Few aspects of caregiving are as challenging—or as rarely discussed—as managing incontinence. It's exhausting, expensive, and emotionally difficult for everyone involved. Your parent feels humiliated. You're changing products multiple times a day, doing endless laundry, and trying to prevent skin breakdown.
Here's what you need to know: Incontinence is extremely common in the elderly, affecting over half of nursing home residents and millions living at home. It's often treatable or at least manageable. And with the right approach, you can handle it while preserving your parent's dignity.
While incontinence becomes more common with age, it's not a normal part of aging. Many causes are treatable: UTIs, medication side effects, constipation, prostate issues, weak pelvic muscles. Always have incontinence evaluated medically—don't assume nothing can be done.
Types of Incontinence
Urinary Incontinence
| Type | What Happens | Common Causes |
|---|---|---|
| Stress | Leaking with cough, sneeze, laugh, lift | Weak pelvic floor muscles, especially in women |
| Urge | Sudden strong urge, can't reach toilet in time | Overactive bladder, UTI, neurological conditions |
| Overflow | Bladder doesn't empty fully, dribbles | Enlarged prostate, nerve damage, diabetes |
| Functional | Can't get to toilet in time (mobility/cognitive) | Dementia, arthritis, physical disability |
| Mixed | Combination of types | Multiple causes |
Bowel Incontinence
- Passive incontinence: No awareness of needing to go
- Urge incontinence: Feels urge but can't reach toilet in time
- Fecal seepage: Small amounts leak out
Common causes: chronic constipation with overflow, nerve damage, muscle weakness, dementia, medications, diarrhea
Sudden onset of incontinence—especially with confusion—can signal a UTI or other medical problem. New bowel incontinence needs evaluation to rule out serious causes. Don't assume it's "just aging."
As an Amazon Associate, we earn from qualifying purchases.
Recommended Incontinence Care Products
- Medline Ultrasorbs Disposable Bed Pads Super absorbent underpads protect mattresses and reduce laundry
- Prevail Maximum Absorbency Underwear Comfortable, discreet protection for moderate to heavy incontinence
- Cavilon No-Rinse Skin Cleanser Gentle cleansing without water to prevent skin irritation
- Medline Raised Toilet Seat with Handles Makes it easier to sit and stand, helping prevent accidents
Treatment Options
Medical Treatments
- Treat underlying causes: UTI, constipation, medication adjustment
- Medications: For overactive bladder (anticholinergics, beta-3 agonists)
- Pelvic floor therapy: Exercises and biofeedback to strengthen muscles
- Pessary: For women with pelvic organ prolapse
- Surgery: Various procedures for specific types
- Botox injections: For overactive bladder
Behavioral Approaches
- Scheduled toileting: Take to bathroom on regular schedule (every 2-3 hours)
- Prompted voiding: Ask regularly if they need to go
- Bladder training: Gradually increase time between voids
- Pelvic floor exercises (Kegels): If cognitively able to participate
- Fluid management: Adequate but not excessive fluids; limit before bed
- Dietary changes: Avoid bladder irritants (caffeine, alcohol, acidic foods)
For many elderly people, especially those with dementia, scheduled toileting is highly effective. Taking them to the bathroom every 2-3 hours—and after meals, upon waking, before bed—can dramatically reduce accidents, even if they can't remember to go themselves.
Incontinence Products
Types of Products
| Product | Best For | Considerations |
|---|---|---|
| Pads/Liners | Light incontinence, stress leakage | Least bulky, less expensive, most discreet |
| Pull-ups (protective underwear) | Mobile adults, moderate incontinence | More dignity, easier for toilet use, costlier |
| Tab-style briefs | Limited mobility, heavy incontinence | Easier to change when lying down, most absorbent |
| Underpads (chux) | Bed and chair protection | Use as backup, not primary protection |
Choosing the Right Size and Absorbency
- Measure waist and hips: Size charts are on packaging
- Match absorbency to need: Light, moderate, heavy, overnight
- Don't over-buy absorbency: More absorbent = more bulky and expensive
- Consider overnight vs. daytime: May need different products
- Sample before bulk buying: Many brands offer samples
Cost-Saving Strategies
- Buy in bulk online (Amazon, medical supply sites)
- Check for subscription discounts
- Compare store brands (often comparable quality)
- Check if Medicaid covers supplies (varies by state)
- Ask about manufacturer coupons
- Consider washable products for some situations
Cheap products that leak cost more in laundry, skin problems, and frustration. Mid-range products from known brands (Depend, Tena, Prevail) usually perform well. Premium products may be worthwhile for overnight or heavy incontinence.
