There are many ways in which you can help overcome bladder problems. Many are very simple, such as changes in the set up of your bathroom, the use of practical aids and changes in your daily routine.
Practical solutions
In Parkinson’s, many incontinence problems are caused by difficulties with the practicalities of going to the toilet. An incontinence advisor or an occupational therapist can assess any difficulties you have and advise on ways of overcoming these. Some of the suggestions they may make include:
- using a stool to lift your feet off the ground can make you more comfortable if the toilet is too high
- a raised toilet seat if the toilet is too low
- grab rails fixed to the walls or floor to make getting to the bathroom easier
- clothing that is easy to undo. For example, velcro fastenings are much easier than buttons or zips and elasticated waists are even simpler
- exercises and techniques to overcome the problems, for example training your bladder to hold on for longer when you need to urinate
- Incontinence aids and equipment, including:
- undergarments that are elasticated at the hip - but not too tightly - so are easy to pull up and down
- underwear shields or pads to absorb any leakages. There are various sizes of pads available with different levels of absorbency to suit your needs. High absorbency pads are available for use during the night. Remember when using pads they need to be worn close to the skin and held firmly in place to prevent circulation of air, so reducing the chance of sore skin, odours or leakage. So make sure your underwear is a snug fit
- briefs with sticky tabs on the sides and elasticated legs to make them easier to get into, or for carers to fit, as they can be slipped between the legs and then fastened, so do not need to be pulled up over the hips
- a commode or portable urinal at night so you don’t have to worry about getting to the toilet in time.
Drinks
People with bladder problems often try to restrict the amount they drink because they worry about needing to go to the toilet. This is understandable but not recommended. It is important to drink approximately eight to ten cups of fluids each day in order to expel waste products efficiently. Taking plenty of fluids during the day whilst restricting fluid intake during the late evening, especially an hour or so before bed-time, is recommended.
Caffeine, which is found in tea, coffee, cola and some other fizzy drinks, can irritate the bladder so is best consumed only in small quantities.
Alcohol can exacerbate incontinence problems so try not to consume too much, especially if you are not in a position to access a toilet easily and quickly. ‘Long’ drinks, such as beers and lagers, tend to have a worse effect than ‘short’ drinks, such as spirits.
Controlled waking
If bedwetting is a problem it may be helpful to set an alarm clock for a couple of hours after you go to sleep so that you are woken up to go to the toilet. You may need to experiment to find the best wakeup call time for you. It is wise to vary the time you set the alarm as this will stop your bladder from becoming accustomed to emptying regardless of the time you go to bed.
Special alarms, known as
enuresis alarms, are also available. These are designed to wake you either with a sound or by vibrating when urine starts to leak. Gradually your body may become accustomed to holding urine or waking you automatically so that you can urinate.
