Understanding Overactive Bladder
“When you gotta go, you gotta go” has been an age old saying. These days, with our knowledge of medicine, we have developed medications and treatments for “the urge.”
Not all urges need to be treated with medication, but in some cases it helps. Behavioral training can benefit any individual who feels they are making too many trips to the bathroom.
DEFINING OVERACTIVE
Our bladders hold varying amounts of liquid at different times of the day, and depending on our age and muscle control, we may find that we may not make it in time to empty out what we’ve taken in. If frequency of urination is the issue, the first step is to determine if we are drinking more than our bladder can reasonably hold.
In Florida or any other state with a hot climate, drinking fluids is essential. As humans, we must stay hydrated so our body’s many systems work effectively. When the body puts out approximately the same amount of fluid being taken in, we have a normal balance.
When a loved one’s system is compromised by various illnesses, fluid balance takes on an additional meaning. The elderly patient who retains fluid and musttake diuretics will naturally make more trips to the bathroom. Diabetics may drink more water than their counterparts of the same age group who do not have a blood sugar disorder.
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Likewise, certain drinks will create a need for a visit to the restroom sooner. Caffeinated drinks, even those with low caffeine content, will “open up” the kidneys. Many soft drinks contain caffeine in various amounts, and even some brands of bottled water are caffeinated. Label reading is important, and so is portion control when a loved one insists on having a favorite soda.
Keeping a small log of which fluids, a ballpark amount, and number of trips to the bathroom within the one to two hours following consumption can help give caregivers a general idea of what is causing the perceived over-activity. It could be the caffeine, or the amount of liquid taken in. Sometimes people will sip at a drink for a much longer period than seems “normal”, and it can be stressful to monitor. Instead of hurrying up your loved one, note the time when the drink is finished, and go from there. If a trip to the restroom is in order before the last sip, take a general note of how much they’ve had, and compare it to the time since the last bathroom trip.
WHEN NOT TO FOLLOW THE URGE
At any age, we can condition ourselves and our bladders to be emptied frequently. While it’s a good idea to void the bladder often enough to prevent bladder irritation, having a loved one on an hourly schedule may increase urges. It can also condition both caregiver and loved one that any twinge is sufficient to visit the rest room.
When someone is memory impaired, just as a caregiver has worked to train the loved one to frequent bathroom visits by suggesting the bathroom (or going together), the reverse is true. Waiting five or even ten minutes longer before a bathroom trip may help with revising frequent urges.
TRACKING MEDICAL CAUSES
If functional abilities are compromised, such as in neurological disease, there may be nerve challenges affecting bladder control. Alzheimer’s patients may have trouble processing the need to go to the bathroom. Anyone can “train” themselves to create an overactive bladder, but it’s important for caregivers to note this. In the attempt to forestall “accidents”, caregivers may take their loved ones to the bathroom frequently.
This can contribute to the urge to urinate, and family members may become accustomed to visiting more often than needed.
Continence professionals and organizations like The National Association for Continence offer resources for individuals who want to know more about various types of incontinence. There are articles, media available for purchase, and free information on determining the actual problem. While the site is not intended to give medical advice, it serves as first steps toward identifying the problem, so medical staff can be informed.
DAYTIME OR NIGHTTIME
Waking more than twice in a night can fall under the umbrella of “urge incontinence.”
However, it should be noted the amount of fluid consumed before bed, as well as any during the night. Some loved ones may complain about getting up to go, but in between bathroom jaunts, they may be having a small glass before going back to bed.
Medications that have diuretic effects figure into fluid intake and output as well. Cutting off liquids after a certain time may work in some cases, but those with memory challenges may not understand. Even a lucid individual will rasp at being given a “last call” before bedtime.
Upbeat commercials aside, it is in the caregiver’s and loved one’s best interests to examine all the factors contributing to the overactive bladder. Before the doctor writes the prescription, offer all details on consuming liquids, current over-the-counter and prescribed medications (including home herbal remedies and/or caffeine intake) before trying the “magic bullet.”