Home Care

When Nature Calls…

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Charles Hitztaler RN, BSN CMSRN

                Incontinence is a major problem facing the elderly today with recent CDC data suggesting about half of all elderly people suffer from this. Despite its prevalence many older individuals do not seek treatment or assistance. Urinary incontinence is not a normal part of aging and is often the result of an underlying problem. There are 4 basic forms of incontinence: Stress, urge, overflow, and functional. Knowing which form of incontinence you have can help you understand what may be needed to care for it.

Stress Incontinence

When pressure is placed on the bladder urine can leak out. This pressure is often the result of coughing, laughing, sneezing, or exercise and activity. Since this is the most common form of incontinence, especially among younger women most people are familiar with it. There are several risk factors that can increase your risk for stress incontinence.

  • Age – Bladder muscles can weaken with increased age contributing to leakage.
  • Weight – Being overweight provides added stress on the abdominal and pelvic organs which can then place added pressure on the bladder.
  • Pregnancy – the act of pushing during pregnancy or the type of delivery can increase your risk for stress incontinence
  • Surgery – prostate surgery for men or pelvic surgery for women can alter support for the bladder

Urge Incontinence

                Sometimes people have a sudden urge or need to go to the bathroom and are unable to get to the toilet in time. This is urge incontinence and can be more common for certain neurological conditions such as MS or Alzheimer’s that may alter an individual’s ability to feel the urge to urinate and diabetes which can increase your need to urinate.

Overflow Incontinence

When your bladder is full small amounts of urine can leak out if the bladder is unable to empty completely. This is overflow incontinence and is often caused by the obstructed flow of urine. Enlarged prostates in men are one of the prime contributors to this along with weakened bladder muscles or an object such as a stone obstructing urine flow. An overfull bladder can also contribute to an increased risk for stones or infections.

Functional Incontinence

If the bladder is functioning normally, but the person is not able to physically make it to the toilet in time you have functional incontinence. Disability is the prime contributor to this with arthritis and other conditions making toileting difficult. Assistance from another person can be very helpful for this incontinence.


Kegel exercises: Helps to strengthen the muscles of the bladder wall. These can be performed by simply stopping the flow of urine midstream. You can either increase the amount of time you hold the contraction or increase the number of repetitions holding each contraction for 3-5 seconds improving to 10 repetitions three or more times a day.

Toileting Schedule: Maintaining a schedule of regular toileting and increasing the time between toileting can help train the bladder. Depending on the level of incontinence you can increase from 15 minute increments or one hour increments striving for longer times between toileting.

Lifestyle Changes: Changing your diet, increasing exercise, and losing weight can help decrease incontinence.

Medical devices and medications: Depending on your condition many medicines may help you by either treating the disease contributing to incontinence or by acting on the bladder muscles themselves.

Home Care and Incontinence

                For many of the different forms of incontinence an in home caregiver can be very beneficial. Caregivers can assist to get someone to the toilet faster to decrease functional and urge incontinence. Our nursing supervisors can assist in creating an individualized bladder training program for both toileting frequency and assistance with exercises to strengthen the bladder wall. We can help to improve socialization by providing transportation services and an extra pair of hands to assist in toileting or toileting hygiene. Click on the icon below if you are in Washington State and in need of home care assistance. Of course, you should always consult with your healthcare provider about incontinence and what treatments may be available to assist you. Please comment and let us know if this information was helpful for you.

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