Skin Care
Incontinence-associated dermatitis (IAD) is a serious risk. Urine and feces irritate skin, leading to redness, breakdown, and increased risk of pressure ulcers and infection.
Prevention
- Change promptly: Don't leave soiled products on
- Clean gently: Use incontinence cleansers, not soap (which dries skin)
- Pat dry: Don't rub; ensure skin is completely dry
- Apply barrier cream: Zinc oxide or dimethicone-based creams protect skin
- Allow air exposure: When possible, let skin air out
- Check skin daily: Look for redness, breakdown
If Skin Is Already Irritated
- Change products more frequently
- Use gentler cleansing
- Apply barrier cream generously
- Consider antifungal cream if yeast suspected (common)
- See doctor if not improving or if skin is broken
Red, raw, or broken skin needs attention. Open wounds in the diaper area can become seriously infected. If you see broken skin, blisters, or wounds that aren't healing, consult the doctor.
Practical Management Tips
Bathroom Accessibility
- Clear path to bathroom (no obstacles)
- Nightlights for nighttime trips
- Raised toilet seat for easier sitting/standing
- Grab bars for stability
- Bedside commode if bathroom is too far
- Urinal for nighttime (men)
Clothing Considerations
- Elastic waistbands (easier than buttons/zippers)
- Pull-on pants rather than complicated fasteners
- Velcro closures instead of buttons
- Avoid belts
- Nightgowns may be easier than pajamas
Bed Protection
- Waterproof mattress protector (fitted)
- Washable underpads on top of sheets
- Keep extra bedding nearby for quick changes
- Consider waterproof pillow covers
Managing Odor
- Change promptly—odor increases with time
- Dispose of products in sealed bags
- Use diaper pails with lids
- Clean thoroughly with each change
- Wash soiled linens promptly
- Add vinegar to laundry for odor
- Good ventilation in room
Preserving Dignity
Incontinence is deeply embarrassing for most people. How you handle it affects their self-worth.
- Use neutral language: "Let me help you change" rather than dwelling on the accident
- Provide privacy: Close doors, cover as much as possible during changes
- Be matter-of-fact: Not disgusted, not pitying—just practical
- Don't scold or show frustration: They can't control it
- Respect their preferences: Product style, who provides care
- Maintain their appearance: Clean clothes, pleasant smell
- Let them do what they can: Some participation preserves dignity
Many elderly people resist "adult diapers." Using terms like "protective underwear" or brand names like "Depends" may be more acceptable. Let them choose products when possible—feeling in control helps.
When Incontinence Becomes Unmanageable
Sometimes incontinence care becomes too much for one person to handle:
- Multiple nighttime changes disrupting your sleep
- Skin breakdown that won't heal
- Physical difficulty with changes (lifting, positioning)
- Caregiver burnout
Options to Consider
- Home health aide: Help with personal care
- Adult day programs: Professional care during day
- Facility care: May be needed if care needs exceed home capacity
- Medical interventions: Catheters (risks and benefits with doctor)
Track Care and Stay Organized
Our Daily Care Log helps you track patterns, product usage, and skin condition—useful for managing care and doctor discussions.
Get the Complete Caregiver Kit- Incontinence is common but often treatable—get medical evaluation
- Scheduled toileting can dramatically reduce accidents
- Choose products based on mobility, incontinence severity, and comfort
- Skin care is critical—clean, dry, barrier cream
- Make the bathroom accessible and clothing easy
- Handle changes matter-of-factly to preserve dignity
- Quality products save money on laundry and skin problems
- Seek help if care becomes unmanageable