Bladder- and bowel-control problems can be embarrassing for you and your loved one. Here are some suggestions to help deal with this difficult situation.

The person you’re caring for may need help using the toilet, or she may have lost control over her bladder or bowel (incontinence.) You may be uncomfortable providing this kind of care. This chapter gives suggestions that will help her maintain as much independence as possible and make your job an easier one.

Incontinence is not a normal part of aging or most illnesses. If incontinence develops, it’s very important to ask the physician for a complete evaluation. Many causes of incontinence are treatable.

If The Person Needs Help Getting To The Bathroom

• Suggest going to the bathroom on a frequent, scheduled basis. Rushing after the urge strikes will increase the chance of accidents. Every 2 hours is too often for most people; start with every 3–4 hours.
• Make sure the hallway and bathroom are well-lighted.
• Remove throw rugs, which could trip someone.
• Install grab bars and/or use a raised toilet seat for more ease getting on and off the toilet.

If The Person Occasionally Has Accidents

• Remember that accidents are very embarrassing for the person.
• Stay calm and reassure her that it’s “okay.”
• Keep a matter-of-fact approach. “Let me help you get out of these wet things.”
• Monitor her for urinary tract infections. Any fever lasting more than 24 hours should be evaluated.

If Accidents Happen Regularly

• See a doctor for a thorough evaluation and treatment recommendations.
• Establish a regular schedule for using the toilet.
• Avoid caffeine, alcohol, citrus juice or other bladder irritants.
• Offer 6–8 glasses of fluids every day to prevent strong urine that can irritate the bladder.
• Find out if she is taking any medications that affect the bladder. Common over-the-counter products like aspirin and Excedrine contain caffeine, which stimulates the bladder. A few high blood pressure medications can irritate the bladder.
• Be aware that incontinence can be a trigger for skin breakdown and pay special attention to skin care.

Medicaid will cover the cost of some incontinence supplies if you have a doctor’s prescription. Be sure the pharmacy you use accepts Medicaid payment.

Avoid Constipation

• Offer foods high in fiber such as fruits, nuts, beans, vegetables, bran and most cereals. Add high fiber foods gradually if the person isn’t used to them.
• Make sure there is adequate liquid in the diet; 6–8 classes of liquid each day are recommended (unless otherwise instructed by the physician).
• Encourage daily exercise to stimulate bowel activity.

Helpful Supplies

• Commodes are available to buy or rent if it’s too hard to get to the bathroom. Commodes are especially helpful during the night.
• Bedpans and urinals may be needed if she can’t get out of bed. They can be purchased at medical supply stores and larger drugstores.
• Disposable pads, briefs, and undergarments are an expensive but effective way to protect clothing and bedding. They are available at medical supply stores, supermarkets, drugstores and many discount stores such as K-Mart, Target and Wal-Mart.

Controlling Stains And Odor

• Include cranberry juice in the diet to help control urine odor.
• Protect the mattress with rubber or plastic sheets. Consider a breathable, washable layer like sheepskin between the sheet and the waterproof to avoid excess sweating or a “sticky” feeling.
• Remove soiled bed linens and clothing quickly. If it’s impossible to launder them immediately, rinse them in cold water. Soak stained items in dishwashing detergent to loosen stains.
• Clean bedpans, urinals, and commodes with household cleaners.
• Avoid odors on furniture or other household items by cleaning soiled areas with a mild dilution of cold water and white vinegar.
• Protect furniture with disposable or other waterproof pads.

Originally written and published by the Aging and Adult Services Administration Department of Social and Health Services, State of Washington. Reprinted with permission.

Washington State Department of Social and Health Services