In our last article, we talked about possible causes of incontinence in the elderly. For whatever reason, if protective undergarments are becoming part of daily life for your loved one, it’s time to schedule an appointment for them to see a health care professional. At the appointment, you can expect the following to take place:
- urinalysis, which will determine if there is blood or infection in the urine
- blood test, which will check kidney function, calcium and glucose levels
- discussion of medical history
- physical exam, including rectal/ pelvic/ urological exam.
It’s a good idea to start keeping a bladder diary before the appointment. Make a note of liquid intake, times of urination, how much urine is eliminated for each trip to the restroom, and description of any and all accidents. Make sure the health care provider reviews the diary at the appointment.
There are tests that can be ordered if your provider feels follow-up is needed to obtain a diagnosis. These include the following:
- Post-void residual: An ultrasound is performed after urination to see if any urine remains in the bladder.
- Urodynamic testing: A catheter fills the bladder with water and the test measure the pressure in the bladder when it is a rest, as it fills, and when it empties.
- Cystogram: dye is injected into the bladder through a catheter, and an x-ray is taken while the patient urinates.
- Cystoscopy: a small scope is inserted into the bladder. The doctor can check for bladder capacity, any tumors, stones, or possible cancer.
Once a diagnosis has been made by a qualified professional, there are many options for treatment and management.
Behavioral therapy is one treatment that often helps. This treatment includes bladder training, scheduled bathroom trips, pelvic floor muscle exercises, and fluid/diet management.
Medications can also be beneficial, especially in combination with behavioral therapies. These medications can and will vary, depending on the cause of the incontinence. Antispasmodic drugs, hormone replacement, antibiotics or even muscle relaxant can assist, depending on the cause.
It’s important to remember to keep up with stringent personal care while dealing with incontinence. Remember to use a mild soap for washing. Use a skin protectant such as cocoa butter or petroleum jelly, and remember to pat the skin completely dry after urinating. If your loved one is often rushing to the restroom, be alert to safety hazards as well.
Finally, it’s good to remember that incontinence in the elderly, though inconvenient and frustrating, is not the individual’s fault. Ensure your loved one that they can still keep their dignity while they deal with the situation, and that you view them as important and valuable, in spite of their difficulties.