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Incontinence: The Caregiver's Role /
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Incontinence: The Caregiver's Role
by Kevin McShane
Incontinence in children is called
"training". In adults, it's often called embarrassing.
Without understanding the problem, people may jump to
the conclusion that their loved one is suddenly getting
too lazy or simply doesn't care. This is so rare, that
it should be the very last consideration when seeking a
cause. Although incontinence is usually not an
emergency, problems with incontinence should be reported
to the doctor. The gynecologist and the urologist are
the specialists who are most familiar with incontinence
and can evaluate the causes and recommend several
There are a number of reasons your loved one may be
experiencing incontinence, thus, while it may not seem
like a medical emergency, it is wise to inform the
doctor when problems are noticed. The specialists more
familiar with incontinence are gynecologists and
urologists. Depending on the cause of the incontinence,
there are several recommended treatments. These should
be discussed in detail with the doctor. The following
possible causes are not arranged in order of likelihood
of occurrence. Such predictions are based on the
individual and aggravating or contributing factors.
Dementia, mental confusion or psychological factors.
Urinary tract or prostate enlargement or infection.
Side effects of medications.
Impaired nervous system.
Pelvic muscle weakness.
Nerve or muscle damage after pelvic radiation.
Developmental problems of the bladder.
Pelvic, prostate, or rectal surgery.
When you do speak with the doctor, give the doctor the
most appropriate and applicable information. Here is a
checklist of things the care recipient should share with
Describe your problem.
When does this occur?
How long has incontinence been a problem?
How much of a problem has this condition become?
How many times does this happen each day?
Are you aware
of the need to urinate before you leak?
Are you immediately aware that you have passed urine?
Are you wet most of the day?
Do you wear diapers in case of accidents? Occasionally?
All the time?
Do you avoid social situations in case of accidents?
History and factors
Do you have a urinary tract infection now? In the past?
Is it more difficult to control your urine when you
cough, sneeze, strain, laugh, run, jump or walk?
Is the incontinence worse when sitting up or standing?
Do you suffer from constipation?
Is there anything you can do to reduce or prevent
Have you ever been treated for this condition before?
Did it help?
Have you tried pelvic floor exercises (Kegel)? Did it
What surgeries have you had?
What injuries have you had?
What medications do you take?
Do you drink coffee? How much?
Do you drink alcohol? How much? How often?
Do you smoke? How much each day?
Expect and prepare your loved one for the likelihood of
a physical exam. For both men and women, expect an
abdominal, rectal and neurological exam. Additionally,
men are given a genital exam and women a pelvic exam.
The doctor will also run a number of diagnostic tests,
which will include urinalysis, cystoscopy (checking the
bladder) and procedures to check urinary functioning.
You should encourage your loved ones and/or clients to
avoid items that irritate the urethra or bladder. Check
with your doctor for more specific information. Some of
these items include liquids that tend to increase
urination (coffee, alcohol), diuretics (water pills),
some anti-spasmodic medications, antidepressants and
antihistamines, cough/cold medications (they should also
avoid coughing, so this may be a tricky one), ventolin (albuterol)
or other beta agonists.