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Caring for Someone with Incontinence: Emotional and Social Issues

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Summary: Incontinence is a common problem among seniors, but incontinence care can help you manage this problem.

Up to 35% of seniors age 60 and over have some form of incontinence. Women suffer from incontinence twice as often as men, according to the National Institutes of Health.

The Family Caregiver Alliance noted that severe incontinence might serve as the deciding factor to move a loved one into a nursing home. It’s important for families to discuss incontinence care and how to manage the emotional and social issues involved.

Denial of incontinence problem

Many seniors are hesitant to admit they have an incontinence problem and may resist using absorbent undergarments and other incontinence products. Incontinence care is much more difficult when your loved one is unwilling to acknowledge the problem.

There are no easy answers to a loved one’s resistance. Sometimes it helps to schedule a time to calmly explain how incontinence products help you provide better care and help keep your loved one more comfortable.

The Family Caregiver Alliance cautions against statements such as “it makes the house smell bad,” and keep the focus on how acknowledging incontinence and using appropriate garments can help your loved one feel better. For example, mention that absorbent underwear will help disguise accidents so she isn’t embarrassed when they occur.

However, you can’t ignore the problem. Complications from prolonged exposure to wetness or fecal material may lead to painful skin rashes, urinary tract infections, and skin sores and infections, according to the Mayo Clinic.

Understand you may both be embarrassed

Incontinence care is often embarrassing for both parties. Your loved one is likely embarrassed by her loss of control, and you may be uncomfortable caring for her in such an intimate way. This is especially true if you are caring for a loved one of the opposite sex.

The Family Caregiver Alliance suggests a healthy way to cope is to acknowledge your discomfort. Simply say “I know this is uncomfortable for both of us sometimes, but it’s something we need to do.” This lets your loved one know you respect her feelings, and are honestly sharing your own.

Your loved one may resent the lack of privacy

The bathroom is one place most people expect complete privacy, but incontinence care may mean invading your loved one’s personal space from time to time. Don’t be surprised if your loved one expresses anger at losing his dignity.

For some families, a bedside commode or urinal will allow for a bit more privacy and independence. It may be less intrusive for your loved one if you can remove the urinal or pan and deal with cleanup out of sight.

Learn about incontinence care equipment and supplies

Incontinence comes in many different forms and degrees of severity. Knowing what’s available and when to use it can help you manage and stay ahead of the problem. For urgency incontinence and “leakers,” underwear liners or pads may be appropriate. Plastic bed and furniture covers, and protective underwear may help for more severe cases of incontinence.

Talk to your doctor about a physical therapy referral if you’re unsure what’s available and what would best help your loved one. Medicare generally doesn’t cover incontinence pads or adult diapers. This means that may have to pay 100% out of pocket for adult diapers and incontinence pads.

Respect your physical limitations

Incontinence care is difficult when there are physical mismatches between the caregiver’s size and strength and the size of the loved one. If you feel you cannot safely provide personal care to your loved one, don’t be afraid to talk to your health care provider and other family members for workable alternatives such as lift equipment.

You may want to ask another family member for help, or even hire a home health aide for a couple of hours a day. This can help you manage morning cleanup and bathing so you don’t risk injuring yourself or your loved one trying to handle the tasks on your own.

It’s okay to be angry sometimes

Incontinence is hard on everyone, especially the person stepping into the caregiver role. You may resent the unpleasant nature of incontinence care, especially if there is fecal incontinence involved. You may be angry when other family members aren’t as helpful as you’d like them to be—or feel anger toward your loved one from time to time.

The Family Caregiver Alliance suggests finding a support group, either in person or online, where you can open up about your emotions in a safe and accepting place. You can also learn coping strategies from others who are going through the same experience. You may want to have an honest conversation with other family members about what you need from them to stay physically and emotionally healthy. If they are unwilling to share the tasks of physically providing incontinence care, perhaps they can contribute money each month so you can hire an aide to give you a break.

Whatever you do, don’t let your anger and resentment get in the way of providing appropriate incontinence care. If your emotions are preventing you from giving dignified care, accept your limitations and talk to your doctor about finding the help you need.

Medicare cover of incontinence

Your doctor may prescribe some medications to help your incontinence. According to the Mayo clinic, these medications could include those that increase how much urine your bladder can hold and medications to calm an overactive bladder. Various medications to treat urinary incontinence include:

  • Detrol
  • Enablex
  • Myrbetriq
  • Flomax
  • Cardura
  • Topical estrogen

Original Medicare generally doesn’t cover medications you take at home, including medications for urinary incontinence. However, Medicare Part D coverage from a private insurance company may cover medications you take at home for incontinence.

You can get Medicare Part D in two ways. You can get it bundled into a Medicare Advantage plan along with your hospital and medical benefits. If you decided to stick with Original Medicare over Medicare Part D, you can get a stand-alone Medicare Part D prescription drug plan. Each Medicare Part D has a formulary, or list of medications it covers. Before you enroll in the plan, you can check that your incontinence medication is included in the formulary.

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