How to Care for a Parent With Urinary Incontinence

How can I talk to my parent about incontinence?

There are some discussions between a parent and child that many of us would rather avoid: Talking to your own children about sex, the proverbial talk about the "birds and bees," is probably not an issue many parents can glide through without some discomfort. Equally difficult, or perhaps even more so, is broaching the subject of incontinence with the very person who used to change your diapers when you were an infant.

Whether or not your parent has memory problems or dementia, the topic of incontinence is among the most challenging. "Society has programmed us to view bodily functions as dirty and private, and when you're dealing with a parent, having such a discussion isn't a natural thing to do," says Carol Jones, a family consultant with the Mountain Caregiver Resource Center in Mount Shasta, California.

In fact, the subject is so fraught with discomfort for elder parents and their children that Jones has developed a two-hour presentation covering the emotional minefields surrounding it, as well as the more practical day-to-day issues.

When talking to adult children who are caregivers, Jones found that they often have such a hard time dealing with their parent's incontinence that they pretend it's not happening. "Sometimes the biggest problem is that the caregiver is embarrassed and feels the need to cover up the accidents, even denying that a parent is incontinent."

Another pitfall, particularly if a parent has dementia, is the misperception that the parent is having accidents "on purpose," as a way of gaining control, according to Jones, yet that's rarely the case.

To overcome these emotional obstacles, Jones recommends tackling the topic head on. "The best way to do it is to speak frankly and say, 'We're in this together. I know this is embarrassing for you, and it's hard to depend on someone else for bodily functions, but I'm your daughter, and I want to work on this with you to make it easier.'" Of course, if your parent has dementia or Alzheimer's, you may need to use a different approach.

Should I take my incontinent parent to the doctor?

If your parent hasn't seen the doctor, he should make an appointment or you should make one for him. Incontinence isn't a normal part of aging; it could be a sign of, say, a urinary tract infection. Medications could also be the cause, or it could be a sign of another medical problem, such as an enlarged prostate in a man.

How can I help my incontinent father have fewer accidents?

Even if your father has lost bladder control and medical treatment hasn't completely solved his problems, you can try a number of things to make it less of a problem.

For instance, one impediment to getting to the toilet on time could be the clothes he's wearing. Jones used to run an adult daycare center, and a big obstacle to reaching the toilet was the men's pants: "I live in cowboy country, and men would come in with button-front jeans, and by the time they got to the bathroom, there's no way they weren't going to wet themselves." An easy solution is to make sure your father wears pants with a large zipper fly or an elastic waistband.

Another option is to check with your local medical supply store to inquire about installing handrails and grab bars to make it easier for your father to get to the toilet, or look into buying a bedside commode or urinal for him to use at night.

If your father's doctor hasn't told you how to set up a toilet schedule, it's easy enough to do. It tends to work best with stress incontinence (this is a result of weak pelvic floor muscles, and is often triggered by sneezing, laughing, coughing, or lifting; it's more common in women) and urge incontinence (when a person has a strong urge to urinate and leaks urine before reaching the toilet). Urge incontinence often occurs in people who have diabetes, stroke, dementia, or Parkinson's disease.

Try keeping a diary or have your father log the times when he urinates for a period of two or three days. Once you've figured out when he typically needs to relieve himself, set up a schedule so that he heads to the toilet before he'd typically need to go.

Of course, how much fluid your parent drinks will affect how often he needs to urinate. People often assume that withholding fluids will help incontinence. However, barring a medical directive from the doctor, your parent should drink fluids throughout the day to avoid dehydration and cut down on fluids in the evening so he doesn't need to go as often at night.

Can dietary changes help my parent gain bladder control?

What your parent does or doesn't drink and eat can affect incontinence. Anything with caffeine, for example, may irritate the bladder and should be reduced or eliminated. "Coffee, colas, and chocolate will cause your parent to have to go much more often, as will alcohol -- though I'm not talking about an occasional glass of wine," says Jones. Spicy foods, carbonated beverages, and foods with high acidity like tomatoes, peppers, and citrus are also bladder irritants and are best avoided. "If he has orange juice in the morning, try switching to apple juice," suggests Jones.

If my parent is incontinent, does he have to wear a diaper?

Long gone are the days when wearers of incontinence products felt as though they were carrying around a log in their pants; today there are plenty of comfortable products to choose from. There are briefs of different sizes and shapes, male and female briefs, some that look like a classic diaper, and some that appear no different from underwear. A variety of cleansers, moisturizers, and skin barriers can protect your parent's skin against developing sores. To find out which type best meets your parent's needs, see " 11 Questions to Ask When Selecting Incontinence Products."