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adult urinary incontinence
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adult urinary incontinence

My mother is experiencing urinary incontinence.  She is in her mid-60s and has stage 4 emphysema.  Her incontinence used to occur only when she was having an exacerbation.  Over the past couple of years it has become daily, and she is now having accidents without realizing it.  She currently uses adult diapers, takes medicine (forget the name), and uses pads where she sits and in her bed.  She's still having frequent accidents, and our efforts to help her are hampered by her reluctance to discuss it.  I think she is also avoiding going to the bathroom because of the exertion it takes. I guess my question is, is there more we can be doing? Also, how common is it for seniors to not realize they've had an accident?
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547368_tn?1332173665
Hello NCteacher,

Welcome to the Caregivers Forum. I am so glad that you found us and took the time to post. I am very sorry to hear about your mom's urinary incontinence issues. It's embarrassing when this occurs no matter what the age.

You may be right that the mere exertion it takes for your mom to get to the bathroom is more than she can tolerate. However it may very well be that no matter how quickly she could get to the bathroom it would do no good. She may be incontinent either way. I am guessing that she has POP, or Pelvic organ prolapse. There are both non-surgical and surgical treatments that can be utilized to control, improve, or repair this condition.

In stage 4 COPD your mom is not a candidate for a surgical repair. Imagine if you will if the tables were turned how very embarrassing this extremely personal issue would be for you. Your mom no more wants to have a bladder control issue than you do. She really isn't all that elderly, though her health may make her older than her years.  

A urogynecologist may be able to evaluate your moms condition better IF her PCP beleives this would be an option. This is an obstetrician/gynecologist (Ob/Gyn) or urologist who specializes in the care of women with POP or pelvic floor dysfunction.

We also have a forum that is more directed at this condition that may provide you with more information.  Here is the link:
http://www.medhelp.org/posts/Urogynecology/Taking-Pelvic-Organ-Prolapse-Out-of-the-Closet/show/1271553

Lastly this may a situation that will just have to manage. I'm sure you would never shame your mom for this medical issues. She probably just has no control. Her stage 4 disease takes much from her. Struggling for breath is absolutely exhausting. The time that she has remaining should be a time of reflection and peace. She should be as comfortable as possible.

In my state she would be eligible for the caring, supportive and kindness help of Hospice. Stage 4 is considered an end stage lung disease. My dad passed 13 weeks ago with that very DX. Hospice was not here to help him die but to help him live. If you have not looked into into this valuable no cost service I encourage you to do so.  They can make the difference.

Your last questions was if it is uncommon that seniors not even be aware that they have had an accident. In your mother's case that may well be the case.

My heart goes out to you. I wish you both the very best. Support your mom as much as you are able. Let her know how much you love her and hug her when you can. Don't forget the big picture. In the scheme of things "accidents" aren't so important.  

I'll be thinking of you and your mom.

Blessings,
~Tuck
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1300526_tn?1275775221
Nice answer Tuck, Just to add to this in case it might help, My mom had a problem and she was not so embarrased and she did manage to get results, She went to a urologist and he gave her a cream that goes right at the entrance of the vagina and it works its way up to help an infection on the plevic floor area that turned out to be her problem and also told her about an exercise she can do to help and this worked for her, Might be hard to convince your mom to do all of this but if she will it is worth a try. The exersize is described on the web if you look it up and may also be in the forum Tuck mentions. It is easy to do but might be hard to talk to your mom about. I hope all goes well and nice to see that you care so much to help your mom. Take care..
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547368_tn?1332173665
Thanks Sallysmart for your wise input. You are correct regarding exercises and creams that my be beneficial.  The fact that her COPD is so advanced may make the normally ordered Kegel exercises very difficult for her. However it certainly is worth looking into.

In rereading by response I noted that I mistakenly said that at stage 4 COPD you mom "is not" a candidate for surgical repair. I did not word that correctly and I apologize. I cannot make a determine what treatments may or may not be available for you mom. Her physician is the one to make that assessment.

What I do know from experience is that her disease condition zaps ones energy and makes any invasive procedures less of an option.

Again I wish you both the best and hope to hear from you soon.

Take Care,
~Tuck

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Avatar_n_tn
Thanks to the both of you for your support and answers.  My sister and I love our mom dearly and would do anything for her.  It's just going to be difficult for her to discuss this because it's so embarrassing for her.  I have told her in the past that aren't upset about her incontinence, but that we need her to help us work with her by being honest and upfront with issues she faces.  

She lives with my sister (I live in a different town), and, while we have avoided the idea of hospice or in-home care, my mom's needs are quickly growing.  

I will take your ideas to my sister, and we'll have a conversation with my mom.  Tuck, I appreciate you correcting yourself that only her doctor could determine her surgical candidacy, but you're absolutely right.  She is no shape for any sort of surgery, and they've already rejected any type of surgery on her bladder.  

This is a very difficult time for us.  She seems to be getting older and weaker daily, and we wonder how much time she has left.  

Anyways, thanks for your input!  It's much appreciated.  
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547368_tn?1332173665
I have been exactly where you are. I KNOW the pain your heart is feeling. I do know how very difficult this time is for you and your sister. My heart aches for you both.

I took care of daddy in our home. He lived with us for almost eight years. He survived 18 months after his DX of end stage lung disease. My sister lives in another state and was unable to actively participate in his daily care...but she was great support. She called almost every day in the last 6-8 months. She sent dad what we called "Care Packages." These small boxes that came very several weeks were filled with candy, writing paper, stamps, snacks, trinkets and so on. He used very little of it but LOVED to get those packages. He couldn't wait to open them.

Your sister and Mom will need to same from you as I am sure you know. The unexpected phone calls or visits just to say "I Love You" will mean so much to both of them.
Hospice is not at all what I had thought it was...their role has greatly changed from what it was 20 years ago. They were so supportive and instrumental in dad's "living."  The last journey would have been MUCH more difficult without them.

Please come visit us when you feel the need. The nights can get long, lonely and painful. Watching my dad slowly deteriorate was the hardest thing I ever did. Truly! MedHelp was another source of support. Use all tools available to you. You'll need them.

My heart goes out to you!

Blessings,
~Tuck
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Avatar_n_tn
I wanted to provide a quick update and to express my thanks for all of the support.  Mom unexpectedly passed away a couple of weeks ago.  Apparently, her emphysema had taken a toll on her heart, and she went into cardiac arrest.  She had not had a recent exacerbation and had not be hospitalized in over a year.  We are deeply saddened but glad that she did not continue to deteriorate with the COPD.  I appreciate the kind responses I received on this forum and other MedHelp forums.  
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