Living with incontinence is difficult, no matter what age you are. I have urge incontinence, probably a side effect of either the brain surgery I had in 2005. There is nothing mechanical going wrong that can be repaired, I simply don’t ever receive the messages from  my brain to tell me I need to go. I published an article about living with it some years ago, a copy of which I have uploaded below. In our western world, living with slight incontinence it seems is ok, as the advertising on television for women in particular who have slight leakage is honed in on as a target group for incontinence aids. I wonder why we aren’t told to get ourselves to physiotherapists who specialise in helping us to strengthen up our pelvic floor muscles to prevent this slight leakage, rather than encouraged to wear pads?! For most women (and men) with slight leakage, it is not a case of something being wrong, more usually simply a case of weak pelvic floor muscles. When it first started to me, I made the assumption it was normal for my age, and did nothing about it, and initially told no-one.

Living with incontinence and dementia is a bit trickier, as the ability to remember to stick to a timed toileting regime, or to wear incontinence pads is impaired. If you are looking after someone, especially with more advanced stages of dementia, then this can become almost impossible. When I worked in aged care, I recall residents simply pulling their pads off, and refusing to wear them;I remember them sitting on toilets, telling me to go to the toilet myself whilst refusing to go themselves. It is difficult to know when someone else needs to go. And then there is the nurses minute that comes into play. Research shows that a nurses minute, can be up to an hour, so if someone does ask you to take them to the toilet, and you say I’ll be back in a minute, by the time you get back there, it will probably be too late. From this is borne incontinence (in the staffs eyes), and therefore the pressure to enforce the wearing of pads or pullups. Nurses and carers in the aged care system in particular are working to very tight task-based schedules, with fewer staff than is needed for true person centred care, in a system that does not pay or value them enough. They are doing their best, in a system that is broken and failing our sick and elderly.

I worked in sales, with products for aged care, and never thought once about the impact of the LACK OF CONTINENCE awareness of the staff and residents in these places, or the impact of the LACK OF TIME to take residents to the toilet. It is not normal to have leakage, and we should all start thinking about this – yes, you will get old, and unless you have been working your pelvic floor muscles, you will get leakage too!! Don’t wait until it is too late, and the staff in aged care force you to wear continence aids. Remember, YOU can then be classified as high care, and therefore qualify for higher funding, if you are incontinent. Just something for you to think about. For me, and for some others, there will be medical reasons why you have incontinence, but if these are ruled out, and you should get yourself checked thoroughly if you have leakage of any kind, then start exercising your pelvic floor muscles NOW. If you are caring for someone with dementia who has incontinence of any kind, take them to see a doctor, and then find a continence nurse who can teach you about things like timed toileting as a way of avoiding the dreaded continence aid. We start out in nappies, but there should be no reason why most of us have to end up in them as we age.

Ps Apologies if the article below is too difficult to read without printing it off, but I can’t work out how to copy the text from the PDF!!