How to Manage Incontinence in Older Adults: A Practical 5-Step Guide

Let’s be honest—discussing private physical issues can be embarrassing at times. As a society, we often feel squeamish at the prospect of having open discussions about incontinence. So let’s talk about how to deal with elderly incontinence.

But we’ve got to do our best to work through any awkward feelings, and the reason why is clear…

Over 50% of people aged 65+ report bladder and/or bowel incontinence.

With this in mind, we’ve put together a five-step guide on how to deal with elderly incontinence. This will be an ideal read if you’re:

a) an older adult who wants advice on managing bladder/bowel issues

b) a family member caring for someone with incontinence

Here’s a quick summary of what we’ll be covering…

• What causes elderly incontinence?

• The 3 types of urinary incontinence 

• The 2 types of bowel incontinence 

• What is incontinence care & management? 

• Where can I find elderly incontinence products?

If you’re a visual learner, the “top tips” graphic below may be a helpful place to start:

What Causes Elderly Incontinence?

A range of factors can lead to bowel and bladder problems, but a common challenge that older adults face is functional incontinence. What exactly does “functional” mean in this context, you may be wondering?

Cognitive, mobility, and sensory limitations can stop elderly people from accessing a toilet when they need it. This could be due to poor eyesight, arthritis, or other health issues. Environmental factors (e.g. dim lighting and steep stairways) can also play a role. 

The possible causes of incontinence in elderly people don’t end there, though. Here are some others to be aware of:

• Urinary tract infections (UTI)

UTIs irritate the bladder lining and make urinary incontinence more likely. They’re common, too. Over 10% of women aged 65+ and around 30% of those over the age of 85 are affected by UTIs.

• Diuretics

Diuretics increase the rate at which your body expels fluids from the blood into the renal system. This is where you might run into trouble, as you’ll pee more often, which can lead to dehydration.

• Excess weight

Being overweight or obese can place extra pressure on the bladder. With enough consistent pressure, the pelvic floor will weaken, increasing the chance of unwelcome leaks.

• Nicotine

Nicotine is the stimulant found in tobacco. On top of it being dangerously addictive, nicotine can irritate the detrusor muscle in the bladder wall.

• Medications

Sedative medications such as diazepam can slow the nervous system’s ability to detect when the bladder is full. 

What’s more, antidepressants and opioids can interrupt bladder function and worsen constipation. 

In addition, side effects of high blood pressure medications (e.g. ACE inhibitors) include a persistent dry cough, which may lead to urinary incontinence.

• Hormone replacement therapy (HRT)

Estrogen levels in the body can affect the function of the lower urinary tract. Women who took HRT post-menopause are found to be between two and three times more at risk of urinary incontinence.

• Prostatitis

This one’s for guys only…

Prostatitis (prostate inflammation) can cause urethral pain and urinary frequency. Around two million health care appointments in the U.S. occur each year due to prostatitis. 

• Constipation

Constipation can be double trouble for elderly people with incontinence, because a full, congested bowel puts more pressure on the bladder. To add to this, frequent straining when trying to pass a stool may fatigue the pelvic floor muscles.

The 3 Types of Urinary Incontinence

Urinary incontinence is frustrating for both seniors and family carers to deal with. The unpredictable leaks, the seemingly never-ending bathroom trips… Symptoms can be exhausting to manage.

Customers at Carewell often speak about the social challenges they experience, such as feelings of embarrassment and worrying what other people will think of them.

We realize it isn’t easy… 

To manage the issue as well as possible, the first thing to find out is which type of incontinence you or your loved one has.

Here’s an outline of the three types of urinary incontinence:

• Urge incontinence

Do you get sudden urges to pee and can’t seem to hold it long enough to reach the bathroom? You may have what’s called “urge incontinence.” 

Neurological conditions such as dementia, multiple sclerosis, and Parkinson’s Disease can lead to urge incontinence because of changes in the nervous system. The brain’s signals to contract and relax the bladder at the right times can be affected.

Diabetes is another condition that may lead to urge incontinence, due to an increase in urine production.

• Stress incontinence

Many of us will experience an episode of stress incontinence at some point in life. Unexpected pressure on the bladder—such as sneezing, coughing, or lifting heavy objects—can cause a temporary loss of control.

