As children, we learn very quickly how to avoid an embarrassing situation, such as incontinence, mostly to avoid public ridicule and or “bullying” from peers. Now, fast forward 50-60 years later to find yourself with the same problem and with the same fears. However, this time you know that the solution may not be as easy as just going to the restroom before leaving the house.
Incontinence is the involuntary loss of urine or feces. It could start with a sneeze, cough or laughter. These first few incidents can be explained away as not voiding as frequently as needed or unexpectedly exerting oneself. However, when the “accidents” become more frequent, the anxiety of when the next accident will occur becomes a quality of life issue, such as social isolation, depression and low self-esteem. When professional intervention is needed, sharing this problem with a health professional is less stressful than telling friends, family or coworkers.
Since the reaction to becoming incontinent is subjective, coping with the emotional impact and its effect on the quality of life while maintaining one’s dignity can be challenging. Julie Clark, PhD, said it well in Nursing Times, “Dignity is a fundamental human right. It is about feeling and/or being treated and regarded as important and valuable in relation to others. Dignity is a subjective, multi-dimensional concept, but also has shared meaning among humanity.”
There are many factors that play a role in this dynamic. For example, my multigenerational family was in a restaurant when my aunt needed to go to the restroom. Most of us knew that she was incontinent but assumed she had protection and enough time to reach the restroom. Unfortunately, our twenty-four year-old niece didn’t understand that the situation was not as dire as she thought, so she stood up insisting that everyone move out of the way to avoid our aunt having an accident. This reaction is similar to how she approaches her young daughter’s needs. Later, my niece asked me if she had done something wrong because she had noticed some looks of disapproval. This was my opportunity to share about what all caregivers deal with on a daily basis: maintaining the dignity of others while providing assistance. I had to remind her that though our aunt’s needs are similar to her little daughter’s, my aunt must always be treated with dignity as an adult. Sometimes all it takes is to ask, “How can I help you?”
For the person living with urinary incontinence, it is recommended to have an assessment conducted by a primary care physician, urologist, continence nurse advisor or other qualified health care specialist to determine the cause of the incontinence. Furthermore, one can prepare for social outings by keeping handy an emergency kit with extra clothes, protection, wipes and odor eliminators.
It is the choice of the incontinent person to share about this part of their life with whom they please. Everyone deserves their privacy and dignity to be preserved under all circumstances throughout their life.
Carlos Santos is on the team at ElderCaring home care services. (760) 333.0427.
Reference: 1) Clark J (2010) Defining the concept of dignity and developing a model to promote its use in practice. Nursing Times; 106:20, early online publication.