwear, to manage symptoms.
Treating UTIs
Older adults who experience UI due to UTIs may need to complete a round of antibiotics. Antibiotics should help clear the infection; once gone, its symptoms, including incontinence, should also ease.
Prioritizing senior hygiene is just as crucial since cleaning the genital area can help prevent the spread of infection-causing bacteria.
Treating Constipation
The first line of treatment for constipation usually involves leading a healthier senior lifestyle, including focusing on a more nutritious diet. Food full of natural fibers, such as fresh fruits, veggies, and whole grains, helps soften stools and make them easier to pass.
Getting enough fluids, primarily plain water, can also help promote regular bowel movements.
Likewise, staying active, such as engaging in senior health and wellness programs that involve physical activity, can help. Physical activity helps stimulate the intestinal muscles' natural contractions, moving food through the digestive system more efficiently.
Pelvic Muscle Exercises
Pelvic muscle exercises, or "Kegel exercises," may help ease the symptoms of urinary incontinence. They strengthen the pelvic floor muscles, allowing them to support the bladder and bowel better.
Incontinence Care Products
Incontinence care products consist of absorbent materials that help soak up urine leaks. Some of the most popular options are:
- Absorbent pads, which adhere to the inside of underwear (like menstrual pads)
- Pull-up incontinence briefs
- Belted or tabbed incontinence underwear
Incontinence products specifically for beds and furniture are also available. Seniors can get protective items like absorbent pads and mats for beds, chairs, and sofas.
Medical Options
Medical treatments for incontinence in seniors may also include medications such as:
- Anticholinergics like oxybutynin and tolterodine
- Mirabegron (Myrbetriq)
- Alpha-blockers
- Topical estrogen to rejuvenate and tone tissues in the urethra and vaginal regions
In some cases, surgery may help with severe PFD or if incontinence occurs as a result of a blockage caused by BPH.
Don't Let Incontinence Get You Down
While incontinence in elderly adults is common, it's not something they should just live with, as there are many treatments available. They're even preventable in many cases, such as UTIs and constipation. The key is not to let feelings of embarrassment get in the way of seeking help and support.
At St. Andrew's Village, our senior living community in Aurora, CO, we're proud of our assisted living campus's highly experienced yet compassionate personal care providers. We provide 24/7 support, including in our independent living enclave. We're always available to help (whether with continence care or personal hygiene) and offer many on-site amenities, from dining to fitness programs and housekeeping.
Speak with us today to learn how we can help you or an older loved one live a more fulfilling life!