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Reducing Incontinence

helping aging parents - Reducing Incontinence

Methods of Reducing Incontinence Accidents

If you have been caring for an incontinent adult, you probably have experienced the frustration, inconvenience and even embarrassment of incontinence for both yourself and the incontinent patient.  Handling toileting and accidents can take over a caregiver’s life and make every day a difficult day.  Here are three methods of reducing incontinence which may help make a difference in your home.

 

Scheduled Toileting

The purpose of scheduled toileting is to develop a habit of consistent independent toileting to prevent accidents and urinary infections. Patients are expected to go to the toilet every two to four hours or at times related to the daily schedule, such as at rising, after meals, before napping, and at bedtime.  A record can be kept of successful voiding and of wetness of underwear. Caregivers can be helpful in establishing a schedule, monitoring the patient’s compliance, and encouraging efforts to avoid accidents.  With a patient who has cognitive and physical disabilities, the caregiver may bear the main responsibility for compliance with the schedule.  Eventually, following a schedule becomes a habit and will help in reducing incontinence.

Prompted Voiding

This method would work best for caregivers who are present with patients throughout most of the day.  It even works for patients who are limited cognitively and in communication ability. The purpose is to increase the patient’s recognition of their need to go to the toilet and to request help if needed from a caregiver to do so.  Every two hours, the caregiver simply asks if the patient needs to go or has already wet their pad/pants.  The caregiver asks the patient to go to the toilet, whether or not they have any recognition of a need or have wet their underwear already. The caregiver praises the patient for changing wet underwear soon or for keeping the underwear dry.   The caregiver might keep a record of the schedule, the patient’s communication of the need, and the successful avoidance of accidents.  The caregiver encourages interaction with the patient about efforts to go to the toilet in time and at regular intervals.

Bladder Retraining to Increase Control

The purpose of bladder retraining is to enable the patient to extend the time between bathroom visits, have more control over the urge to go, and hold more liquid in one’s bladder.  Bladder retraining can take six to twelve weeks to be successful.  It is particularly helpful to patients who have overactive bladder and urge incontinence.  Your family doctor can help you and the patient carry out a bladder retraining program by providing a written record.  To determine a baseline, begin keeping a diary by recording when the patient goes to the restroom and the time of accidents.   The patient will gradually extend the time between toilet visits, For example, if the patient is going to the bathroom every hour, try to schedule bathroom visits at every one hour, 15 minutes.  The patient will use the bathroom at each scheduled visit, regardless of whether there is actually an urge to go. Gradually increase the amount of time between bathroom breaks during the day.  When the patient feels the urge to urinate before the next designated time, the patient should use deep breathing or  sit down until the sensation passes.     A physician can assist you in the details of conducting a bladder retraining program.

Incontinence can be treated.   Ruling out conditions which cause incontinence, such as   an enlarged prostate in men or a prolapsed bladder in women, which can be treated with surgical intervention, is important.   For some conditions, a doctor can suggest exercises, suggest lifestyle changes, and prescribe drugs to help in reducing incontinence.

How toileting accidents are handled at home influences the attitudes of both patient and caregiver.  Making a positive change can  improve the atmosphere of your home life.

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