How to Care for Incontinent Elderly

Whereas urinary continence means the ability to voluntarily control urinary discharge, urinary incontinence refers to an inability to control urination, leading to involuntary leakage. Although it affects people of all ages and genders, urinary incontinence is particularly common among elderly adults.  However it is not considered a normal part of aging.

To improve the quality of life for incontinent elderly, the healthcare profession has various means to care for them. This article explains in considerable length how to care for incontinent elderly.

Please note that in this article whenever incontinence or continence is mentioned, it refers to urinary incontinence or urinary continence.

How to Care for Incontinent Elderly

How to care for incontinent patient, especially the incontinent elderly, is a question of significance. While there is no standard answers to this question, there are some optimal practices which have been designed based on medical and clinical knowledge and the patient’s particular conditions. This section tries to elaborate on how to care for incontinent elderly, given that the elderly are the age group most vulnerable to urinary incontinence.

General Guidelines for Caring for Incontinent Elderly

1) Maintain Regular Bathroom Schedules

Establish a toileting schedule, taking the individual to the bathroom at regular intervals (e.g., every 2-3 hours). This helps reduce accidents and maintains a routine that supports bladder control.

2) Ensure Safe and Easy Bathroom Access

Equip the bathroom with grab bars and non-slip mats to enhance safety. Ensure the bathroom is well-lit and clutter-free, especially for elderly individuals with mobility issues.

3) Use Incontinence Products

Provide absorbent pads, protective undergarments, or adult diapers to manage leaks. Ensure they are changed frequently to maintain hygiene and prevent skin irritation.

Encourage the use of mattress protectors to safeguard bedding.

4) Hygiene and Skin Care

Clean the genital area after each incident of incontinence to prevent skin breakdown and infections. Use gentle, pH-balanced cleansers and apply barrier creams to protect the skin from moisture and irritation.

5) Bladder Training and Pelvic Floor Exercises

If appropriate, encourage bladder training by gradually increasing the time between bathroom visits.

Introduce pelvic floor exercises (Kegel exercises) to strengthen the muscles that control urination. These exercises may help reduce incontinence over time.

6) Fluid and Diet Management

Encourage the elderly individual to stay hydrated but limit fluids during the evening to reduce nighttime accidents.

Avoid bladder irritants such as caffeine, alcohol, and spicy foods.

A balanced diet that prevents constipation is essential, as constipation can worsen incontinence.

Specialized Care for Elderly Using Urinary Catheters

For some elderly individuals, urinary catheters are necessary when they are unable to empty their bladder naturally due to medical conditions such as urinary retention, prostate issues, or neurological disorders. Catheters can improve comfort and prevent complications, but they require careful handling to avoid infections and other issues.

Types of Urinary Catheters

Indwelling Catheters (Foley Catheters): These are inserted into the bladder and remain in place, connected to a drainage bag.

Intermittent Catheterization: A catheter is inserted to empty the bladder and then removed. This procedure is done periodically throughout the day.

External Catheters (Condom Catheters): Used for men, these fit over the penis and drain urine into a bag.

Manufacturer websites provides some details on catheters such as material, specifications. You can visit delve into their websites such as this one: www.bevermedical.com

Guidelines for Caring for Elderly with Catheters

1) Sterile Insertion and Removal

Ensure that trained healthcare professionals handle the insertion and removal of catheters. Using sterile techniques helps prevent urinary tract infections (UTIs).

2) Daily Hygiene and Maintenance

Clean the catheter insertion site daily with mild soap and water. Avoid applying creams, lotions, or powders near the catheter.

Ensure the drainage bag remains below bladder level to prevent backflow, which can cause infections.

Regularly empty the drainage bag (at least every 6-8 hours) or when it’s half full, and clean the bag as directed by healthcare professionals.

3) Monitor for Signs of Infection

Look for common UTI symptoms such as cloudy or foul-smelling urine, fever, or discomfort. An elderly person may also exhibit increased confusion, which could indicate an infection.

If any signs of infection occur, contact a healthcare provider immediately for evaluation and treatment.

4) Prevent Blockages

Ensure the elderly individual is well-hydrated, as this keeps urine flowing through the catheter and prevents blockages. If they are on fluid restrictions, consult with their doctor for advice.

Be alert for signs of catheter blockages, such as reduced urine flow, bladder pain, or leakage around the catheter.

5) Catheter Replacement

Indwelling catheters typically need to be replaced every 4-6 weeks, or sooner if there is any indication of complications such as blockage or infection. Always follow a healthcare provider’s recommendations for catheter care and replacement.

6) Promote Comfort and Dignity

Ensure the catheter and tubing are positioned comfortably to avoid pulling or kinking. Secure the catheter with straps or adhesive as needed to minimize discomfort.

Provide emotional support and maintain privacy during catheter care to preserve the individual’s dignity.

Skin Care for Incontinent Elderly

We need to understand that patients with incontinence are frequently exposed to the effects of urine on their skin, especially skins around the urinary tract system. Skin care for incontinent patients is a major concern. An important part of care for incontinent elderly is to give skin care to the incontinence elderly so that the risk of skin irritation or infection to the elderly is minimized. We will go into more details on this topic in future articles.