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Incontinence and falls

Incontinence can range from a small leak of urine to completely losing control of your bladder or bowel.

There are two types of incontinence:

  1. Urinary incontinence, or poor bladder control.
  2. Faecal incontinence, or poor bowel control.

Older adults with urinary incontinence, particularly those who experience physical symptoms such as pain or frequent urination, are at an increased risk of having a fall.

1 in 4 adults in Australia have urinary or faecal incontinence and women account for 80% of adults living in the community with urinary incontinence.

Incontinence is not part of ageing.

Risk factors for falls in older adults with incontinence

The direct relationship between urinary incontinence and falls is difficult to determine, however it is suspected that the following incontinence-related factors may increase the falls risk among older adults:

Urgency

The urgency for an older adult to reach a toilet may affect an individual’s speed, stride width, and balance, in turn increasing their risk of a fall.

Nocturia

Nocturia, or frequently visiting the toilet during the night, can cause the older adult to potentially make unsafe choices in order to get to the bathroom on time, increasing the risk of having a fall.

Having to wake up to use the toilet during the night can also result in increased drowsiness during the day.

Reduced social activities

Incontinence can lead to older adults reducing their social contact and physical activity outside of the home, which can influence their falls risk.

Dehydration

Older adults with incontinence may drink less fluids to avoid leaking urine, however this can result in dehydration.

Medication

Some medications used to treat urinary incontinence can cause side effects such as low blood pressure when standing up, dizziness, and blurry vision, contributing to an increase risk of falls.

Read more about medication management for falls prevention among older adults.

Cognition

Symptoms involving the lower urinary tract can contribute to a decline in cognitive ability.

How can I help older adults with incontinence?

There are a number of strategies that can be implemented to address the incontinence-related risk factors for falls among older adults. These include:

  • Bladder training, conducted by a Continence Nurse or Continence Physiotherapist, to assist the older adult to gain better control over the bladder.
  • Environmental modifications, such as a bedside commode or ensuring a clear pathway to the toilet.
  • Balance and pelvic floor strengthening exercises.
  • Assisting older adults in addressing triggers and fears associated with urinary urgency.

To explore other lifestyle-related incontinence prevention strategies, visit the Continence Foundation of Australia website.

Screening for incontinence in older adults

It is recommended that routine screening of older adults be conducted for urinary incontinence using the 3 Incontinence Questions screening tool. This screening tool can help to identify the presence and type of urinary incontinence being experienced.

Who can I collaboratively work with to support older adults with incontinence?

A multidisciplinary team for older adults with incontinence may consist of a Doctor, Pharmacist, Continence Nurse, Continence Physiotherapist, and Urologist.

The Continence Foundation of Australia Service Provider Directory can assist you to find incontinence service providers near you.

More information

For more information, resources, and support about incontinence, visit the Continence Foundation Australia website.

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