Managing Incontinence

About half of stroke survivors admitted to the hospital will experience loss of bladder control, and about a third will experience loss of bowel control. This is called incontinence.

This can be very distressing for both the stroke survivors and their caregivers. For many, it can be a very sensitive and personal issue that causes embarrassment or a loss of dignity.

While many stroke survivors experience incontinence early on, it has been reported that only 15% will continue to have continence problems a year after their stroke. These are common issues survivors experience and tips for managing post-stroke incontinence.

Common Post-Stroke Continence and Bowel Problems

• Frequency – need to urinate often
• Urgency – sudden, urgent, and uncontrollable need to urinate
• Nocturnal incontinence - loss of control while sleeping (bedwetting)
• Functional incontinence - when physical disabilities impede the person’s ability to get to the toilet in time (loss of mobility, inability to unfasten clothes in time, etc.)
• Stress incontinence - leaking of urine when the person coughs, sneezes or laughs
• Reflex incontinence – passing urine without releasing it
• Overflow incontinence – leaking of the bladder due to it being too full
• Fecal incontinence - uncontrolled bowel movement
• Constipation with overflow – watery stool leakage when large stool gets stuck and blocks the bowel
• Fecal Impaction – dry, hardened stool collected in the rectum

Treatments for Bladder Incontinence

• Bladder training
• Pelvic floor exercises
• Bladder stimulation
• Medication
• Weight loss

Treatments for Bowel Incontinence

• Bowel training
• Medication
• Laxatives
• A bowel regimen
• Dietary changes

Managing Your Loved One’s Incontinence at Home

• Find the right incontinence products (absorbency pads or pull ups)
• Use washable seat pads to protect furniture
• Use mattress protectors
• Get a commode for easy toilet access
• Plan access to toilets when outside of the home
• Bring a change of clothes and hygiene kit when going out
• Establish a daily toileting routine of regular visits to the toilet
• Wear a silent, vibrating alarm watch to discreetly remind you of toileting routine
• Limit drinks that irritate the bladder and bowels (e.g. caffeine or alcohol)
• Encourage a balanced diet plan with plenty of fiber (e.g. fruits and vegetables)
• Keep your loved one as active as possible to help stimulate bowel movement
• If your loved one has aphasia, establish a way for them to communicate to you when they must use the toilet (e.g. ringing a bell)
• Have your loved one wear clothes that are easier to unfasten and remove (e.g. velcro, elastic waistbands, etc.)
• Help your loved one practice good hygiene to avoid urinary, bladder, or skin infections