Incontinence

Incontinence

Incontinence—when someone loses urine or feces by accident—does not have to be part of aging.

Many older people never experience incontinence.  There are many ways to prevent or reverse it

What is incontinence?

To understand what incontinence is, we need to understand what continence is. Continence is the ability to voluntarily control when you empty your bladder and bowels. Most adults will keep this ability throughout their life.

Incontinence is when someone does not have this consistent control. It might show up as a little leak when you cough, sneeze, laugh, or lift a heavy object. You might have a sudden urge to go to the toilet, but your don’t make it in time. Or maybe you leak a bit even after urinating.

There are different types of incontinence. To learn more about the different types, click here and see page 13 or see Resources, below.

Don’t ignore incontinence

Incontinence is not just an inconvenience. It is a health condition. If you don’t get help, incontinence can contribute to other health problems. It can become a reason people stop exercising, socializing, or participating in hobbies. This can lead to more medical challenges.

Your healthy aging journey or your role as a caregiver will benefit if you learn about incontinence.

The Top Three Things You Can Do to Prevent Incontinence

  • Drink plenty of non-caffeinated, non-carbonated, non-alcoholic fluid each day, ideally water
  • If nocturia (needing to get up in the night to urinate more than one or two times) is a problem, stop drinking after dinner, and drink regularly during the day, especially in the morning
  • Pelvic muscle exercises, known as Kegels, if done properly, help prevent or reverse incontinence [link to final bullet point in What the Numbers Say]
  • Kegels must be practiced correctly to be effective
    • Click here and go to pages 65 – 68 for detailed instructions [link to Marcia Carr’s booklet for women] CAN A LINK GO TO A SPECIFIC PAGE OR CAN A PAGE OR TWO BE EXCERPTED AS A STANDALONE PDF?
    • Click here for a quick five-step guide
  • Trans and non-binary people:
    • Find information about pelvic floor health specifically tailored to your bodies and identities here
  • 50% of women who rely on written or verbal instructions do not do Kegel’s properly, so if in doubt, talk to a health care provider
  • By practicing Kegels and changing some lifestyle choices, you will see improvements in your bladder and bowel control in three to six months
  • Kegels are important for all genders
  • A brief delay is okay, but make sure you listen to your body
  • If you hold your urine for more than 20 minutes, you put stress on the bladder, kidneys, and pelvic floor muscles This can weaken your muscles and lead to incontinence

More Prevention Tips

Talking to a Health Care Provider

Getting help for incontinence can be hard. Many people feel embarrassed or ashamed. We’ve been taught not to talk about such personal things. But health care providers are used to hearing about all kinds of bodily issues. They can help you best when they know about symptoms early.

When to Bring up Incontinence?

Signs you should talk to your health care provider

  • Needing to urinate more often or suddenly
  • Cloudy urine
  • Blood in the urine
  • Pain while urinating
  • Urinating eight or more times a day
  • Trouble starting, passing only small amounts, or having a weak stream while urinating
  • A change in bowel movements—leakage or constipation

If you have a history of prostate cancer in your family and have any symptoms relevant to your prostate (Irregularities in urination), see a doctor as soon as possible. You can take a simple self-assessment quiz (for all genders) on page six of this booklet to help you know if it’s time to seek advice.

Who to Talk To?

  • Start with your primary care provider. If you don’t have a primary care provider, go to a walk-in clinic
  • Your doctor will likely refer you to a specialist, maybe at a clinic focussing on continence
  • Because incontinence is a common problem with a wide variety of causes and treatments, there are a variety of specialists who can help

Incontinence Talking Tips

  • Describe clearly the symptom/s that are troubling you. For instance, you can say, “I have to go to the bathroom every half hour, but only a little bit comes out,” or “I’m up five or six times a night to go pee”
  • Don’t be shy! Talking about intimate and potentially messy topics is part of a health care provider’s everyday world
  • Ask to see to a specialist or get connected to a continence clinic

Find more tips on how to talk to your health care provider about incontinence here.

Managing Incontinence

Incontinence often can be prevented, but if it does happen, it doesn’t have to stop you having an active and healthy life. Management needs to fit each individual situation. It may involve:

  • Pads, adult underwear, bed protectors, and other absorbent products
    • Only use products made specifically for incontinence
    • DO NOT use sanitary napkins (menstrual products), toilet paper, paper towels, or homemade cloth pads. They can cause infection and leaking
    • Your health care provider can provide advice and possibly point you towards free sample programs
  • Regular timed trips to the toilet
  • Practical arrangements such as
    • making sure the path to the toilet is clear
    • using a commode
    • keeping a walking aid nearby at all time
    • wearing clothing that is easy to get down and up again
  • Barrier creams to protect the skin when wearing incontinence pads and underwear. Ask your health care provider or pharmacist for a recommendation

Incontinence and Other Health Challenges

Incontinence can be more complex when there are other health challenges. Diseases that affect the nervous system, such as diabetes, multiple sclerosis, Parkinson’s disease, dementia, delirium, and stroke, can make it hard to get to the toilet in time or cause you to need to void frequently.

Joint, muscle, or bone problems such as arthritis, a broken bone, or recent joint replacement surgery can make it hard to reach or use a toilet. Diabetes can cause loss of feeling in the bladder.

The good news is that many health care providers can provide advice, support, and treatment. Talk to your family doctor for referral to a specialist.

What the Numbers Say

1%
Approximately 10% of all adult Canadians experience some form of incontinence
30%
30 – 60% of middle-aged women experience urinary incontinence
1%
2 – 7% of all adults experience fecal incontinence
$1400
Each year, an older adult living at home with urinary incontinence will spend on average $1,400-$2,100 on incontinence supplies
0%
Kegels have been shown to be 66% effective at correcting pelvic floor problems without the need for additional treatment

Resources

Canadian Continence Foundation

Lots of clear information, a help line, frequently-asked-questions, links to resources, fact-sheets, and an eight-question quiz to help you learn if you have urinary incontinence.

HealthLinkBC Urinary Incontinence in Women

Causes, symptoms, types, prevention, treatment, links for help.

HealthLinkBC Urinary Incontinence in Men

Causes, symptoms, types, prevention, treatment, links for help.

HealthLinkBC How to Do Kegels

A simple give-step guide to exercises that strengthen your pelvic floor muscles.

Call BC 811 for 24/7 help

This will connect you to HealthLinkBC’s health service navigators. They can

  • Answer basic health care questions
  • Help you find your way around the health care system
  • Connect with a registered nurse, registered dietitian, qualified exercise professional, or pharmacist

[Brad can you put the following four lines in a box  a box or otherwise highlighted next to the above bulleted text? This “Call 8-1-1“ box should be a feature for almost every topic ]

Call 8-1-1 (7-1-1 for the deaf and hard of hearing)

Health advice and information

24 hours a day, seven days a week

Translation services are available in over 130 languages

For non-emergency situations only

Canadian Continence Foundation

Call 1-855-415-3917 with questions about incontinence

A Woman’s Health Issue: Helping to Manage Incontinence

A thorough and easy-to-read guide to all aspects of incontinence, including quizzes to help you understand your situation, and clear explanations of treatment.

A Man’s Health Guide: Bowel/Bladder Continence

A thorough and easy-to-read guide to all aspects of incontinence, including quizzes to help you understand your situation, and clear explanations of treatment.

Gender-affirming care

Booklets on pelvic floor muscle exercises and advice for trans and non-binary people.

TransCare BC

Health information and resources for trans people.