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Over the past year I have talked alot about incontinence, but not really ever touched on a type of incontinence that is going to become increasingly prevalent as our aging population explodes in the next few decades. Functional incontinence occurs when problems getting to the toilet are caused by environmental, physical or mental difficulties. For Alzheimer’s patients, even remembering where the toilet is, causes challenges. For those with slow walking due to hip, knee or back pain, having had a stroke or Parkinson’s disease, the slow pace of their gait may mean they will leak before they make the toilet. So if you are caring for someone with these problems, what are the things you can do to improve their continence problems.
Toilet set-up:
Clearly label the toilet door if any memory issues.
Remove any mats that may cause a hazard when trying to reach the toilet.
Always have a footstool to optimise emptying for the bowel and a A4 poster near the toilet to show the correct posture.
Appropriately placed hand rails to assist safe getting on and off the toilet. An Occupational Therapist will be able to assist with an assessment
Simple rules to minimise increased risk of leakage:
Always offer decaffeinated tea and coffee.
Timed voiding often helps prevent incontinence – work out roughly what the time is between wees and then encourage toileting around this time.
There are special watches which can be set to give a vibration at set times to help remind it’s time for a wee.
Ensure adequate drinking of fluids.
Ensure there is no constipation with the 4 F’s- fluids, fibre, fruit and f(v)eggies.
So if you are a baby boomer looking down the gun barrel of older age – what do you do?
Pelvic floor exercises daily.
Always try for 350-500 ml bladder capacities, drink plenty of fluids but minimise or eliminate caffeine.
Brace with increased intra-abdominal pressure such as when bending, coughing, sneezing, lifting.
Keep moving and exercising every day to maintain good mobility, flexibility and general muscle strength.
Keep your weight in the safe range and give up smoking.
So if you are caring for someone who has functional incontinence, hopefully with these hints, there will be some improvement.

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