Bowel Incontinence Care

Ashley Lamar (not her real name) recalls how she and her sister first realized the scope of their mother's incontinence when they went to her apartment in Santa Monica. "There were big white bleach spots all over the pink carpet, and we asked the caregiver, 'What are these about?'" says Lamar. The caregiver told her that her mother was having "accidents."

"The thing I didn't realize was that my mom, who has dementia, had no sense of it. Some people have shame -- my mom didn't have any. She was walking around the house getting feces all over the place. She wasn't wearing underwear and refused to wear diapers."

Lamar had to make a special trip from her home in San Francisco to Southern California to get her mother to wear diapers, because her mother wouldn't listen to the caregiver. "It took three days. I just told her, 'This isn't your decision. It's not optional.'" Finally her mother got used to the idea and stopped protesting.

What causes fecal incontinence?

Fecal incontinence, which affects more than 5 million Americans and is more common in older adults, is often caused by weakness in the anal sphincter muscle, which normally contracts to keep stool from leaking out. Another cause of fecal incontinence is damage to the nerves that signal the need to have a bowel movement. Childbirth, straining to go on the toilet (which can happen with constipation), and diabetes can all cause injury to these nerves. There can be a disconnect between the brain and bowel caused by Alzheimer's, stroke, Parkinson's and other diseases that strike older adults. Even some medications cause fecal incontinence.

If the person you're caring for hasn't seen his doctor about it, schedule an appointment. Bowel incontinence could also be a sign of a more serious medical problem, such as fecal impaction, a condition in which hardened stool is lodged in the bowel, causing an obstruction and leakage of loose stool around it.