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 livesbut a head-in-the-sand approach usually backfiresdrawing more attention to their condition. There are ways to encourage a loved one to address this problembut they require patienceunderstanding 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 incontinenceand I absolutely sympathize. Howeverone 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 furtherthink about this. If you are a middle-aged woman who has had childrenyou’ve probably suffered from stress incontinence occasionallymeaning that you’ve leaked a little urine while coughingsneezing 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 adultregardless of their level of physical or mental disabilityshould 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 importantbut 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 nitpickingbut please refer to adult incontinence products with age-appropriate terms. Think along the lines of briefspadsunderpantspull-upsthe 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.
Read: “Elderspeak” Can Be Detrimental to Seniors’ Mental and Physical Health
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 issueit’s important for your loved one to see their doctor about it. It may be caused by something straightforwardsuch 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 likelyyou’ve already helped your loved one seek medical attention for this issue. After testing to determine the type of incontinence they’re experiencingtheir doctor may be able to recommend pelvic floor exercisesminor surgical proceduresor even medications that can help manage incontinence symptoms. Sometimes a second opinion from a urologist is a good idea. For seniors experiencing fecal incontinencemake an appointment with a gastroenterologist. If you can identify and treat what’s causing a loved one’s symptomsthen adult briefs and other protection might wind up being unnecessary.
Deal With Elderly Incontinence Denial Head On
If your loved one is still cognitively soundbut they simply prefer to live in denial about this new development in their healthtry appealing to their sense of vanity. After allpride 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.
Certainlyincontinence is very difficult to accept. Howeverif youor a third partycan convince your elder that it’s much more embarrassing to smell like urine than it is to wear proper protectionyou may get somewhere. Promise to work with them to find a comfortableabsorbent and low-profile solution that will enable them to maintain their dignityextend their independence and improve their appearance. Incontinence frequently causes seniors to withdraw and become less active so they can avoid embarrassing situationsbut it doesn’t have to be this way.
Ask Their Doctor or a Friend for Help
Just like many other issues with our aging parentsincontinence may be better approached by a non-family membersuch as a trusted friend or doctor. Why? Because seniors tend to discredit or shrug off observations and suggestions from their own familyespecially 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 defensivewhich 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 downthey’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 controland 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 accidentthey 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 presentationthey may truly feel that incontinence protection is unnecessaryespecially if they don’t leave the house or have visitors often.
It’s a difficult subject to broachbut 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.
Depression
If your loved one feels no embarrassment or concern over their smell or appearancethen you may have a more serious underlying issue on your hands. Unfortunatelyloss of interest in personal caresocialization and other activities can be symptoms of depression.
Spotting depression in seniors is trickybut social isolationchronic health conditions and pain put this demographic at a significantly higher risk. At the very leastdepression screening should be part of your loved one’s annual visit to their primary care physician. If you notice the symptoms between visitsit’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 againwhichin turncan boost their self-esteem and encourage them to venture out and socialize more.
Cognitive Decline
If denialobliviousness and depression aren’t factors in your loved one’s refusal to partake in continence carea 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 factora senior may no longer be capable of making sound decisions about wearing incontinence productschanging 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 FailsLet 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 placethere 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 helptreat them with respect and dignityand then let go.
Time may take care of the very things you pushed so hard to correct. Sometimeswhen we leave people alone to work out their problemsthey stop resisting and tackle them head on. Howeverif their living situation is extremely dire and you feel it constitutes elder self-neglectcall your local Adult Protective Services (APS) agency. A welfare check may be needed to make some positive changes in your loved one’s life.
