Question

I have noticed recently that my mother has a problem with incontinence. Sometimes when I enter her home, I notice a urine smell, especially in the winter months when the windows are closed. 

I don’t know how to approach this issue with my mother. She is a very proud lady and she is of sound mind, though maybe not as sharp as she once was. I don’t want to embarrass her, nor do I want her home to take on the smell of stale urine. I need some advice on how to help her with as little offense as possible. Any suggestions?

Answer

Incontinence is a common problem for the elderly, and is a touchy subject for them and their children. Bladder control is very important for all of us, and not something to be taken lightly or ignored. A lack of bladder control can impact our social life or affect our mood. It can be a safety issue, or a symptom of a serious illness. While more common as we age, it is not just a simple aging problem.  

Loss of bladder control requires, first and foremost, a medical evaluation. Yes, this is an embarrassing topic, but it should not be ignored in hopes it will resolve on its own. 

Indeed, it may be a minor issue related to simple muscle weakness, which can be treated with a concerted effort to strengthen the pelvic musculature. What happens sometimes as we age is a weakening of the round muscle that constricts to hold back the flow of urine – the sphincter.

One cannot assume that the situation is a simple fix though. There are times when the entire pelvic floor is weakening and placing pressure on the bladder. This is more common in women, and should be evaluated. 

Another consideration is urinary tract infections (UTI) which are quite common in the elderly and often cause hospitalizations. Infections are irritating to the bladder and may cause frequent urination. Often times, the elderly are less mobile and may not make it to the bathroom on time.

If it’s not a UTI but a physical issue, it will come to light during evaluation and you will have a medical team helping you communicate and problem solve the incontinence. 

Please do not delay in seeking assistance for this issue. I hope you are able to find a positive outcome.