Bladder dysfunction that involves inefficiencies in urine retention and emptying is common among older individuals. The common bladder dysfunction observed in senior citizens is urinary incontinence or inability to control urination. With the rising prevalence of urinary incontinence among elders it is important to seek professional help to reduce the severity of the condition by addressing certain modifiable or reversible causes.
The bladder is located in the lower abdomen as part of the urinary system which also includes kidneys, ureters, and urethra. To eliminate urine, the muscles in the bladder contract allowing the urine to move into the urethra while the muscles in the urethra relax to pass the urine out of the body. When the muscles are not functioning well, it could result in urinary incontinence.
Though this occurs as a part of the age-related physiological changes, many seniors may feel embarrassed about their situation. Understanding the cause and getting professional help for management should be encouraged among seniors. Our home nursing services including skilled nurses and nursing assistants employ appropriate techniques to manage incontinence while making them feel comfortable and respected.
Age-associated changes
With an increase in age, changes occur in different organs including the kidneys and the bladder. Some of the changes include,
- Reduction in the number of tissues in the kidney
- Reduction in the number of nephrons or filtering units of the kidney
- Thickening of the blood vessels leading to slow filtration
- Bladder walls become stiff and less flexible, therefore holding less urine than before.
- Weakening of bladder muscles
- Blocking (partially or totally) of the urethra.
With a healthy lifestyle kidney functions and physiological changes occur at a much slower rate.
Causes of urinary incontinence
Short-term incontinence may occur due to urinary tract infections, constipation, or vaginal infections. Other causes that result in long-term incontinence are
- Overactive bladder muscles
- Weakening of muscles
- Damaged nerves in the sphincter muscles due to diseases like Parkinson’s disease, multiple sclerosis, or diabetes.
- Arthritis that makes mobility difficult
- Pelvic organ prolapse, where the pelvic organs drop from their normal position.
- In men, inflammation or enlargement of the prostate gland can lead to urinary incontinence.
- Some medicines may cause incontinence as a side effect.
Types of urinary incontinence
Functional incontinence occurs when the individual’s mobility is affected either due to surgery, or arthritis and hence has a problem getting to the toilet.
Stress incontinence occurs when urine leakage is stimulated by exercise, sneezing, coughing, lifting heavy objects, or laughing.
Urge incontinence occurs commonly among seniors with diabetes, Parkinson’s disease, stroke, multiple sclerosis, or Alzheimer’s disease. The individual may suddenly feel the urge to urinate and are unable to hold it even for a short time.
Overflow incontinence occurs when little amounts of urine overflow from a constantly full bladder. Injuries in the spinal cord and diabetes are the common causes of this type. The nerves in the spinal cord are responsible for sending messages from the brain to the bladder and may be disrupted due to injuries.
Bladder outlet obstruction is associated with the loss of parasympathetic nerve endings that lead to the weakening of the muscles around the bladder.
Effective strategies for management
With the advancements in medical science, there are several strategies to treat and manage bladder dysfunctions. Depending on the severity of the condition and the type of incontinence treatment approaches may vary. In our home care services, along with nursing services we also provide home doctor consultation and physiotherapy for seniors to effectively manage incontinence.
- Medical treatments may include medicines or topical creams that help with bladder control. Devices such as catheters, urethral inserts, or vaginal pessary rings may also be suggested to avoid leakage. Electric nerve stimulations are provided to stimulate the nerves around the bladder. While surgery is considered when there is a change in the position of the bladder or blockage due to enlarged prostate glands.
- Pelvic muscle exercises or kegel exercises can be practised to strengthen the muscles and hold urine in the bladder.
- Urgency suppression is a technique where the individual distracts themselves when there is an urge to urinate until they reach the toilet. Deep breaths and contracting pelvic muscles are helpful distractions.
- Scheduled voiding is an instrumental technique where the senior urinates at fixed intervals. For example, our nurses remind seniors to urinate every hour when they are awake. This helps in better bladder control.
- Lifestyle changes can go a long way in managing bladder dysfunctions. Weight management, avoiding fluids before bedtime, quitting alcohol and smoking, and practising pelvic exercises regularly can over time strengthen the bladder muscles and promote bladder functioning.
In summary
Bladder dysfunctions when ignored and not treated appropriately can negatively impact the seniors’ quality of life. Seniors demand professional assistance in controlling bladder difficulties as well as ongoing support to feel comfortable in overcoming the same. At Athulya Home Healthcare, our nurses play a significant role in helping seniors regulate their bladder and employ techniques that effectively improve their condition. To learn more about our home care services visit our website Athulya Senior Care.
Information: This blog is for informational purposes only and should not be considered as a substitute for any treatment or diagnosis. Seek professional help in case of any emergency. Athulya is not responsible for any consequences.
