Incontinence: Looking Away is Not an Answer

Incontinence may never be a cocktail-party topic, but in an aging society, it needs to shed its taboo status. More than 25 million Americans suffer from incontinence, according to a 2008 report from the National Institutes of Health. And nearly two-thirds of caregivers say the family members they look after have some type of incontinence, according to a current survey by Caring.com and SCA, makers of the TENA brand of bladder-weakness and incontinence products.

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Of course, these numbers will get larger as society gets older. But they already are large enough. Incontinence sufferers as well as caregivers surely could use more support and reassurance. It is hard not to be embarrassed when you've lost some degree of bladder or bowel control. But when you're in the same boat as 25 million other people, it should be a bit easier to take. And in nearly all cases, no one is at fault here. Incontinence is not a victimless crime but rather a creator of crime-less victims.

Incontinence can take a big toll on sufferers and caregivers alike. According to the survey of caregivers: 42 percent experience depression from dealing with a loved one's incontinence; nearly a third have emotional problems changing out incontinence products; more than one in four say incontinence has hurt their relationship with a loved one, and, more than 30 percent say they have had to pass up vacations because of a loved one's incontinence. More dramatically, incontinence can be the "trigger" that leads to decisions to remove sufferers from their homes and place them in a nursing home or assisted-living facility. Nearly one in five caregivers polled for the Caring.com and SCA survey said they were considering moving a parent for that reason, or had already done so.

Spencer Deane, vice president for marketing at SCA Personal Care in North America, laid out four general steps that people need to take to deal with incontinence:

1. Get medical advice and treatment. Find out the the causes of the problem and see if there is an available treatment. While age is a driving factor, there can be underlying medical conditions causing incontinence. Proper exercise and diet can help in some cases. There may be certain foods that make one person incontinent but have no effect on most other people.

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2. Talk about it. Opening up a communications process between sufferers and family members can be very difficult. "How to talk about it is the key point," says Andy Cohen, CEO and co-founder of Caring.com. His website has a helpful piece on talking about incontinence, including guidance for caregivers who are looking after someone with dementia.

3. Individual care management program. Sufferers and caregivers can build a record of how incontinence affects behavior and activities—how often does the person need to use the bathroom, when do they have meals, and does diet play any observable role in the severity of their incontinence? Include needed activities outside of the home, and then determine the best way to schedule those trips.

4. Select the proper incontinence products. There is a wide range of absorbent and other incontinence products that can be used, and which may be most appropriate for different activities and circumstances.

Pelvic and kegeling exercises may help reduce incontinence problems or even be a preventive aid, Deane says. Certain food types also can worsen incontinence for some people—tomato-based dishes, spicy foods, citrus, caffeine, alcohol, and, sadly, chocolate, are suspect here. Deane says incontinence also is more of a problem for people who are overweight or diabetic. So, if those conditions can be dealt with, there might be a side benefit in reduced incontinence, he says.

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