CPNC Home Care Blog

Management of Stress Urinary Incontinence in the Elderly

October 21st, 2013


Management of Stress Urinary Incontinence in the Elderly

Exact numbers are hard to pin down, as people are reluctant to report incontinence, but it can become more prevalent with age. It’s estimated that 25 million American adults have incontinence issues. Many of those people are 60 or older. Incontinence is usually a symptom of another condition.

Stress urinary incontinence refers to a loss of bladder control during physical activities or coughing.

Women are twice as likely to suffer from incontinence. Incontinence may also become an issue with people in late stages of dementia.

Incontinence is a very personal issue and can have major effects on a person’s self-esteem, sense of independence and privacy. Some people’s incontinence issues become so serious, they end up confined to their homes or an assisted living facility. Caregivers can play a major role in helping people deal with their incontinence issues.

The Delicate Act of Addressing Incontinence

A conversation about incontinence can be embarrassing and unpleasant for both parties. The caregiver sometimes has to shoulder the responsibility of dealing with an accident without causing the person any shame. It’s important to remember that there are treatments available and a variety of things that can be done to manage the problem and reduce the embarrassment and stress that can be involved. Caregivers can alleviate these issues by trying the following:

  • Avoid getting mad.
  • Infuse humor into certain situations.
  • Help the person overcome embarrassment by acknowledging that it happened without any judgment.

Treatment of incontinence depends on how severe the symptoms are. Treating it may range from easy solutions such as behavior changes and exercising, to medication or even surgery

Behavioral Changes

A caregiver can help by reinforcing behaviors that may reduce accidents or reducing habits that may impair the bladder’s function, like:

  • Drinking less fluids, especially before bedtime
  • Encouraging more frequent bathroom trips
  • Avoiding actions like running and jumping that may promote leakage
  • Quitting smoking to reduce coughing
  • Losing weight
  • Controlling blood sugar in patients with diabetes
  • Avoiding bladder-irritating foods like citrus, carbonated drinks or spicy foods

Caregivers may also want to help the person manage their accidents by being proactive. This may involve:

  • Regularly reminding the person to go to the bathroom
  • Looking for signs that they may be about to go
  • Providing waterproof clothing or adult incontinence pads and undergarments

Retraining the bladder may be another solution. It’s the process of going to the bathroom at intervals whether a person feels the urge to go or not. Bladder retraining also involves pelvic floor exercises that may strengthen the muscles.

Bladder Strengthening Exercises

Pelvic floor exercises may be an effective way to treat stress urinary incontinence. Women must identify these muscles by figuring out which ones can stop the flow of urine without using their abdomen, leg or buttocks muscles.

Kegel exercises strengthen pelvic muscles and may control urine leakage problems. These can be performed anywhere by contracting those pelvic muscles and holding them for a count of 10, releasing and then repeating.

Doing these exercises three times a day will hopefully help strengthen the muscles. One good tip is to try Kegel exercises while lying down.

Another pelvic exercise involves a cone that is inserted in the vagina. It involves squeezing the pelvic muscles to hold the cone in place for 15 minutes at a time. Experts say many women experience improvement to their symptoms after doing this twice a day for a month or month and a half.

Talk to a Doctor About Further Methods

Managing incontinence should always involve a doctor’s input, and they will have to step in further when it comes to prescribing medicine or recommending surgery. If surgery is necessary, caregivers should talk to the doctor about solutions that do not involve transvaginal mesh.


From a caregiver’s perspective, helping a person manage their condition may be as simple as creating a supportive environment where the person feels comfortable and safe as they learn to deal with living with everything that comes with having urinary incontinence.


Julian Hills has been a staff writer for Drugwatch since 2013. He has a background in newspaper and television journalism.  He studied Communication and English at Florida State University.

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