The medical implications of incontinence are the worst part of this condition.
When I sneeze, I sneeze at least eight times in a row. I can remember my Aunt Mary Ellen saying to me, “Oh good, you sneeze just like me, get ready, cause when you get older, you’re gonna start peeing when you sneeze.” She was right.
Why is incontinence still such a taboo subject, despite all the commercials? Some believe it is because it is associated with babies and the loss of faculties. I get that, but over 25 million adult Americans experience temporary or chronic urinary incontinence. You will notice that this statistic from the National Association for Continence doesn’t say 25 million WOMEN. This is a problem for men as well.
Incontinence happens for many reasons. It can be caused by a urinary tract infection, irritation or constipation. Some medications can cause bladder control problems and if you’ve ever been pregnant, you know it can be due to weak pelvic floor muscles or a weak bladder. It is not a condition that only affects older adults.
Any caregiver dealing with incontinence can tell you how many mornings in a week they have had to change bed sheets. They can tell you of the struggle to get an incontinence product off someone who is in a bed. And they can tell you the number of UTIs the person they are caring for has had in the last couple of months.
It is this, the medical implications of incontinence that is the worst part of the condition. To understand, I spoke with *Carol Hallisey, BSN, MHA, about what she has seen in hospitals, skilled nursing facility (SNF) and assisted living (AL) communities and about her own experience caring for her mother at home.
“The number one medical problem caused by incontinence is urinary tract infections (UTIs). UTIs in older adults are hard to recognize because they don’t show the signs of infections until it is almost too late. I’ve seen so many people come into the emergency room because of an unrecognized UTI and a number of them go into sepsis. They go from the emergency room to ICU and are put on antibiotics. For older people, the antibiotics can cause a secondary problem because they can hurt the kidneys at a time when the function may not be 100%.”
“Then there are the problems caused by the urine being on the skin for too long. When that happens, the skin breaks down causing bed sores and pressure sores. The other problem is incontinence products made with plastic hold in the heat which results in yeast infections. On top of that, pull ups are hard to change when someone is in bed. It can be a two- or three-person job and hospitals are just not staffed for it.”
“Whether you are in a hospital, SNF or AL, the protocol is to check every two hours to try and get them to the bathroom and/or see if someone has voided. That means interrupting their sleep over and over. If they have voided, staff has to wash them because warm urine, especially on antibiotics, can cause skin irritations which can eventually become pressure sores. It can mean changing sheets if they have leaked through the pad and the number of gloves staff goes through is astronomical.”
“I know what it is like at home as well because of my mother’s incontinence. She was getting heavier and it was hard to get her up to change her at night. I started putting several plastic-based products on her to see if that would help catch the urine, but it only caused more problems. I finally went to just pads on the bed and in the morning had to deal with the wet sheets and wet bed. It was a lot of work, but she never had a pressure sore.”
If you care for someone living with a progressive brain disease, incontinence will become an issue. As the disease progresses, they will no longer know where the bathroom is located, won’t realize the need to urinate or can’t remember the toileting process.
I want to introduce you to a brand of incontinence products I just learned about, Seni. It is a Polish-based company that now has a presence in the U.S.
I was surprised that the product feels like a soft cloth and is fully breathable. The way it is designed, with NO core plastic material for absorption, the Seni product wicks away moisture from the body. It has leak guards and, on the back, two yellow lines turn green as urine is absorbed. Unlike other products, you don’t have to wake someone up in the middle of the night, you can discreetly check the back of the brief.
I was impressed when a 16.9 oz. bottle of water was poured into the adult brief and within minutes, when I pressed my hand on it, it was completely dry. Because warm urine does not stay on their skin, UTIs, skin breakdowns and yeast infections caused by a plastic-based adult brief are eliminated.
Seni incontinence products come in a variety of options for use and sizes. To ensure a good fit and because European sizes differ from the U.S., it is important to get waist and hip measurements. They are available online from Amazon, Walmart and Carewell. Adoro Healthcare here in New Jersey can answer any questions and ships Seni products anywhere in the U.S.
“The breathability and not having warm urine on someone’s skin is a Godsend and will keep people away from skin breakdowns. I can see SNF, assisted living communities and families using these products.” Carol Hallisey, BSN, MHA
If you need another opinion, here is Teepa Snow talking about incontinence during dementia and the Seni product line. https://www.youtube.com/watch?v=xjxjCGzILtE
*Full disclosure, Carol is my sister-in-law, and I would not have gotten through the last eight years as my mother’s caregiver without her guidance and support.
Disclaimer: The material in this blog is for educational purposes only. It is not intended to replace, nor does it replace, consulting with a physician, lawyer, accountant, financial planner or other qualified professional.
Deb is the author of “Your Caregiver Relationship Contract and “A Relationship Contract for Dementia Caregivers.” Your Caregiver Relationship Contract is available in both English and Spanish. It explains how to have an intentional conversation and the how unspoken expectations can cause problems during caregiving. A Relationship Contract for Dementia Caregivers explains how important it is to learn how your person wants to live their live out and how you, the caregiver is the most important person in this relationship, giving you tips and tricks for this journey.
Click here to learn more about Your Caregiver Relationship Contract or here for the Spanish version: Su Contrato de relación como cuidador de un ser querido. Click here to learn more about A Relationship Contract for Dementia Caregivers.
Deb is available as a caregiver consultant. She will answer the question: “Where do I start?” and find the resources to alleviate your stress. If you would like to invest a half hour to learn how she can help you, please contact her at: Free 30 minute consulting call