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Of all the senior health and wellness challenges to bring up with your doctor, incontinence might be one of the most difficult to discuss. It’s hard for some people to talk about being unable to make it to the bathroom on time, having accidents that ruin your day, and leaking urine that requires you to wear pads or specialized underwear.
But talking about it is very important, as that’s the only way to find solutions. Treatment can greatly improve your quality of life and make you so grateful you took the step of talking to your doctor about what is going on with your body.
And remember: Though incontinence becomes more common with age, there are new treatments available that can help.
Understanding Incontinence
According to the Urology Care Foundation, up to a third of adults in the United States suffer from incontinence.1 But the number is likely higher than that, considering that many people don’t tell their doctors about bathroom accidents. They might be embarrassed to talk about it, or they might believe that it’s a normal part of aging that they must simply deal with.
The usual, initial approach is to try home remedies and lifestyle changes. For instance, drinking less in the evening might reduce the need to urinate during the night, or going to the bathroom before you feel the urge might prevent a leakage of urine. Kegel exercises, which strengthen the muscles of the pelvic floor, can make it easier to hold urine long enough to get to the bathroom and avoid an accident.
If those remedies don’t help after a few months, doctors will often turn to prescription medication. You might have heard of the most popular ones, including Ditropan XL, Detrol, and Mirabegron. These help calm an overactive or irritated bladder and thus can ease the frequent urge to go or the inability to make it to a bathroom in time.
If you’re a senior or elderly adult suffering from incontinence, it’s highly likely that you often rush to the bathroom. That’s a good reason to use a fall alert. Rushing may increase one’s fall risk, and a medical alert device can help ensure that you can get any help you may need, right when you need it.
Fecal incontinence is surprisingly common. According to studies in Gastroenterology, about one in seven people have reported experiencing fecal incontinence at some point in their lives, and that number increases among seniors.2 Those who have suffered some sort of trauma to the pelvic area, including radiation for certain cancers, are even more likely to develop the problem. It is also a common complication for those who have Crohn’s disease or irritable bowel syndrome.
Some exercises can be prescribed to help reduce fecal incontinence, and there are surgical interventions as well. Some medications might help, such as anti-diarrheal meds or those that bulk up your stool. But much like urine incontinence, many believe that there is no help for the situation, or that any assistance might be minimal.
Again, rushing to the bathroom to avoid an accident can lead to falls. An emergency alert system can help anyone who is suffering from incontinence. Simply pressing a button to get help fast provides incredible peace of mind.
Today, there are new treatments for incontinence that don’t require medication, and these treatments seem to work wonders to help individuals overcome the issue. Here are some of the more promising therapies out there today.
Posterior Tibial Nerve Stimulation
This is a unique treatment that is minimally invasive and easily administered in your doctor’s office. Here’s how it works:
You will sit in a comfortable chair or lie down. A tiny needle will be inserted into your ankle. (This might seem scary, but it’s not nearly as bad as it sounds.) This needle is attached to a stimulator, which sends a very mild electrical current up your leg. The current targets the sacral plexus and the tibial nerve, both of which play a role in bladder spasms.
Most people go through twelve sessions of 30 minutes each. You might feel some very mild discomfort, but the current can be adjusted to make you feel more comfortable during the procedure.
It might take a few sessions before you see improvements. But in the end, it’s 80% effective in reducing incontinence, according to the Roswell Park Comprehensive Cancer Center. And that improvement can be remarkable, as those who undergo the procedure usually see greater than 50% improvement in the frequency of bathroom accidents.
There’s no medication to take, no interactions with medications you are already on, and no side effects of the procedure. It’s safe for any age.3
Pelvic Floor Rehabilitation
The muscles in the pelvic floor play a crucial role in the function of your bladder and bowels. These muscles can weaken as we get older, leading to problems with leaking urine or feces, constipation or diarrhea, sudden urgency to pee, and even pain when you urinate. Pelvic floor problems are also associated with sexual dysfunction, which can take away from the pleasures of intimacy.
Since pelvic floor muscles gradually weaken, many might think it’s a natural part of aging and thus, they suffer in silence. However, pelvic floor rehabilitation is not only possible but incredibly effective for most patients. Pelvic floor therapy focuses on the muscles that line the bottom of the pelvis. These are the muscles that support the pelvic organs, including the bowel and bladder. If you have ever stopped urinating in mid-stream, held back from passing gas, or waited out the urgency to have a bowel movement, you have used your pelvic floor muscles to do so.
Pelvic floor rehabilitation uses guided exercises, both with a physical therapist and at home, to slowly build up those muscles. It might take a few months to see improvements but over time you will find it easier to hold your urine or bowel movement long enough to get to a bathroom. This can greatly improve quality of life.
And many of the exercises can be done while sitting down and doing other things, such as watching television or reading. Once you become accustomed to it, you might start doing them without much thought, which is a great way to ensure that your pelvic floor stays strong.
Bladder Botox
You’ve certainly hard of Botox, the miracle injections that can make wrinkles fade away. Botox works by paralyzing small muscles for a period of several weeks, making your skin look smooth and more youthful.
But scientists have learned that Botox can work wonders in other parts of the body to treat other ailments, such as overactive bladder. As your bladder contracts involuntarily, you might leak urine – that’s a particular problem called urge incontinence.
Here’s how it works: You will rest in a comfortable position in your urologist’s office. A tiny needle will be inserted into the muscles surrounding your bladder. The injection itself doesn’t hurt nearly as badly as the description might make it sound; you might feel a bit of discomfort or cramping afterward as the Botox begins to do its work.
The result is usually fast relief – sometimes as quickly as the same day. And that relief from incontinence can last for about six months before more injections are needed. For some, this works so well that urinary incontinence becomes something they don’t have to worry about again until it’s time for the next visit to the doctor.
Sacral Nerve Stimulation
As with posterior tibial nerve stimulation, sacral nerve stimulation uses electrical current. The big difference is that this is a relatively permanent solution; if it works well for you, the procedure will need to be repeated in 10-15 years. Here’s how it works:
The SNS device is very small, about the size of a credit card. The initial treatment takes about an hour in an outpatient clinic. During that first stage, a very thin wire is inserted into the lower back near the sacral nerves. That wire attaches to the SNS device. The device will then be taped to your back – remember, this is the initial stage – and you will be asked to go about your normal life for the next day or two.
During that time, you will be able to tell if the device is working. Incontinence will dramatically reduce or disappear altogether. The doctor will want to give it about a week to make sure the device is working. If it is, then you know you’re a good candidate for the second stage of the procedure.
The second stage is more invasive. It includes another one-hour procedure, but this time, the tiny device is inserted underneath the skin of your lower back, right above your buttock. This requires only a small incision and local anesthesia. After a few weeks of healing, you should have no further problems with fecal or urinary incontinence.
The battery in the device lasts for up to 15 years. Similar to what you get with a pacemaker and other implantable devices, the manufacturer can monitor and fine-tune the electrical impulses if necessary to make sure it works well for you.
This is a procedure that should be tried only after other attempts to solve the problem have failed (and often an insurance company will require proof of trying other things before they will pay for the procedure). For many, it provides the sort of long-term relief they might have come to believe was impossible.
No matter your choice of treatment for senior incontinence, medical alert systems for seniors are an excellent idea. Now is the time to get the peace of mind you need so you can live your golden years to the fullest.
