Why Might a Person Become Incontinent

Written by Active Minds on Thursday the 27th of September 2018.

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As we get older, many of us may start to experience a variety of symptoms associated with older age, with one of the most common (and often least discussed) symptoms being incontinence. In fact, incontinence is so common the NHS estimates that around 3 to 6 million people in the UK have some degree of urinary incontinence, and 1.4% of over 40s are affected by faecal constipation.

In this blog, we look at what causes incontinence, especially when related to people living with dementia, and what help and support is available.

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What Is Incontinence?

Incontinence is divided into two categories, urinary incontinence and faecal incontinence.

Urinary Incontinence:

Urinary incontinence can range from fairly mild, occasional leaks to complete loss of bladder control. For example, stress incontinence is mainly experienced by women, and is caused by coughing, sneezing or laughing, resulting in a small leak of urine. The most common form of incontinence in people living with dementia is an overactive bladder, which gives people the feeling of suddenly and desperately needing the toilet, as well as frequent urination.

Faecal Incontinence:

Again, the severity of this type of incontinence ranges from small amounts of faeces being passed when a person breaks wind, to total loss of bowel control. Faecal incontinence is less common than urinary incontinence and affects both men and women equally.

Reasons a Person Might Develop Incontinence?

Whilst a person can develop incontinence at any age, older people generally have a high risk.

Constipation – Severe constipation can affect how a person holds and empties their bladder, making it more uncomfortable and difficult. It can also cause faecal incontinence as liquid faeces flows around the hard, impacted stool.

Urinary Tract Infection (UTI) – UTI’s are caused by bacteria getting into the urethra, causing issues in the bladder and kidneys. Apart from pain when passing urine, frequent and sudden urges to urinate and a fever, incontinence can also be another side effect of an UTI. Luckily, UTIs can generally be treated with antibiotics, thus eliminating the incontinence issue.

Prostate Gland Problems – This treatable condition affects men, and can cause incontinence.

Medication Side Effects – Some medicines can cause incontinence. If you believe this has happened, then speak to your GP about changing the medication or altering the dose.

Gut Conditions – Some gut conditions can cause incontinence, with the most common being irritable bowel syndrome.

Incontinence and Dementia

Whilst people with dementia may experience incontinence due to any of the issues above, there are other dementia-related causes that may mean a person is more likely to have accidents or issues using the toilet. These can include:

  • Not being able to tell someone their need to use the toilet due to issues communicating.
  • Unable to react quickly enough when they feel the sensation of needing to use the toilet.
  • Struggling to reach the toilet in time, perhaps due to mobility issues.
  • Difficulty finding, using or recognising the toilet. They may also become confused and urinate in the wrong place.
  • Depression or lack of motivation, often common in dementia, can mean that they fail to make any attempt to find the toilet.
  • Refusing help using the toilet due to embarrassment or failure to understand the help on offer.
  • Forgetting how to perform basic actions such as using the toilet or undoing clothes to use the toilet.
  • Not recognising the feeling of a full bladder and bowel – this often develops as the messages between the brain, bowel and bladder don’t work properly.

Help with Incontinence

Whilst many of us consider incontinence an embarrassing issue, and one we’d rather not talk about, there are a number of continence aids and support sources available.

First port of call should be your GP, who will undertake an investigation and see if they can help resolve the issue. If the problem persists then your GP may refer you to a continence advisor who will undertake a thorough assessment and help create a continence care plan, as well as referring you to further professionals to help. These professionals include community nurses, occupational therapists, physiotherapists and community mental health teams as well as Admiral nurses (if the issues might be associated with dementia).

Apart from professional support, there are also continence aids that will may help you feel more comfortable and protect your clothing, bedding and furniture.

  • Absorbent bed pad – These are either disposable or washable, providing a dry surface to lie or sit on.
  • Incontinence pads and pants – Can be worn either day or night, or both, and help protect your skin from any urine leak.
  • Male continence sheath – A silicone condom which is attached to a bag in the leg, draining the urine.
  • Waterproof mattress protector – Slipped underneath the bed sheet, this acts as protection for your mattress and can be re-used, once washed.

If a loved one is experiencing problems with incontinence, offer them support and comfort, never admonish them for their accidents. Once you have helped them to get changed,  carry on as normal, and maybe try to distract them with an activity, perhaps some dementia sensory activities or a puzzle for Alzheimer’s patients. Ensure they know that they are not in trouble, accidents happen, and you will support and care for them no matter what.