Ageing and its effects on the bladder and bowel health 

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Getting older doesn’t have to mean that you will lose control of your bladder and/or bowel and become incontinent. However, changes that occur as we get older can make it more difficult to maintain effective bladder and bowel control.

Changes to the bladder when we get older can result in the bladder becoming a bit smaller and not contracting as efficiently to empty. The bladder may also become more sensitive and it may be more difficult to “hold on” if the bladder muscle is overactive. 

As we get older our body tends to produce less antidiuretic hormone. This means that when we are sleeping our urine does not get as concentrated. This results in an increase in the amount of urine produced, resulting in the need to wake up and go to the toilet. Waking at night to go to the toilet is called nocturia. This problem can be made worse if there are fluid problems elsewhere in the body such as swollen legs or Congestive Cardiac Failure. Breathing problems such as snoring and sleep apnoea can also result in nocturia. 

Other conditions that can affect bladder function include diabetes, urinary tract infections, bladder tumours and an enlarged prostate in men. These conditions should be checked by your doctor. 

Some medicines may also contribute to nocturia, as can having excessive fluids to drink in the late evening – particularly drinks containing alcohol and those containing caffeine such as tea, coffee, and cola. 

Some medical conditions, physical changes and disabilities can affect the ability to recognise the need to go to the toilet or the ability to get to the toilet on time. 

Arthritis, stroke, and Parkinson’s diseases are some of the conditions that can affect our ability to manage handling buttons, zips and other fastenings on clothing.These conditions can also make walking and getting to the toilet on time difficult. 

Poor balance or difficulty getting onto or off the toilet may cause concern for an older person. Poor eyesight may make it more difficult to locate the toilet, especially when out in public. 

People with dementia may have difficulty locating the toilet or remembering what to do when they get there. Some people may benefit from having a sign on the toilet door – this could be the word “toilet” or a picture of a toilet. A night light can also be helpful in the evening as it makes it easier to locate the toilet.

The following points may help if you are an older person or are caring for an older person: 

  • try clothes with elastic waist bands that can be pulled up or down without needing to use buttons, zips or other fasteners. 

  • see a physiotherapist regarding rehabilitation or walking aids. 

  • see an occupational therapist for invaluable information on types of hand held urinals, bedside commodes, and home modifications such as rails in the bathroom to make toileting easier. Other aids such as bottom wipers are helpful if there is restricted shoulder movement. 

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Kylie – parent of a child that wets the bed 

Kylie rang our service as she was concerned about her five-year-old daughter, Mia, who was wetting the bed. Kylie had tried limiting Mia’s drinks in the late afternoon and evening and was also getting up at night to wake Mia and take her to the toilet.

Our advisor explained that it may take children until they around 5 ½ years old before they gain bladder control during sleep. Kylie was advised to encourage Mia to drink well throughout the day and was cautioned against cutting out drinks in the afternoon and early evening. Kylie was discouraged from waking Mia at night to take her to the toilet. Kylie was provided with information on obtaining a referral from Mia’s doctor to a bedwetting clinic if Mia continues to wet the bed past 5 ½ years of age.

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Anastasiya’s story

“As a mum of two young children, I have experienced the joys of two pregnancies and postpartum recoveries. I was shocked after the birth of my first child to discover that my pelvic floor muscles had become weak. I sought advice from Bladder and Bowel Health Australia and learnt the importance of exercising these muscles. This knowledge helped, and because I was better informed second time around, I have now fully restored the dignity of my body and truly enjoyed the changes - and my motherhood. Thank you, Bladder and Bowel Health Australia, for informing young families about bladder and bowel health issues.” 

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Doreen – carer of her husband who has dementia 

Doreen was becoming exhausted caring for her husband Tom, who has dementia. Tom was not always making it to the toilet on time and needed his trousers to be changed several times a day. Every day Doreen was also washing bedlinen and the four towels that Tom was laying on at night as he was soaking through his pull-up pants. 

Tom was receiving a high-level Home Care Package, and Doreen was able to arrange with their provider for some of Tom’s package to be allocated to funding continence assessment and management.  

Our advisor went to Tom’s home and conducted a thorough continence assessment. A continence management plan was developed with input from Doreen, and appropriate incontinence aids and linen protection were organised. Doreen is relieved that Tom’s incontinence has reduced, and her washing load has lessened. Doreen is now confident that she can continue caring for Tom in their home. 

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Gary – experiencing leakage after his recent prostate surgery 

Gary met with one of our Bladder and Bowel Health advisors, as he was concerned about his urine leakage that was persisting after his radical prostatectomy five weeks earlier.   

Gary discussed his concerns with the advisor and was reassured that he was making good progress towards regaining bladder control. This reinforced the information he had received from his urologist. Gary was encouraged to switch to a smaller incontinence pad rather than continuing to wear the pull- up incontinence pants he had worn since his surgery. The advisor arranged some smaller pads for him to trial and provided details on where he could buy them close to his home. 

Gary was encouraged to drink plenty of fluid (particularly water) and to increase his fruit and vegetable intake to avoid constipation. Gary was uncertain if his pelvic floor muscles were working properly and he was referred to a pelvic floor physiotherapist. Gary left the clinic in a brighter frame of mind, confident that he was improving and had clear strategies to further support his recovery.