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

5 answers | Last updated: Aug 23, 2017
A fellow caregiver asked...

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

Expert Answers

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.

Community Answers

Cbhillman answered...

This is not an answer, rather a comment about the use of the word diapers for older adults. Babies wear diapers. Older adults wear protective underwear. To be sure, this is hardly an earth-shattering issue but I do believe that maintaining a person's dignity is a good thing!

A fellow caregiver answered...

in no way do i mean to judge anyone whose situation requires placement out of the home - only the people living with their own situation know all the facts. what i want to remind people to think about, in the course of reacting to incontinence care, is that as long as your relative is at home, someone who loves them is trying their hardest to keep them functioning at their peak. in a skilled nursing facility, the staff may or may not do a better job than you are now, your relative will start to live in a wheelchair most of the day, may even be left in bed much of the day - yes, even though they came in fully ambulatory,& before long they will deteriorate physically from inactivity. Additionally, they will be in a health-care environment (where germs are rampant), and their lives will become regimented and perhaps, joyless. My mom is incontinent, takes water pills twice daily on top of this, has had some fecal incontinence, and has had serious health issues which required care and management. but the joy of interacting with her, seeing her as fully engaged in her life, her family, and the greater world, as she can be, outweighs any momentary discomfort! I tell her - you diapered me, didn't you? why should i be upset about returning the kindness. let's be happy you are well enough to...., this is a nothing, let's be happy! I urge you to allow yourself and your parent time to figure out how to manage, find the approach and products that work best for you, get advice from nurse practitioners, stay matter of fact when dealing with this, and otherwise get on with living and loving and enjoying life! Continue to take your parent out as often as ever (with a knapsack with change of clothes, and all the things you'd bring for baby, including plastics to seal clothes for laundering at home) you both will enjoy the things you always have, your parent will continue to walk, to move, to interact, and to live fully. If the issue is incontinence, it is a challenge, but not a life altering event such as stroke or alzheimers, & it can be managed if you work at it. after a while it becomes just part of the routine, yes even the accidents while out. happy to share that in our family, snfs are for short term rehab and OUT, not for incontinence! we have a wheelie suitcase that the folding, cleaned commode fits into, and away we go to spend time with family and friends, with no one watching us load the car the wiser! for sleepovers, we bring our own sheets, rubber sheets, etc, & if mom is uncertain she sits on her walker rather than the upholstery. You can triumph over the nonsense, don't let it get you down!

A fellow caregiver answered...

Bowel incontinence is just a bowel movement, isn't it? My 92 year old mother has explosive diarrhea incontinence. I never blame her, of course not. But, the odor is toxic and I can't help gagging and dry heaving while cleaning up the mess.This is not the only issue, just one more and I can't help her in a positive way anymore. (I moved her in 5 years ago after her husband passed) She refuses any "at home" medical assistance or physical therapy that could help. She has a prescription medication for it, but it seems to have worsened. Her doctor said she needs to be placed in a home for both our sakes. It's comforting to hear the doctor say that not everyone is cut out to be a caregiver and burn-out is nothing to be ashamed of. So, all of you angels/caregivers that spend years caring for elderly, sick, and/or incontinent parents, I admire the heck out of you and send you the very best wishes.

Gladigotyou answered...

SNFs are not the only alternatives for out-of-home care. My mom has been in assisted living for quite some time, & if you choose carefully and remain engaged with your loved one, it can be a great thing for all. (We are fortunate that our parents wrote into their advance directives years ago that none of us may take them into our homes when they could no longer care for themselves, and they planned for it with long-term care insurance. They had seen how hard that can be on a family.) They can meet her physical & mental needs better than we can, & her social & emotional needs are addressed there, too. We certainly didn't "dump" her there, and it's important that we see her often and bring her to our house as well.