How do I approach my father about is intermittent incontinence?

3 answers | Last updated: Oct 06, 2016
Kathyleen asked...

HI, I am wondering how to approach my father (79) about what I call intermittent incontinence meaning it is not a constant problem but seems to happen in social situations. One of my brothers spoke to him but it became emotional and ended badly. I would like to discuss it with my dad but do not want the same ending. I realize it is a delicate conversation and since it has not happened while he has been visiting it is more difficult to bring it up. Any thoughts would be apprecitated.

Expert Answers

Jennifer Serafin, N.P. is a registered nurse and geriatric nurse practitioner at the Jewish Homes for the Aged in San Francisco.

I am not suprised that your brother had a difficult time talking to your dad about his incontinence. Many older persons who develop incontinence are very embarrassed about it, and it is common for them to get upset when it is discussed.

First, your father should see a urologist for an evaluation of his incontinence problem. As they age, men may get prostate enlargement, or BPH, which causes obstructive and irritative urinary symptoms. Obstruction causes slow urine flow, eventually leading to hesitancy and starting/stopping of the urine. Irritative symptoms include urgency, nighttime urination (nocturia), and frequency. Some men may even have difficulty emptying their bladder completely. There are medications out there that can help with this problem. While he is seeing the urologist, he should be checked for a bladder infection, and screened for prostate cancer with a prostate exam.

Now, when bringing up the incontinence subject with your father, here is what I would recommend. Talk to him in a private place, just the two of you. I would address it as a medical concern (not a hygiene problem). For example, I would say something like: "Dad, I know there are times when you just cannot make it to the bathroom in time, and you have accidents. I am concerned that this may mean you have a problem with your prostate. Can we go to the urologist to get this checked out? Maybe they can help you." By focusing on the fact that this is a medical problem, it should make it less embarrassing for him. Please do not focus on the hygiene issue. I wouldn't use terms like "wetting your pants" or "peeing your pants", as this may make him feel like your treating him like a child. However, if your father refuses help from a urologist, don't push him.

You can help him by getting him to go to the bathroom more frequently. Remember, an empty bladder is a happy bladder. I think his main problem is that he is not getting the urge to go until his bladder is ready to burst, so then he tries to rush to the bathroom. Since he is in an unfamiliar place (not at home), it takes him longer to find/ get to the bathroom. He just can't hold his urine that long. He should probably go to the bathroom about every 2 hours when he is in a social situation, to try and avoid accidents. You can help remind him to go to the bathroom before he feels like he has to go. Don't say "Dad, you need to go to the bathroom now!", like he is a child. Instead quietly say, "Hey Dad, do you want to go to the restroom before we sit down to eat/before we leave/etc?".

Hopefully, this will help. Good luck!

Community Answers

The practical expert answered...

Incontinence in senior men is usally caused by: something physically wrong that needs to be checked out; due to interactions of medications (diutretics for heart conditions are common causes but add in certain other meds and incontinence can become a major problem) - so again, check with the doctor on what can be done; last is that it is a sign of that person's aging process - sometimes a medication can help but some prefer to not go that route.

So, private conversation about incontinence, as mentioned is needed. I did this with me Dad. I spoke about my concern that I didn't want him to be embarrassed in public (he wasn't but I used it as a point) and others to not treat him as they should, smell of urine that others could smell and that it gets into the fabric of this clothing, about 'wouldn't it be nice to not be wet until you air dried' and be more comfortable and finally, I explained about what having wet urine can do to his skin integrity. I then respectually asked if he would be willing to try some products if I went and picked them out.

I bought several different types of male incontinence products and my father tried all of them. I have memories of us laughing when neither of us could figure out how to wear some of the products. My dad even showed up with halp a product hanging below his shorts!

Well, we finally found a product that worked and he could do by himself and he actually admitted that it felt nice not to be wet, not to have wet pants in public too. I kept a copy of the package of product that worked tacked up in a closet and a picture of it for Dad to use when shopping - stores change product placements and the shear number of products available, even I found daunting. The picture means he could find his right product anywhere.

Eventually, years later, medicaitons finally got adjusted and suddenly he wasn't incontinenent anymore. But I vividly remember the years that we did deal with it and the humorous way we decided to deal with it.

Frena answered...

i agree that incontinence is usually due to a specific medical problem and that's the way to talk about it. As well as prostate issues, it is often due to urinary tract infections, which in elders may not be signaled by anything other than sudden incontinence.

when talking with older gentlemen about this, it really helps to keep the conversation adult and non-finger-pointing and to concentrate on the practical. i always say, "actually lots of men your age wear this type of underwear now and the great thing is, no-one can ever tell."

getting decent underwear style protective wear helps and taking away all other underwear can also help, leaving no opportunity to forget.

while it seems a big issue to everyone, it's really not big, in the whole scheme of things that elders face. if we keep kind and cool, so will they (usually).

good luck!