Handling Incontinence

One of the more challenging aspects of being a caregiver is learning to deal with your loved one’s incontinence. While incontinence can create embarrassing situations for both patient and caregiver, there are some things you can do to handle the situation with grace and allow your loved one some dignity.

First, it’s important to determine the cause of incontinence, whether it’s physical or rooted in a mental impairment. When incontinence first occurs, consult your physician. Causes for incontinence include infection, constipation, medication, prostate enlargement and hormonal changes. If incontinence is caused by something physical, it can often be treated.

Incontinence is also caused by dementia stemming from illnesses such as Alzheimer’s disease, the result of the brain not sending the message that your loved one has to go to the bathroom. Bodily sensations decrease and they may not realize they need to go, or they may have forgotten how to respond to such feelings. In this case, learning to manage incontinence is the best course of action. Caregivers may have trouble realizing that even the simplest things, the things that we do without thinking, will need to be addressed and considered for the incontinent loved one.

One of the things that makes incontinence difficult to deal with for the person affected is the loss of control of something we all take for granted, the ability to manage one’s bodily functions. Try to empathize with how difficult it is for your loved one to suddenly need help with something so personal.

For the caregiver, other issues are involved. Dealing with a loved one’s incontinence can be especially difficult for the grown child of an ailing mother or father. This role reversal can be traumatic. The important thing is to learn ways to deal with incontinence on a daily basis. There are things a caregiver can do to manage incontinence effectively and efficiently.

Bathroom 101

Make the necessary changes to create a safe and manageable environment. Make sure the bathroom is well lit. Some patients have a hard time recognizing the toilet, so make sure it stands out. If the bathroom is nicely decorated in the same color, the toilet could get lost in the mix. Try using a brightly colored toilet seat so it’s easy to find. A raised toilet seat might help, as well as grab bars so your loved one has an easier time getting up and down. If the bathroom isn’t close enough, try using a portable toilet near the bed. Most importantly, do what you can to help, but be sure to respect privacy as much as possible. Freely giving that respect can restore some dignity to your loved one.

Clothes Call

Re-examine your loved one’s wardrobe. Turn this change into a happy experience by focusing on the idea of getting brand new clothes. Avoid tight-fitting, complicated clothing that could be difficult to get in and out of.  Opt for loose fitting garments with elastic waists and Velcro closures instead of buttons and zippers.

Whenever your loved one does have an accident, change clothes as soon as possible. Protective undergarments can also help. Some patients want to avoid these because it makes their situation too real for them and escalates feelings of helplessness. Try to find protective undergarments that look as much like regular underwear as possible. Don’t call attention to the fact that these are “special.” Your loved one will be much more likely to accept this change if you don’t call attention to it or make a big production out of it.

Dietary Detecting

Look at your loved one’s diet. There are certain foods that exacerbate incontinence. These include alcohol, carbonated drinks, milk, citrus, tomatoes, chocolate, spicy foods and caffeine. Limiting these foods can help curtail episodes. Also, try keeping a food diary to monitor what other kinds of food triggers incontinence.

Avoiding Skin Problems

It’s very important to keep your loved one’s skin clean, especially after an accident. Stray waste matter can cause irritation and can result in rashes. Clean the skin thoroughly with a gentle, fragrance free cleanser or cream your doctor recommends. You can follow-up with baby powder to keep the area dry.

Keep a Positive Attitude

As with most things in the patient/caregiver relationship, communication is key. Remember that your loved one may have to be reminded to do what most of us do without thinking. Use simple language they can easily understand. Be gentle and non-judgmental, but not patronizing. Be up front about why you are doing what you are doing, but keep a positive attitude.

• Set a regular schedule to use the bathroom. Frequent and planned visits to the bathroom, usually every two to three hours, will help your loved one avoid soiling themselves and can assist with bladder retraining.
• Place a small rug in front of the toilet so that if your loved one slips, he or she doesn’t fall.
• If your loved one is living with incontinence due to a memory disorder, try replacing regular underwear in his or her dresser with protective pull-up underwear. It will lessen confusion and help make the adjustment to the protective undergarments easier.