Urinary incontinence is a significant public health problem for elderly people. It affects their self-confidence and quality of life, as well as their ability to function properly in their homes and communities.
In addition to using incontinence underwear and reusable bed pads, there are a variety of treatment options for urinary incontinence in the elderly. However, they all must be tailored to the needs of each person.
Medications
If you have an overactive bladder and are unable to control your urges, medications can help. Several anticholinergics (anti-bladder drugs) may be effective, such as oxybutynin (Ditropan XL), tolterodine (Detrol), darifenacin (Enablex), fesoterodine (Toviaz) and solifenacin (Vesicare).
You can also learn how to train your brain and bladder to better control your incontinence using behavioral approaches. This includes exercises called pelvic floor muscle training (Kegel exercises) and biofeedback techniques.
However, some of these medications can have side effects, including dry mouth and eyes, constipation and increased risk of confusion and falls in the elderly. Your GP will discuss your medical history before prescribing any medication.
If you have an urge incontinence problem but don't want surgery, your GP may prescribe a drug called mirabegron (Myrbetriq). This medicine works by relaxing the bladder muscle to help it fill with and store urine. It comes as a tablet or capsule that you take once a day. It can improve your incontinence and prevent accidents.
Physical Therapy
Physical therapy (PT) is a common treatment for urinary incontinence. It helps improve bladder control, reduce leakage, and strengthen the pelvic floor muscles.
A PT will do an assessment and a number of other tests to help decide what treatments are right for you. This includes a physical examination, questions about your life and habits, and a mental health assessment.
It’s also important to follow the PT’s plan for home exercises. Stick to the number, order and frequency of each exercise they tell you to do.
If an exercise doesn’t work for you or makes you feel worse, talk to your PT about it.
A PT will spend a lot of time getting to know you and your condition. This can help build a relationship with you that can go beyond the physical. It can also make a big difference in the quality of the therapy you get. You’ll probably feel like you can trust your therapist and be more motivated to do the exercises they teach you.
Behavioral Therapy
Behavioral therapy is a common treatment option for older adults with urinary incontinence. It focuses on changing behaviors that may be causing the incontinence. It can also be used to help people learn new skills, such as bladder training or pelvic floor muscle exercises.
Licensed clinical therapists who practice behavioral therapy believe that individuals are responsible for their own behaviors, and that they can change those habits through education and practice. They typically use a variety of techniques to help their patients learn new behavior patterns and replace unhealthy ones with healthy ones.
Using biofeedback-assisted behavioral treatment, older women who have urinary incontinence can reduce the frequency of their urge or mixed incontinence episodes. Compared to oxybutynin, which is the standard pharmacological treatment for urge incontinence, this conservative approach has proven safe, yields high patient satisfaction and is practical for older individuals.
Surgery
If medications are not enough for you or your aging loved one to control urinary incontinence, there are surgical options. These procedures involve putting extra support under the bladder neck to help the urethra stay closed, so you don't leak.
Using a sling, a surgeon creates a "hoop" out of mesh or human tissue and places it under the urethra. This surgery can lessen or stop urine leaks and improve your quality of life.
In most cases, the surgery is very effective in improving your incontinence symptoms and your quality of life. However, it is important to discuss the risks and benefits with your doctor.
Urinary incontinence can affect the lives of many elderly people, from bedridden patients to those living in a nursing home. It is an uncomfortable problem that can have a negative impact on their daily lives.
