The Inconvenience of Incontinence

We now know that there are many other contributing factors that can lead to incontinence. Examples are: poor body mechanics during lifting, urinary tract infections, obesity, side effects from medication (such as diuretics, sedatives and alcohol, pain relievers, antihistamines, and cold medicines), nerve/muscle damage, physical and emotional stress, medical conditions such as diabetes, Parkinson’s disease, Alzheimer’s disease, multiple sclerosis, loss of muscle control from prostate surgery or a hysterectomy, repeated catheterizations and prolonged states of immobility (especially among patients who are bedridden or have extended hospitalizations).

One of the most important roles of a caregiver is to take the lead in addressing the problem and advocate not only for their loved one but also for themselves. Since incontinence is not an inevitable part of aging, the inability to control urination should always be brought to the attention of the physician. Caregivers can help in ensuring their loved one is able to communicate with the doctor and partake in a joint treatment plan that benefits both parties. Urinary-control problems must be assessed in the context of a complete medical history and physical exam from a physician. This thorough medical evaluation can identify the type of incontinence that one faces. A urologist or gynecologist may also be consulted for diagnoses and treatment options. A variety of treatment choices are now available to manage bladder health; however, choosing the right treatment plan is the key for both the caregiver and the care receiver.

The following effective approaches have been identified:

Medications (however, not all bladder leakage issues require medication to correct)
Exercises (such as Kegel’s) to strengthen the pelvic muscles around the bladder
Relaxation/breathing techniques
Lifestyle changes
Physical therapy including biofeedback and muscle stimulation
Behavior changes such as keeping a bladder diary and monitoring diet and fluid intake. 
Medical interventions (surgery, implants and catheterization)

Robert has been caring for his wife for four years following a series of chronic health events. In the past year, his wife’s incontinence has become of increasing concern to both of them. Robert knows the problem is affecting more areas of their lives including their social life and sleep patterns. He is also concerned about skin infections and his ability to properly bathe his wife. Robert has become weary and is finding it progressively more difficult to manage his wife’s care. He consulted a physician and together they were referred to a physical therapist for an evaluation.

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