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Thanks to TV commercials, incontinence, or loss of urine
control, is no longer as hush-hush a topic as it once was.
However, it remains a costly and long-neglected health care
problem.
Incontinence affects more than half of the elderly in long-term care, about one-third of hospitalized elderly, and up to 30 percent of Americans over the age of 60 living at home. Yet less than half of those affected see a physician about their
condition.
Incontinence can range from the discomfort of slight losses
of urine to the disability and shame of severe, frequent wetting.
For many people, losing control of one's own body is among the
worst things they can imagine happening. In part, this is because
of the images people have of those who are incontinent and the
feelings incontinent people have about themselves.
Due to fear of embarrassment, people who lose bladder
control often restrict outings and social activities because they
are afraid of "having an accident." Even short trips to the
grocery store may be planned around the availability of a toilet.
A vicious cycle can develop. Incontinence can lead to
isolation and inactivity, which can lead to depression, which can
increase isolation. The irony of the cycle is that 80 percent of
incontinence cases are treatable and can be improved or managed.
Incontinence is not an inevitable result of aging and it is
not a disease. There are three common types of incontinence, each
with different causes. Talk to your health care provider to
determine the type, cause and appropriate treatment.
Urge incontinence refers to the inability to hold urine long
enough to reach a toilet. It is the most common type. It can
occur in normal elderly people, but may also be caused by
infection, disease, stroke or dementia.
Stress incontinence is the leakage of small amounts of urine
when pressure on the bladder is increased by coughing, sneezing,
laughing, exercising or lifting. It occurs most often in women
and can occur at any age.
Overflow incontinence is the leakage of small amounts of
urine from a constantly filled bladder. A common cause in older
men is blockage of urine outflow from the bladder by an enlarged
prostate gland.
Treatment must be tailored to each person's needs. Options
include medications, behavioral management, exercises, surgery,
prosthetic devices or catheterization.
There also is specially designed, absorbent under-clothing
available. Many of these garments are no more bulky than normal
underwear. One source estimates that one fourth of the sanitary
pads sold are for incontinence.
Eight steps can help prevent incontinence:
- Urinate whenever the urge arises; never ignore it.
- Drink at least six 8-ounce glasses of water daily.
- Eliminate or reduce beverages that have a diuretic
effect, such as coffee, tea, cola and alcohol.
- Drink cranberry juice or take Vitamin C to help maintain
the acid nature of urine. Because bacteria thrive in alkaline
urine, this helps lower the chance of bladder infections.
- Take diuretic medications in the morning.
- Limit use of sleeping medications, sedatives and alcohol.
They decrease the feeling of needing to urinate and can increase
incontinence, especially at night.
- Do Kegel exercises to strengthen the pelvic muscles and
bladder sphincter. A specialist in urology will have information
on these exercises.
- Lose weight if you are overweight.
For more information, contact your local
Colorado State University Extension office.
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