Urinary Incontinence & Toileting Issues in Older People


The sunlight rays crept through my window and caressed my cheek. Its warmth spread through my body and this rejuvenated me. I pushed off my bedspread and peeped outside my window. The children were screaming in delight as they cycled along the street. I looked at Jimmy, my dog, my loyal companion for the past ten years “c''mon boy! This is it, we are going out today. I have had it!”.
I am now 78 years old. I have been suffering from urinary incontinence for several years now.
I started having leaking of urine after my first baby when I was 34 years old then. Initially, it didn’t bother me much since the episodes were infrequent. However, as time and age went by, the problem worsened and I noticed I was leaking urine even when I sneezed.
I didn’t tell my husband or any of my 4 children. Ten years ago, my husband passed away, I cut myself from the outside world and took this opportunity to stay at home. Bought myself a dog and built my own world. Once in a while I would sit on the porch and watch the children play but this also reduced over time since I had to rush to the bathroom everytime I needed to pee.
Many a time, the local community staff nurse would drop me a visit and urge me to come out. I would just smile in silence. How I wish you knew what I am going through!

The prevalence of urinary incontinence in the elderly population varies from 30% to 50% according to age [1]. More than one third of women over the age of 65 years have some degree of incontinence and in men, the prevalence ranges from 3-11%.

Incontinence is defined as the inability to control either the bladder or the bowel resulting in leakage of urine or faeces.

Types of Urinary Incontinence

Faecal Incontinence: the involuntary evacuation of the bowel resulting in faecal smearing. Constipation is one of the most common causes of faecal incontinence in the elderly.

Risk Factors of Urinary Incontinence

Loss of bladder control is not easy to talk about but there is no need to feel uncomfortable bringing up the subject with your doctor. Take the opportunity to discuss incontinence during your visit. Make sure you have brought along your bladder diary that includes information such as time of the day incontinence usually occurs, activities proceeding incontinence, amount of fluids consumed per day, use of over-the-counter medications, intake of drinks such as caffeine etc. You can help your doctor make an accurate assessment and diagnosis by providing as much information as possible during the appointment.

As a caregiver

You and your loved one may feel uncomfortable about some of the tasks involved in continence care. The level of help your loved one needs can be quite demanding and draining. Caring for your family member is important, but you should look after yourself as well.

Treatment Options

Many people are suffering from incontinence. If you are one of them, do not suffer in silence alone. Come out and talk about it. Incontinence is treatable, and with some help from your doctor, this problem may be cured.



Keilman LJ. Urinary incontinence .Basic evaluation and management in the primary care office .Prim Care Clin Office Pract 2005;32:699 – 722.

DR. TAJMUL is a lecturer in Internal Medicine based in Cyberjaya University and a Clinical Fellow in Geriatric Medicine based in University of Malaya Medical Centre.