The symptoms are more of a concern if they become a regular, or even daily, issue.

• Overflow incontinence

Overflow incontinence happens when the bladder can’t fully empty. 

Men with an enlarged prostate gland (also called Benign Prostate Hyperplasia) are at particular risk of overflow incontinence. An enlarged prostate can cause blockages, stopping the urethra from being able to void all of the urine in the bladder.

The 2 Types of Bowel Incontinence 

Next up, it’s time to talk about bowel incontinence. Before you cringe, bear in mind that we’ve all experienced the “joy” of diarrhea before. If you’re ever had a case that resulted in an unforeseen…escape…then you’ve suffered from temporary bowel incontinence.

The two main types of chronic bowel incontinence are:

• Fecal incontinence (recurring)

Recurring fecal incontinence is when the body can’t control bowel movements. Stool leaks when passing gas and total loss of bowel function are both forms of chronic fecal incontinence. Possible causes may include nerve damage, muscle weakness, and constipation.

• Passive incontinence

Just like with recurring fecal incontinence, passive bowel incontinence leads to the involuntary passing of stool. The key difference with passive incontinence is that the individual is unaware when it happens. 

Elderly people with cognitive disorders such as Alzheimer’s Disease are at more risk of this. Passive incontinence can be particularly unpleasant, as leaks may go unnoticed for some time. 

What is Incontinence Care & Management? 

Are you trying to figure out how to best manage a type of incontinence listed above? 

Or, maybe you’re a carer who needs tips on how to help a loved one experiencing pesky symptoms?

Either way, this section on incontinence care could be the most vital part of the article for you.

Read: Discussing Incontinence with an Elderly Loved One

Please note that recommendations on how to deal with elderly incontinence management will depend on the cause.

As always, the most appropriate starting point is to speak with your doctor.

Obvious advice, right? 

But the reason we recommend this is that your doctor may be able to tell you what’s brought about the incontinence. If they can’t, they’ll most likely refer you to a specialist, such as a urologist or a gastroenterologist. Specialist professionals can carry out more comprehensive tests to give you a diagnosis. Depending on the diagnosis, your doctor/specialist may recommend medication, surgery, or lifestyle changes.

Aside from the sensible approach of talking to a health professional, there are also strategies you can follow from home. Have are our top tips for elderly incontinence management, to live with more comfort, control, and dignity.

• Do kegel exercises

Kegel exercises (or pelvic floor exercises) can be done from home to strengthen the muscles that clench when you need the toilet. 

Simply put, these exercises can help you hold your pee longer!

You shouldn’t try to hold on for too long when you’ve got a full bladder, though. This can actually do more harm than good. 

Still, pelvic floor training is handy to give you a few more precious seconds if you struggle to reach the bathroom in time.

• Try “timed voiding”

If you like to stay organized, this tip is for you! 

Timed voiding involves setting the times you urinate on a schedule, e.g. every two hours. With enough repetition, a “pee schedule” may train the mind to send signals to the bladder at certain times of day, which makes planning easier.

If you’re a caregiver, you can also set reminders to prompt your loved one to go to the bathroom.

• Maintain a healthy weight

Have you got a stubborn layer of fat around your belly that won’t shift? Unfortunately, this may aggravate incontinence symptoms. Dropping a few pounds has health benefits across the board, but it can take some pressure away from the bladder, too.

• Quit smoking

The increased risk of cancer is one thing to consider, but cigarette use can also cause chronic coughing. This coughing may weaken the pelvic floor muscles.

Breaking long-term habits like smoking can be hard, we know. But the good news is that there are plenty of smoking cessation options out there to help.

• Reduce alcohol and caffeine intake

We mentioned earlier that alcohol and caffeine act as diuretics. Elderly people need to take extra care when it comes to alcohol intake, due to the potential for blackouts and changes in coordination.

• Treat constipation

Constipation is another issue that we recommend you speak with your doctor about.

This list of 13 home remedies for constipation—featured in Medical News Today—is also worth checking out. Tips include eating more fibrous foods, taking herbal laxatives, and following a low FODMAP diet.

• Limit drinks in the evening

One of the simplest strategies for incontinence management is to drink less before you go to sleep.

