Dementia

It’s hard to see our loved ones grow old: wrinkles framing their face, locks of hair fading to grey,  their once quick steps now shuffled. The truth of the matter is, these are some expected normals of aging. What is NOT normal is a once-functioning bladder and bowel now leaking urine or feces.  This topic can be much harder to discuss with our loved ones, but communication is imperative to improve the quality of life for our elders. Research shows that urinary incontinence is associated with a higher risk of infection, depression, loneliness and risk of institutionalization. The good news is there are options to help manage bowel and bladder function and mitigate these associated risks.

The first step is bringing up the topic in a simple and direct manner. Ask questions such as, ‘Do you have any difficulty with bladder control?’, or ‘Does urine ever come out when you don’t want it to?’. If you believe this conversation may upset your loved one, try speaking to their health care provider privately, before their next visit. Don’t worry about being using correct medical terminology, just voice your concerns about what your loved one may be experiencing.

Management techniques include influencing toileting behaviors and changing lifestyle habits. Some elders may benefit from being prompted to use the restroom by gentle reminders, such as  ‘Would you like to use the toilet?’, since there is a decreased sensation of bladder filling with aging. Additionally, try establishing a routine around when they would be likely to go to the bathroom. For example, the most common times for bowel movements are upon awakening and after meals. Modifying lifestyle habits can include increasing fluid intake between 48-64 oz per day, spacing fluid intake throughout the day,  and increasing plain water compared to other fluids.  Try limiting beverages with caffeine and carbonation that may be irritating to the bladder.

A pelvic floor physical therapist can provide in-depth and individualized care to help manage bladder and bowel control. Your loved one may require pelvic floor muscle strengthening, relaxation, or a mix of both, for improved function and control over their bowel and bladder. Therapists can also provide education regarding appropriate voiding schedules, lifestyle modifications and environmental adaptations specific to the patient.

 

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