What If I Can't Handle Caring for Someone With Incontinence?

A fellow caregiver asked...

What if I just can't handle caring for someone with incontinence?

Expert Answer

As Founder and Director of Circles of Care, Ann Cason provides caregiving, consulting, and training services to individuals and public and private organizations involved in eldercare. She is the author of Circles of Care: How to Set Up Quality Home Care for Our Elders.

Here's the thing about handling incontinence: It's the turning point upon which many caregivers feel they can no longer look after someone at home, and for some good reasons. Incontinence can be frustrating and difficult to deal with. But at the same time, there are many approaches to coping with incontinence that can make it less awkward and challenging than a beginner first anticipates.

Everybody who's had to change an adult relative's diaper has what I call the what's-a-nice-girl (or boy)-like-me-doing-in-a-situation-like-this moment. You never wanted it to come to this, and here you are. It's hard, but have patience with yourself. After you do it several times, a real sense of intimacy and closeness takes place; it's a good feeling to be helping another human being resolve a basic problem.

To decide whether you can handle incontinence, it's a good idea to explore the options:

1. Talk to a doctor to be sure you're pursuing all the treatment options. Many causes of incontinence are fixable. Treatment ranges from medications and lifestyle changes (such as scheduled bathroom visits) to wearing protective undergarments and covering the bed with waterproof covering.

2. Speak the language of incontinence frankly. Many people try to ignore the subject or use euphemisms, which only makes things more awkward for everyone involved. Better to be matter-of-fact: Everybody spends part of their day urinating and eliminating. As we age, some of us develop problems with our bladder or bowel function. You'll lessen both your embarrassment and that of the person with the trouble if you can remain straightforward and talk about it like the medical issue that it is. It's really a pretty ordinary thing.

3. Go easy on yourself, and give it time. Family caregivers often place high expectations on themselves. They think they have to manage everything perfectly, every time. It can take awhile to get on top of an incontinence situation -- for example, to learn how to clean a person after an accident or for the person to adjust to wearing special protective pull-ups.

4. Get help if you need it. Sometimes there are physical impediments to taking care of someone with incontinence. A person with a bad back or other health condition might need a home attendant to help during certain hours, for example.

5. Realize that sometimes it's not possible for an incontinent person to remain at home, and that's OK. Every care situation is different. A small woman with a large and rambunctious husband with dementia, for example, may not be able to go it alone if she doesn't have his trust and cooperation so that he's willing to sit on the commode while she removes the pull-up, cleans him, and has him step into a fresh one.

Don't think of an alternate living situation as "shoving him off" but as a more positive reality, which is that you're creating a situation in which you're getting someone the help he needs to function safely.