Night-time incontinence is a common issue for seniors. The body fails to wake up when the bladder or bowel is full, leading to leaks, which can be unpleasant for both sufferers and carers to deal with.

But that’s not all…

Elderly people are more likely to experience sleep disturbances, too. Multiple trips to the bathroom each night will only worsen sleep quality.

And if you’re caring for a family member with night-time incontinence, you’ll know how tiring it is to have to manage “clean-up duties.” 

Nevertheless, getting the balance right with fluids is essential. 

Your fluid intake is too low? There’s a risk of dehydration. We certainly don’t want that!

But drink too much before bed? Don’t be surprised if you need to pee every couple of hours during the night.

• Adapt the home environment

Minor amendments to the home can make a big difference in terms of safety and practicality.

A smart place to begin? Improve the lighting and make sure any mobility aids are within reach. 

Further options include commodes and stairlifts if the bathroom is on another floor of the home.

• Wear incontinence underwear

While not necessarily the most fashionable items of clothing, incontinence underwear such as pads can bring peace of mind. They’re also more hygienic than soiled bedding and clothing, which caregivers often have to wash or dispose of.

Fortunately, the quality of incontinence products has significantly improved over the years, and you can now buy products online. If you find that the pad you buy isn’t right for you, don’t be put off. You can experiment until you find what works best for you or the person you’re caring for.

Stay with us for the final section of this article, as we’ll be suggesting a few incontinence pads that you may want to consider.

Where Can I Find Elderly Incontinence Products?

Prefer to browse a full range of incontinence products?

We have a dedicated page for incontinence support that you may wish to scroll through.

But if you’re looking for specific recommendations, we’ve got a few in store. 

Below are four popular pads for elderly incontinence management, starting with one designed for heavy-duty use:

Attends Supersorb Advanced with Dry-Lock

Key benefits:

• Protects your home and furniture from incontinence

• Great for beds, wheelchairs, couches, kitchen chairs, or anything else you might need to protect

• An absorbent core pulls moisture from the topsheet so it feels dry against the skin

• Ultra-breathable and clinically proven to reduce Stage 1 and 2 pressure ulcers

• Odor-blocking properties and air-permeable design

Prevail Belted Shields

Key benefits:

• Sturdy belt fastens the incontinence pad securely to the body

• Absorbent pads feature QUICKWICK with MaxSoft technology and MaxSorb Gel, which pull the moisture down into the absorbent core, so you feel dry and comfortable

• Clothlike backing is silent and discreet, allowing air to pass through the product for maximum skin protection 

• Can be worn alone or in your favorite underwear

• Each pack contains one reusable strap, providing advanced protection and eliminating unnecessary waste 

Tranquility TopLiner Contour Booster Pads

Key benefits:

• Hourglass shape is contoured to fit larger bodies, and can accommodate both urine and bowel incontinence

• Can be placed on the inside of another product like protective underwear or adult diapers to add an extra layer of security and protection

• Comfortable and absorbent

Abena Abri-San Special Pads

Key benefits:

• Comes in a 15 x 29 inch pad and will fill to capacity at 68 fl oz / 8.5 cups (for reference, the average adult releases 8-12 fl ounces / 1-1½ cups when they “go”)

• Specifically designed with an innovative core to contain bowel incontinence and light urine incontinence 

• Fully breathable backsheet allows the skin to breathe for better skin health 

• TopDry layer quickly draws in leaks and locks them under to keep the skin feeling dry to the touch 

• Odor guard blocks unpleasant odors 

• Wetness indicator helps determine when it’s time for a change, saving time and money with unnecessary changes

Summary

Whew, we made it…

Learning about incontinence wasn’t so bad, was it? 

Here’s what we’ve managed to cover in our five-step guide:

• What causes elderly incontinence?

• Types of urinary incontinence 

• Types of bowel incontinence 

• Incontinence care & management

• Elderly incontinence products & pads

Experiencing (or caring for someone with) incontinence can be isolating, but please remember that you’re not alone.

Our team at Carewell is standing by if you ever need advice or support.

Call us at (800) 696-CARE

Or send an email to support@carewell.com

Thanks for reading and speak soon 🙂

See where you can find the best diapers & diaper alternatives for men.