Entering old age, various systems in the body naturally deteriorate. This can lead to various abnormal conditions, one of which is a decrease in bladder performance. For those caring for the elderly, it is important to understand the condition and know how to give them care.
What is urinary incontinence?
We usually want to go to the bathroom when our bladder is about half full of urine and not yet at the point that makes us want to go right away. We are able to tolerate the pressure when we can’t get to a bathroom yet. On the other hand, those with bladder dysfunction want to urinate every hour or so even through the night. As such, they don’t sleep well. This is because, even though it isn’t full, they feel their bladder squeezing. Even when the build-up of urine isn’t much, those who have symptoms can’t tolerate the pressure and can’t prevent the urine coming out, so they wet themselves.
The condition is caused by a deterioration in the strength of the pelvic floor muscles as well as sexual factors. For example, older men may develop an enlarged prostate which makes them urinate more often. Older women may experience frequent urination during menopause as their body produces less estrogen. The condition can also be a side effect of certain medications and diseases such as diabetes and bladder cancer, among others. If an elderly person experiences frequent urinary incontinence or they must get up and go to the bathroom often at night, they may have urinary incontinence. They should see a doctor for a diagnosis and seek advice for further treatment.
Types of urinary incontinence
There are many symptoms of urinary incontinence which may occur simultaneously. These symptoms can be divided into four types as follows:
1. Functional Incontinence is a pain in the urinary tract that the elderly person can’t tolerate due to certain physical conditions or external factors. This makes the elderly unable to get to the bathroom in time. Such elderly persons may have arthritis symptoms that make it impossible to take down their pants in time. There are also those who have limited mobility, making it impossible to walk to the bathroom in time as well as resulting in bedwetting at night.
2. Stress Incontinence is a condition where the patient experiences urinary incontinence when they cough, sneeze, laugh or engage in physical activities. This is usually caused by weakening of the muscles in the pelvic floor and sphincter. Even if there isn’t much urine in the bladder, slight pressure on the abdomen is enough to cause a leak.
3. Urge Incontinence is a symptom of unconscious urination where the sensation of urinating is sudden and intense. This makes the elderly unable to hold urine or get to the bathroom in time. The condition is more common in patients with diseases such as diabetes, Alzheimer’s, and Parkinson's, and those with chronic prostate enlargement caused by a lot of residual water in the bladder that overflows.
4. Overflow Incontinence is a symptom of slight urinary incontinence due to incomplete urination. This may be the result of a narrowed urethra or an abnormality in the nerves that control urination. This symptom includes the feeling of having a full bladder all the time. It is more common in women who have problems with urethral cysts and men with enlarged prostates.
How to deal with urinary incontinence
1. Refrain from alcohol, coffee and drinks that have a diuretic effect.
2. Refrain from drinking water 2-4 hours before going to bed to avoid going to the bathroom at night.
3. Give the pelvic floor muscles a workout with Kegel Exercise which can restore the ability to control urination.
4. Clean the excretory organs thoroughly to prevent infection.
5. Keep an eye out for symptoms, keep a journal of the amount of water consumed each day, and adjust your behavior accordingly.
6. Consult a doctor to determine the exact cause of the symptoms for proper treatment.
Urinary incontinence is a problem that family members should pay attention to as it affects both the physical and mental health of the elderly. Understanding and knowing how to care for those with this condition will help the elderly in the family live more happily.
Krungthai-AXA life insurance customers can get a basic symptom check using the Symptom Checker in the Emma by AXA application. For more information, please visit https://www.krungthai-axa.co.th/th/emma-by-axa
· Bangkok Hospital
· Corporate Communication, Faculty of Medicine, Ramathibodi Hospital
· Samitivej Hospital