Just published: The American College of Physicians’ New Guidelines
re: women’s urinary incontinence–see Newsworthy at right–
triggers thoughts:

1.  An experience with Mother.
2.  One of this blog’s key thoughts: Is it better for parents or better for us (in this instance the caregiver)?
3.  A prejudice about the word “diapers” used in conjunction with old/older people’s incontinence.

Incontinence was never a problem for mother. But it was a concern of hers after hospitalization following a stroke that required a catheter. Her first outing after leaving the hospital, other than to a doctor’s appointment, was lunch with me at Marie Callendar’s. She needed to gain weight and loved their pies. All went well until the end of the meal when she said she needed to get to the bathroom fast. While it wasn’t far she was frail, walked cautiously, and as we got through the first door she said she didn’t think she’d make it to the stall. Mind over matter to the rescue?

(I was always fasciated by those people who could walk barefoot over hot coals. It was, I thought, an incredible example of mind over matter. I still think of it when I’m at the doctor’s or dentist’s and anticipate pain. What works for me is asking  her/him to talk to me about anything so my attention/mind is diverted from possible pain thoughts. [Surprising what you learn! I learned one doctor’s wife was in my Teachers College counseling program, among other interesting things.])

I tried this diversion tactic with Mother, suggesting that in less than a minute she’d be in the stall, seated and wouldn’t feel embarrassed. Her mind was diverted; the plan worked. Result: she felt liberated–and confident about going out. Her preference to sit near the Ladies Room lasted a few weeks then was no longer an issue….until a year later.

After a bad fall in an unlit movie theater, and resulting hospitalization, Mother came home extremely frail and weak. Although Dad was at home and had a good mind, he was old. Mom needed caregivers 24/7 for an extended period. My only request from the newly-hired, highly-recommended caregiver was that Mother get appropriate exercise, which included walking to the bathroom and back since she had no bathroom issues. I figured Dad could take care of the rest. I came back to NY, confident that things were moving forward nicely.

A month later I flew back at night to see my parents. The night caregiver “tattled.” The day caregiver (who hired the others) was using “diapers” on Mother. Made it easier for this caregiver, but was unnecessary for Mother. Saying I just happened to find  “pull-ups” in the closet, took the night caregiver off the hook and made beginning the conversation I needed to have with the day caregiver easier.

Incontinence is embarrassing enough without having people use the word “diapers” or deciding a person needs them because it means less work for the caregiver.  And wouldn’t “pull-ups” be a more respectful term than “diapers”–simply because it’s not equated with being a helpless infant?

The American College of Physicians’ new guidelines for dealing with female urinary incontinence stress trying normal (pill-free and lifestyle changes) solutions first. Doesn’t maintaining feelings of normalcy help parents–and everyone–age well?
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Note: “Urinary incontinence (UI), the involuntary loss of urine, has a prevalence of approximately 25% in young women (aged 14 to 21 years) (1), 44% to 57% in middle-aged and postmenopausal women (aged 40 to 60 years) (2), and 75% in elderly women (aged ≥75 years)” ACP

Related: For the Guidelines as published by the ACP, click this link or link in last paragraph. They’re easily understandable and the helpfulness of the exercises is clear.

The recommended Kegel exercises–courtesy Mayo Clinic (there’s also a link within the Newsworthy article).