Managing Incontinence in Stroke Survivors

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

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