Incontinence is an embarrassing condition that is often difficult for a person to accept and deal with. Many seniors try to ignore this new development and carry on with their lives, but a head-in-the-sand approach usually draws more attention to the problem. Fortunately, there are ways to encourage a loved one to address this issue, but they require patience, understanding and a commitment to upholding your loved one’s dignity.
Change Your Vocabulary
“My parent won’t wear adult diapers and it drives me nuts!”
This is a common complaint for caregivers whose loved ones are suffering from incontinence, and I absolutely sympathize. However, one glaring piece of this sentence stands out to me: the use of the word “diaper.” The first thing I urge caregivers to do when tackling this sensitive topic is think carefully about their word choices. Seniors often rebel against the word “diaper” as an adult of any age would—and for good reason. This word implies a piece of clothing used for a baby or toddler who has yet to be toilet trained. What adult would take kindly to this word when it’s applied to them?
To take it one step further, think about this. If you are a middle-aged woman who has had children, you have probably suffered from stress incontinence occasionally, meaning that you’ve leaked a little urine while coughing, sneezing or laughing. Perhaps you’ve even used a panty protector just in case. How would you feel if your husband or friend referred to this little protection as a diaper?
Diapers are associated with babies. No adult, regardless of their level of physical or mental disability, should be treated as though they are a baby. Aging and age-related conditions already rob our loved ones of much of their independence and dignity. Our word choices and tone of voice may not seem that important but communicating and providing care in a way that helps our loved ones feel dignified is a game-changer when it comes to promoting cooperation and boosting their self-esteem.
This may seem like nitpicking, but please refer to incontinence products with age-appropriate terms. Think along the lines of briefs, pads, underpants, the actual brand name like Depends—anything you want. Just make the word respectful and you’ll have mastered the first step toward getting a senior to wear incontinence protection. I ask you to do this not only for the elder, but yourself. Using respectful words will help remind you that you are caring for an adult who deserves to be treated as such.
See a Specialist
I’m aware that just changing the words you use isn’t going to completely solve the problem. When incontinence becomes even an occasional issue, it’s important for your loved one to see their doctor about it. It may be caused by something straightforward, such as a urinary tract infection (UTI) or an over active bladder (OAB), or a more serious underlying issue like prostate problems in men or pelvic organ prolapse (POP) in women.
Most likely, you’ve taken your elder to the doctor to address the issue. After testing to determine the type of incontinence your loved one is experiencing, their doctor may be able to recommend pelvic floor exercises, minor surgical procedures and even medications that can help manage incontinence and prevent accidents. Sometimes a second opinion from a urologist is a good idea as well. If you deal with what’s causing symptoms of incontinence, then adult briefs and other protection may wind up being unnecessary.
Deal with Denial Head On
If your loved one’s cognition is still good but they simply prefer to live in denial about this new development in their health, try appealing to their sense of vanity. After all, vanity is what keeps us in denial about many age-related issues. Our culture is guilty of ageism to the extent that many people go to extremes to appear as though they are winning this losing battle against nature.
Certainly, incontinence is very difficult to accept. However, if you, or a third party, can convince your elder that it’s much more embarrassing to smell like urine because you ignore leakage than it is to wear proper protection, you may get somewhere. Promise to work with them to find a comfortable, absorbent and low-profile solution that will enable them to maintain their dignity, extend their independence and improve their appearance. Incontinence frequently causes seniors to venture out less to avoid embarrassing situations, but it doesn’t have to be this way.
Ask Their Doctor or a Friend for Help
Just like many other issues with our aging parents, incontinence may be better approached by a non-family member, such as a trusted friend or a doctor. Why? Because seniors tend to discredit or shrug off observations and suggestions from their own family, especially when it’s coming from an adult child.
Our aging parents changed our diapers when we were babies. It’s difficult for them to grapple with the fact that Mother Nature has pulled this cruel switch on them. Receiving advice and directions on “how to cope” from someone you raised and who has no first-hand experience with the issue is often just too much to handle, so they start getting dismissive or defensive.
It may be less embarrassing to have the discussion with an objective doctor who’s seen it all or a friend who is dealing with the same challenges. When their defenses are down, they’re usually more willing to listen.
Reasons Why Seniors Refuse to Wear Incontinence Protection
There are plenty of other reasons beside denial and embarrassment that can make it difficult (if not impossible) to get an elder to wear adult briefs. Some of these factors are out of their control and it can take a great deal of patience on behalf of caregivers to work through them.
Diminished Senses of Sight and Smell
Our senses weaken naturally as we age and can result in seniors’ lack of awareness of how smelly and soiled their clothing and furniture is. Even if they acknowledge that they’ve had an accident, they may downplay it and continue wearing the same clothing (wet or dry) when it desperately needs to be laundered. Because they don’t realize the full impact that incontinence has on their personal presentation, they may truly feel that incontinence protection is unnecessary, especially if they don’t leave the house or have visitors over regularly.
It’s a difficult subject to broach but informing a loved one that their personal odor or the smell in their home has become offensive is sometimes the ticket to compliance with incontinence products. Some elders are truly embarrassed when they realize that others have caught onto the issue they thought they had been successfully covering up. Just be sure to break the news gently and respectfully.
Depression Can Be a Contributing Factor
If your loved one feels no embarrassment or concern over their smell or appearance, then you may have a more serious underlying issue on your hands. Unfortunately, loss of interest in personal care, socialization and other activities can be symptoms of depression.
Spotting depression in seniors is tricky, but social isolation, chronic health conditions and pain put this demographic at a significantly higher risk. At the very least, depression screening should be part of your loved one’s annual visit to their primary care physician. If you notice the symptoms in between visits, it’s important to make an appointment as soon as possible. Treating depression may help your loved one feel better and spur them to engage in personal care again, which, in turn, can boost their self-esteem and encourage them to venture out and socialize more.
Dementia Might Be the Culprit
If denial, obliviousness and depression aren’t factors in your loved one’s refusal to partake in continence care, a dementia screening might be the next step. It doesn’t matter who reasons with them if cognitive decline is a factor. Depending on their mental acuity, they may no longer be capable of making sound decisions, like wearing incontinence products, changing their clothing or following their medication regimen. If you notice any other signs of decline or memory issues, it’s important to make a doctor’s appointment for a full evaluation. Early diagnosis is crucial for adequate planning and care.
When All Else Fails, Let Them Work It Out
I’m aware that there are times when none of the above tips will work. Our elders are in charge of their lives and daily choices. While our gentle suggestions come from a good place, there is little we can do about issues like this while they are still competent to make their own decisions. Do what you can to get medical help, treat the person with respect and dignity, and then let go.
Time may take care of the very things you pushed so hard to correct. Sometimes, when we leave people alone to work out their problems, they stop resisting and tackle them head on. However, if the situation is extremely dire, call your local adult protection services (APS) agency. A welfare check may be needed to make some positive changes in your loved one’s life.