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  • Cameron Oglesby

The condition too embarrassing to talk about

It’s incontinence.

Depending on whose statistics you believe, between 15 and 23million Americans have it, 80 to 85 percent of them women. Half of all older adults living at home or in long-term care facilities are incontinent, according to the Illinois Department of Health.

All too many people with loss of bladder control isolate themselves, skip social events, or stop visiting with friends and family for fear of ridicule. Which is a shame, because although about 80 percent of them can be cured or improved, only one out of every 12 people with incontinence (8.3 percent) seeks help.

Though incontinence is a singular noun, it can take on multiple forms:

· When damaged pelvic muscles cause the bladder to leak, stress incontinence can result from exercise, coughing, sneezing, laughing, or any other body movement that puts pressure on the bladder.

· Damaged nerve passages from the bladder to the brain can cause urge incontinence, when the brain doesn’t get the bladder’s message soon enough to get to a toilet in time.

· Mixed incontinence is a combination of stress and urge incontinence, and it’s very common.

· Overflow incontinence happens when the kidneys put out more urine than the bladder can hold. This can happen with older men whose prostate glands have grown and press into the bladder, reducing its capacity.

· A leak from the bladder, urethra, or ureter that makes you urinate without being physically aware you had to is called reflex incontinence.

· Surgery, specifically prostate, lower intestinal, or rectal surgery – or hysterectomies and C-sections – can cause incontinence as a side effect.

If you have a leaky bladder, there are steps you can take on your own that might help:

· Maintain a healthy weight.

· Cut out contributing factors such as alcohol, caffeine, sodas and carbonated water, artificial sweeteners, honey, or corn syrup.

· Stop smoking and avoid secondhand smoke.

· If you can, start doing exercises that strengthen your pelvic and core muscles.

· Track your urinary patterns in a bladder symptom diary. Bring that diary with you when you take the next step.

· Talk to your doctor about any lifestyle, physical or hormonal changes that make be contributing.

Because incontinence has so many possible causes, diagnosing it calls for a thorough physical examination. This would include X-rays, cystoscopic exams, blood chemistry, urine analysis, and tests to determine bladder capacity, sphincter function, and urethral pressure.

Once the specific cause is identified, about 80 percent of the patients can be cured or improved through one of three techniques (or sometimes a combination).

Behavioral techniques can include:

· Toilet scheduling, where a caregiver prompts the patient to use the bathroom every two to four hours. A regular schedule can keep patients dry and is particularly helpful for frail, elderly, or bedridden patients

· Bladder retraining is like toilet scheduling, only with the time between bathroom visits gradually lengthened. By training the bladder to literally hold its water longer, it’s especially effective for urge and mixed incontinence.

· Pelvic physical therapy – When damaged pelvic muscles cause stress incontinence, pelvic muscle rehabilitation (sometimes in conjunction with biofeedback therapy, vaginal weight training, pelvic floor stimulation, and magnetic therapy) can strengthen and restore them.

Medical techniques can include discontinuing diuretics and other prescription meds that increase urination or prescribing drugs that can help control incontinence.

If other treatments fail to work, surgery may be called for. Depending on the incontinence’s type and cause, this could be bladder neck suspension, collagen injections around the urethra, or implanting a sacral nerve stimulator or artificial sphincter.

It may feel odd to read this, but in many ways incontinence care and senior care have things in common. Both deal with multiple issues arising from multiple causes. Both affect not only someone’s physical condition, but also their emotional state, their quality of life, and their independence. And both call for much more than superficial knowledge of the patient or client.

That’s why, before we do anything else for clients, we get to really know them, and their families, through our thorough three-part needs assessment. We learn about not just their state of health, but also their state of mind, the state of their family and social relationships, and their individual values, preferences, interests and hobbies, schedules, and overall lifestyles.

Then, and only then, do we custom-design a holistic senior care management plan that delivers the specific care they need while avoiding the waste of money and independence that often comes with care they don’t need.

If that sounds like the right kind of care for someone in your family, please contact us.

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