It’s often difficult for older adults to accept and deal with incontinence issues. Many try to ignore this new development and carry on with their lives, but a head-in-the-sand approach usually backfires, drawing more attention to their condition. There are ways to encourage a loved one to address this problem, but they require patience, understanding and a commitment to upholding your loved one’s dignity.
Pro Tip: Strike the Word Diaper From Your Vocabulary
“My parent won’t wear adult diapers and it drives me nuts!”
This is a common complaint from family caregivers whose loved ones are suffering from incontinence, and I absolutely sympathize. However, one glaring piece of this sentence stands out to me: the word “diaper.”
Figuring out how to talk to elderly parents about incontinence is difficult. The first thing I urge caregivers to do 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 term is typically associated with babies or toddlers who have yet to be toilet trained. What adult would take kindly to the 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’ve 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 significant other or a friend referred to this little protection as a diaper?
Bottom line: diapers are for babies. No adult, regardless of their level of physical or mental disability, should be treated like 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 ways that help our loved ones feel dignified is a game-changer—especially when it comes to promoting cooperation and boosting self-esteem.
This may seem like nitpicking, but please refer to adult incontinence products with age-appropriate terms. Think along the lines of briefs, pads, underpants, pull-ups, the actual brand name (e.g., Depends)—anything you want. Just make your terminology 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 also for yourself. Using respectful language will help remind you that you are caring for an adult who deserves to be treated as such.
Determine the Underlying Cause of “Accidents”
I’m aware that just changing the words you use isn’t going to magically 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 already helped your loved one seek medical attention for this issue. After testing to determine the type of incontinence they’re experiencing, their doctor may be able to recommend pelvic floor exercises, minor surgical procedures, or even medications that can help manage incontinence symptoms. Sometimes a second opinion from a urologist is a good idea. For seniors experiencing fecal incontinence, make an appointment with a gastroenterologist. If you can identify and treat what’s causing a loved one’s symptoms, then adult briefs and other protection might wind up being unnecessary.
Deal With Elderly Incontinence Denial Head On
If your loved one is still cognitively sound, but they simply prefer to live in denial about this new development in their health, try appealing to their sense of vanity. After all, pride is what keeps us in denial about many age-related changes. 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 time.
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 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 withdraw and become less active so they can 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 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. Seniors typically react by getting dismissive or defensive, which helps no one.
It may be less embarrassing to have the discussion with an objective doctor who’s “seen it all before” or a friend who is dealing with the same challenges. When their defenses are down, they’re usually more willing to listen.
Why Seniors Refuse to Wear Adult Diapers
There are plenty of other reasons that can make it difficult (if not impossible) to get an elder to wear incontinence underwear. Some of these factors are out of their control, and it can take a great deal of patience on behalf of their family caregivers to work through them.
Diminished Senses of Sight and Smell
Our senses weaken naturally with age and can result in a lack of awareness of how smelly and soiled one’s clothing and furniture are. Even if a senior acknowledges 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. Since 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 often.
It’s a difficult subject to broach, but informing a loved one that their body 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’d been successfully covering up. Just be sure to break the news gently and respectfully.
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 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.
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 tries to reason with them or how they go about it. If cognitive decline is a factor, a senior may no longer be capable of making sound decisions about wearing incontinence products, changing their clothing or other important self-care tasks. Make a doctor’s appointment for a full evaluation whenever new or worsening memory issues or signs of dementia appear. 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 for well-meaning family caregivers. 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 them medical help, treat them 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 their living situation is extremely dire and you feel it constitutes elder self-neglect, call your local Adult Protective Services (APS) agency. A welfare check may be needed to make some positive changes in your loved one’s life.