When a patient suddenly has urinary incontinence (UI), it usually is a symptom of an underlying disease.^[i] In older people, urinary incontinence may occur due to urinary tract infections, advanced dementia, severe damage to the central nervous system, prostatectomy, and many more. Therefore, it is important to know and understand what causes it and how to address it properly. If the underlying disease is irreversible, it is crucial to treat the patient’s incontinence in order to try to mitigate health complications.

Read on to learn everything you need to know about incontinence care for the elderly, from creating a care plan, assessment, interventions, to our recommended coping strategies. 

Elderly Care for Patients with Incontinence 

Based on research, 50.4% of 65-year-old adults with incontinence are independent at home. The other 41.5% are being looked after at home while 8.1% are dependent on caregivers in nursing facilities.^[ii] 

Total loss of bladder control and immobility are the most common reasons for admitting a senior to an institution. Approximately 50% of nursing home residents experience urinary incontinence, and some are already incontinent on admission while others develop it post-admission.^[iii] 

For this reason, it is important to perform a proper medical evaluation of the elderly patient. Specialists should also perform close monitoring and review incontinence care approaches to manage the condition effectively or restore the normal urinary process.  

Development of Incontinence Care Plan  

As someone who will provide elderly care, it is crucial to take an active part in the development of the patient’s incontinence care plan, whether they are independent at home or dependent on a nurse in an Care Home. There should be a discussion between the facility and the resident’s family about the diagnosis, treatment options, expectations, and effects of rejecting treatment.^{[iv] This way, you and the patient can make an informed decision.} 

Assessment: Types of Urinary Incontinence 

Identifying the type of incontinence is a step in providing a patient with a proper assessment, appropriate interventions, and management of urinary incontinence in the elderly.^[v]  

• Overactive Bladder may be caused by ageing or neurological diseases such as multiple sclerosis, stroke, bladder infection or diabetes. Patients can feel the urge to pass urine frequently but is unable to hold it in long enough to reach the bathroom. 

• Stress Incontinence occurs when there’s added stress on the bladder. Patients may leak a few drops of urine while laughing, sneezing, lifting, coughing, or walking.  

• Mixed Incontinence is the combination of stress incontinence and overactive bladder. 

• Overflow Incontinence happens when a patient’s bladder never empties completely, as urine cannot flow out of the bladder due to a blockage. The bladder either doesn’t have the ability to contract at all or has very weak contractions. Thus, the patients always feel that their bladder is full and often leak a few drops unknowingly.  

• Functional Incontinence may be caused by neurological disorders, stroke, or severe spine problems. When the patients feel the need to urinate, they often can’t go to the bathroom by themselves.  

• Transient Incontinence may be related to poor mobility, physical weakness, neurological disorders, infections, impediments in the location (e.g., poor lighting, far location of the bathroom, or physical restraints), and numerous medications.^[vi] 

Interventions for Incontinence in Elderly Patients 

Medication therapy and behavioural programs are the most common options for keeping urinary incontinence under control.^{[vii] Behavioural programs involve} bladder retraining, pelvic floor muscle exercises, and timed voiding. Other interventions include medical devices (e.g., pessaries), intermittent catheterisation every 3 to 6 hours for emptying the bladder, and use of incontinence pads and garments. 

Ensure that you prevent complications the best you can, as UI can lead to embarrassment, discomfort and physical problems. For example, seniors can contract skin problems from getting their skin wet day and night.^[viii] Regular use of a catheter increases the likelihood of developing bacterial infections like UTI.^[ix] Lastly, deterioration of the pelvic floor muscles can cause prolapse of the uterus, increasing the risk of overflow incontinence.^[x] 

How to Properly Care for Elderly Patients with Incontinence 

Urinary incontinence in elderly people is a symptom of an underlying disease. Because diseases may get worse over time, so does incontinence. Therefore, proper assessment and appropriate interventions are critical to helping elderly patients restore their normal urinary function while reducing health complications. Additionally, perform close monitoring to see any signs of improvement and address any problem that arises. 

When caring for someone with incontinence, you should get involved in making care decisions and following the recommended care process to help restore the normal bladder function of the patient while keeping complications low.  

Click here to read more advice on incontinence care for elderly at home and caregiving facilities.   

^{[i] What is Urinary Incontinence?} 

^{[ii] How Big is the Problem? Incontinence in Numbers} 

^{[iii] Urinary and Faecal Incontinence in Nursing Home Residents} 

^{[iv] Management of Urinary Incontinence in the Community} 

^{[v] Incontinence: Tips for Carers} 

^{[vi] What Causes Transient Incontinence?} 

^{[vii] Incontinence Management for Nursing Homes} 

^{[viii] Skin Problems that are Caused by Incontinence} 

^{[ix] Catheter-Associated Urinary Tract Infections} 

^{[x] Incontinence and Voiding Difficulties Associated with Prolapse}