Are you making these common mistakes in managing incontinence? Sonya Meyer shares tips for better care
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Incontinence is a common and often undiscussed issue affecting elderly Australians, with as many as 1 in 4 people over the age of 85 experiencing severe incontinence.
In this Healthcare Channel interview with Sonya Meyer, National Clinical Educator at ConfidenceClub, we talked all about incontinence and its common misconceptions, the emotional impact on individuals and how healthcare professionals and caregivers can better support those with the condition.
Prevalence of Incontinence among the Elderly in Australia
According to the Australian Bureau of Statistics Survey of Disability, Ageing and Carers, as of 2009, 1 in every 14 people over 65 (7.2%) and 1 out of 4 people over 85 (24.5%) experienced severe incontinence. The prevalence of incontinence among the elderly population is due to many reasons, including the bladder no longer holding as much urine. Sonya listed the other reasons as follows:
- A reduction in the anti-diuretic hormone being produced
- A reduction in muscle tone
- Enlarged prostate gland
- Reduced fluid intake
- Some side effects from medication
- Prolonged sitting, especially in women
- Mobility restrictions
- Poor dexterity
- Co-morbidities like dementia
Common Misconceptions and How to Address Them
Misconceptions about incontinence can be harmful and can prevent individuals from seeking appropriate treatment. Sonya addresses some of the most common misconceptions:
“Incontinence is a normal part of ageing”: Although incontinence is common in the elderly population, it should not be automatically considered ‘normal.’ It’s often cases of incontinence that go untreated or mistreated, so there is definitely an opportunity to better manage it. In fact, 75% of incontinence cases can be cured or better managed.
“I had big babies naturally, so it’s normal”: This idea isn’t entirely accurate. While having a growing baby resting on our pelvic floor can lead to stretching and a compromised pelvic floor, which in turn can lead to incontinence, a pelvic floor training regime can help strengthen the pelvic muscles, which can help the person regain their bladder/bowel control. It’s also important to note that it is possible for vaginal delivery to cause damage to the pelvic floor, and while it’s less likely for those who have a c-section, it doesn’t mean postpartum incontinence isn’t a possibility.
“There is nothing I can do about being incontinent”: There are many treatments for incontinence, depending on what type of incontinence you have. In all instances, pelvic floor training or physio is the starting point. You should always seek the advice of a continence nurse or continence physiotherapist to get an initial diagnosis; they can then follow up with a treatment plan. The best-case scenario is that you will regain control of your incontinence. And don’t worry, the worst case really isn’t the worst. You might still experience incontinence, BUT you can manage it much better, which means an improved quality of life.
“A menstrual pad will work fine”: A menstrual pad is designed for a slow flow, thick velocity, and small amounts of loss. They do not manage the faster, larger volume of urine that someone passes when incontinent. Incontinent pads have less fluff (think cotton wool) and more super-absorbent polymers, which capture and lock urine away in the pad, not allowing it to resurface next to the skin – unlike menstrual pads. This can cause some nasty skin irritation and overall discomfort.
Emotional Impact and Coping Strategies
Incontinence at any age can have a significant impact emotionally on people. Many people isolate themselves, even from family, due to fear of leakage and odour.
“Often they feel ashamed and confused. They feel they have no one to talk to and as they feel this is a ‘normal part of ageing’ and don’t ever seek professional help.
“The best way to overcome this is to start the conversation. Talking with one trusted individual starts to make it feel easier,” Sonya stated.
Better Addressing and Supporting Patients with Incontinence
Healthcare professionals need to maintain privacy and dignity and eliminate the practice of padding for the “just-in-case” moment, which can lead to growing numbers of incontinent individuals.
Sonya said this can lead to growing numbers of incontinent individuals because they stop listening to their body’s signals to use the bathroom if they’re still mobile.
Healthcare professionals need to ensure appropriate referrals are given to specialists in the field and education on causative factors and support both physically and emotionally. There also needs to be thorough continence assessments to ensure individuals are wearing the most appropriate products for their specific needs.
Practical Tips for Caregivers of Individuals with Incontinence
The skin of an incontinent individual is always considered “at-risk skin.”
Caregivers of individuals with incontinence must be mindful of their hygiene and prevent skin irritation. Incontinence-associated dermatitis (IAD) is a common skin problem that can lead to bedsores and fatalities. Practising good hygiene and using skin-friendly, absorbent products can help prevent skin problems. Caregivers should also ensure that individuals wear the most appropriate products, and continence assessments should be performed regularly.
Incontinence is a common issue affecting elderly Australians, but it can be better managed with appropriate products, education, and support from healthcare professionals and caregivers. By starting the conversation and addressing common misconceptions, we can improve the quality of life for those living with incontinence.
For an individual struggling with their incontinence, Sonya shared some tips to regain dignity and independence in their life.
Start by working on being ‘socially continent’.
“No one around you knows you’re incontinent unless you want to tell them, so there’s no use carrying around the shame of what other people might think when they don’t know.”
“Make sure you try any new continence management products at home for several days to ensure they will work for you once you’re out and about.”
There is so much more to life than incontinence; don’t let it stop you from doing things you love.
If ever you are feeling down and lost, just remember these high-profile people who have or used to live with incontinence: Kris Jenner, Stephen King, Katy Perr, Helena Bonham Carter, Tony Romo and Whoopi Goldberg, among others.
“These people get on and live full lives. It’s all in the mindset,” Sonya said.
Ritchelle is a Content Producer for Healthcare Channel, Australia’s premier resource of information for healthcare.
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