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