Management of Functional Incontinence in Older People - How Is It Done?

What Is Functional Incontinence?

Functional incontinence occurs in older individuals with standard bladder control but who cannot get to the toilet due to arthritis or other disorders. These disorders make it hard for an individual to move quickly.

What Are the Different Types of Incontinence?

The different types of incontinence are based on the cause, triggers, and characteristics of urine leakage. Therefore, knowing the type of incontinence is often an essential part of the diagnosis and treatment plan of incontinence. The following are the types of incontinence:

• Urge Incontinence: This type is characterized by an intense need (urge) to urinate. This happens too quickly, before making it to the toilet, and ends up in a leakage. Urge incontinence is caused by a condition called overactive bladder. Overactive bladder can be due to various reasons like nerve damage, infection, weak pelvic muscles, infection and low levels of estrogen after menopause, or heavy body weight.

• Stress Incontinence: The urine leak occurs during activities and often during stress. In this type of incontinence, pelvic muscles are weak and no longer support the pelvic organs as they should. Muscle weakness means that they are more likely to leak urine accidentally. Many people face leakage issues when they cough, sneeze, run, jump, laugh, or lift their thighs. This action can place pressure on the bladder. With the support of strong pelvic muscles, more urine can leak. Women who have given birth are prone to a higher risk of having stress incontinence. Men with prostate surgery can develop stress incontinence.

• Overflow Incontinence: If the bladder does not empty each time when one urinates, it can lead to overflow incontinence. There could still be a risk of the spill when the individuals move around. Individuals with overflow incontinence never empty their bladder. This results in small amounts of urine leakage out over time instead of one big gush of urine. This incontinence is more common in individuals with stroke, multiple sclerosis, and diabetes. This can also result in a large prostate.

• Mixed Incontinence: This type of incontinence combines several diseased issues that can lead to leakage. Mixed incontinence can be dealing with overactive bladder with stress incontinence. It is necessary to pay attention to leakage issues with the type of incontinence. Identifying what triggers incontinence is usually the best way to manage this incontinence.

What Causes Functional Incontinence?

There are many causes of functional incontinence. These can cause various conditions depending on women and men. The causes can be temporary health conditions that usually go away once treated. The causes of incontinence, once treated, usually stop the condition. Incontinence can be caused by long-term medical conditions. Chronic conditions usually do not go away. Incontinence can be managed over time as a symptom of the chronic condition. Temporary and short-term causes of incontinence can include:

• Urinary Tract Infections: Infections inside the urinary tract can cause pain and increase the urge to pee more often.

• Medications: Side effects of certain medications can lead to incontinence, including antidepressants and diuretics.

• Pregnancy: The uterus places extra pressure on the bladder as it expands. This can lead to incontinence during pregnancy and goes away after delivery.

• Constipation: Chronic constipation can cause bladder control issues.

• Beverages: Drinks like alcohol and coffee can increase the urge to urinate frequently.

• Stroke: Stroke can cause muscle control issues, including muscles that regulate the urinary system.

• Pelvic floor disorders: Pelvic floor muscle can impact the way of organ function, including the bladder and bowel.

• Menopause: Menopause is another time of change in a woman’s body; the hormone levels can change rapidly, and pelvic floor muscles become weaker.

• Diabetes: Diabetes can lead to more urine production. This leads to an increase in the amount of urine, leading to leakage issues. Peripheral neuropathy can affect bladder function.

• Enlarged Prostate: The prostate is more significant than usual and can lead to several bladder control issues. This condition is called benign prostatic hyperplasia, or BPH.

• Multiple Sclerosis: Multiple sclerosis may experience a loss of control of the bladder, leading to leakage issues.

• After Prostate Cancer Surgery: Prostate cancer surgery can sometimes damage the sphincter muscle, leading to stress incontinence.

How Is Functional Incontinence in Elderly People Managed?

Treatment of functional incontinence can be done by addressing environmental factors to improve accessibility. Reduction in the risk of accidents can be made, and bathrooms can be made accessible and uncluttered, which could help avoid delays and falls. Arthritis conditions can lead to fingers that can be difficult to work while wearing pants, zippers, or elastic waists. Transferring from a wheelchair to a toilet can be troublesome. Another person can help the individual facing the issue. Treatments include the following:

• Bladder Training: This training involves scheduling an amount of time between bathroom trips. Once the urge to urinate is under control, an individual can visit the bathroom and urinate. This method involves contracting pelvic muscles and concentrating on making the urge to urinate go away.

• Pelvic Muscle Exercises: Pelvic muscle exercises are also known as kegel exercises. They strengthen the support of the bladder and ureter to prevent leakage and focus on isolating pelvic muscles and contraction in muscles. Improvement is noticed within a few weeks of exercise.

• Devices and Absorbent Products: Protective pads and panty liners can help individuals from embarrassing situations. A pessary can be inserted in the vagina to prevent urinary leakage by supporting the bladder neck. This is most useful in stress incontinence. Non-invasive device pants with electric pads work by stimulating the pelvic floor muscles and helping strengthen the muscles to help control bladder leakage. A newly approved coin-sized device known as a tibial neurostimulator can be implanted in the lower leg to reduce symptoms.

• Scheduled, Timed, and Prompted Voiding: Setting a schedule for bathroom trips can make one less likely to hurry bathroom visits. Schedules and prompted voiding can be helpful in dementia individuals who fail to recognize the need when they need to use the bathroom. These methods require effort and motivation for many individuals to switch to functional incontinence.

Conclusion:

Functional incontinence can result from many issues. Individuals with severe depression may lose all desire to care for themselves, including using the restroom. Functional incontinence is related to impaired mobility and cognitive functioning. With proper treatment and management, this condition helps the elderly.