Here's what you should know about urinary incontinence in older adults

Bladder control is a widespread issue among older adults. According to the National Association for Continence, 1 in 5 individuals older than 40 suffers from urinary continence.

Urinary incontinence isn’t just a physical condition. It can also affect a patient’s quality of life. It causes many older people to avoid activities, limit social interactions, become depressed and even struggle to get a good night’s sleep. There’s also the risk of falling in patients who try to make it to the bathroom in time.

A challenge for sufferers

Even though it’s common and can cause problems, patients find the subject difficult to bring up with their doctors. According to the Agency for Healthcare Research and Quality, more than 50 percent of women never get treatment for their stress incontinence.

Not only do patients find it embarrassing, they assume incontinence or leakage is a natural part of the aging process. They may not realize it’s a treatable condition.

Starting the discussion about urinary incontinence with patients may be what helps them understand they no longer have to live with it.

Forms of urinary incontinence

To help you discuss the topic with patients, here’s a refresher on the ways urinary incontinence can occur.

• Urge incontinence: The most common diagnosis, this involves an urgent need to urinate resulting in the loss of urine before one arrives to a toilet.
• Stress incontinence: This occurs when an increase in abdominal pressure overcomes the closing pressure of the bladder. Abdominal pressure rises when you cough, sneeze, laugh, climb stairs or lift objects.
• Overflow incontinence: Rarely diagnosed, this happens when one’s bladder never completely empties causing leakage when the bladder becomes overly full.
• Functional incontinence: This is a form of urinary incontinence in which a person is usually aware of the need to urinate but for one or more physical or mental reasons, the person is unable to get to the bathroom.
• Mixed incontinence: Sometimes patients experience more than one type of incontinence, and usually it’s a combination of stress and urge incontinence, especially for women.

Treatment options

After a diagnosis is made, available courses of treatment include:

• Behavioral therapy: Usually the first line of treatment is behavioral therapy, which will often help improve the incontinence. Treatments can include bladder training, scheduled bathroom trips, pelvic floor muscle exercises and fluid and diet management.
• Medications: These are frequently used in combination with behavioral therapies and include anticholinergic or antispasmodic drugs, topical hormonal therapy for females or antibiotics when incontinence is caused by a urinary tract infection or an inflamed prostate gland.
• Medical devices: Women can be prescribed devices such as urethral inserts, which are placed usually before activities related to urinary incontinence episodes, and pessaries or intra-vaginal devices, which are similar to diaphragms and support the bladder.

With your help, urinary incontinence doesn’t have to take over the lives of your patients. Start the discussion and tell them about the variety of treatments that can help them enjoy life without the worry of leakage.