What is functional incontinence?
As the name suggests, functional incontinence is caused by a physical, cognitive or environmental barrier to getting to the toilet in time. Unlike other types of incontinence, it’s not usually a bladder or bowel problem. That said, it is possible to have both functional incontinences, as well as stress Stress incontinence in Men or urge Male Urge Incontinence incontinence, and even all three.
Causes of functional incontinence
As mentioned, the causes fall into three categories; physical, cognitive and environmental.
• Mobility issues due to injury, illness, disability or being frail aged. Any of these can pose limitation on getting to the toilet in time. Using a wheelchair or walking aid or requiring assistance to get up and out of a chair or bed can compromise toileting independence. The ability to get on and off the toilet and effectively using toilet paper can also be challenging, especially for the aged.
• Dexterity issues such as severe arthritis, which slows the ability to undo buttons, belts and zips to remove clothing. Opening doors and lifting toilet lids and seats can also be problematic.
• Poor eyesight can also pose a challenge in locating and safely getting on the toilet and for men, ensuring they’re urinating into the bowl.
• Dementia-related diseases can cause functional incontinence as the person forgets where the toilet is, what to do when they get there or even to go. It can also interfere with recognising messages between the bladder and brain, indicating that it’s time to go to the toilet. You can read more in this article, Does Dementia Cause Incontinence?
• Brain injury or intellectual disability which, like dementia, can impair messages between the brain and bladder as well as memory. Being able to communicate the need to go to the toilet and asking for assistance, can also be an issue.
• Although much progress has been made in the accessibility of public bathrooms, they can still catch people out. Stairs, poor lighting, distance, queues and narrow corridors can be the difference between making it and experiencing incontinence. This is extremely frustrating and embarrassing, as people who would typically be continent are caught out.
• Visiting friends and relatives can be even more difficult. Space and access may be unknown before arrival, and in many houses and apartments, both
can be very limited.
Discuss it with your doctor
If you or the person you care for is suffering from functional incontinence, discuss it with your doctor. While they may not be able to fix the underlying cause, there are other aspects they can check, such as:
• Infection. A UTI or Urinary Tract Infection can cause incontinence and is treated with a course on antibiotics. While generally associated with women, anyone can develop a UTI, and in the elderly, there may be only mild, if any, symptoms.
• Medication. Some medications are known to contribute to incontinence. If you raise the issue with your doctor, they’ll be able to check your regular medications and make any substitutions.
• Cancer. Incontinence can be a symptom of bladder cancer or prostate cancer. Although the continence issues cancer causes aren’t functional, if there’s also stress and urge incontinence, it’s worth having it checked out – just to be sure.
• Referrals. The doctor might also refer you to a Continence Nurse or other health care specialists. They can help in developing a management plan and making changes at home to better manage on-going incontinence.
Managing functional incontinence
Although the causes of functional incontinence can’t usually be corrected, there are things you can try to improve management.
For physical barriers, consider:
• Grabrails to assist getting on and off the toilet
• Handrails in the approaching corridor and into the bathroom
• Keeping the door to the toilet open and the lid up
• Ensuring there are no obstacles in the way, including rugs and bathmats which could pose tripping hazards
• A commode that sits over the toilet. There are many types available. Some have the advantage of raising the sitting position (reducing the distance
of getting up and down), backrest and armrests for stability and footplates to assist with a good toileting position
• Chose clothing with an elastic waist instead of buttons and zips
• Make sure lighting to and in the toilet is bright
For cognitive barriers, try:
• Taking the person to the toilet at the same times across the day – routine toileting can be very effective
• TENA Pants look and feel like regular underwear providing familiarity for those with dementia. They allow for self-toileting where possible with the
back-up of high absorbency should an accident occur
Environmental barriers are often the most difficult to manage as they’re typically unexpected. You may be at a café or restaurant, travelling or at a friend’s
house when you discover that getting to the toilet is going to be very difficult. To prepare for these situations, it may be best to ‘expect the worst’ and use
a disposable product like TENA Pants – just in case.
If you’re a carer, you may find this article, Practical Tips for Carers Managing Incontinence at Home, useful.
The psychological toll of incontinence
The impact of incontinence on a person’s wellbeing should never be underestimated. Whether it’s you or someone your caring for, the condition can cause embarrassment and shame as well as being an indicator of deterioration. Further, it can interfere with everyday activities such as sleep, outings and social interactions, curbing the sufferer’s quality of life.
Research has shown the emotional stages of incurable incontinence can mirror that of grief, including denial, anxiety, frustration, anger and depression.
You can read more about these in this article; Incontinence can take a psychological toll on men.
If you or the person your caring for is experiencing low mood because of incontinence (or any other reason for that matter), take action. Speak with your doctor about a referral to a psychologist or contact your local mental health organisation; Beyond Blue in Australia and the Mental Health Foundation in New Zealand.
Additional articles that may be of interest to carers are:
Products for managing functional incontinence
While women find the use of pads familiar, men can struggle with the concept. The reality is that once men discover how comfortable, discreet and
absorbent they are, they don’t look back.
For men who’ve not used protective products before, this article, Understanding Incontinence Pads for Men explains more about the products, how to
wear them, and how to dispose of them. It also busts a lot of myths men have about wearing ‘pads’.
Choosing the right product for you (or the person you care for) is essential in optimising management. TENA has an extensive range of Men’s Products and Specialist Products which are ideal for those requiring additional support.
With such a selection, TENA has developed a Product Finder Tool to assist in identifying the right one for your needs. This online program steps you through a short series of questions, then suggests products that may be suitable. You can even order free samples. If the samples you request aren’t quite right, come back to the website and try something else. That’s because here at TENA, we’re committed to helping you find the best product for your situation.
Asaleo Care makes no warranties or representations regarding the completeness or accuracy of the information. This information should be used only as a guide and should not be relied upon as a substitute for professional, medical or other health professional advice.