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Functional Incontinence

Functional incontinence

Functional incontinence occurs not from bladder problems, but rather from more physical problems of actually getting to the toilet in time. This could be because of poor eyesight, mobility issues, neurological conditions or more cognitive problems like dementia.

About functional urinary incontinence

Although it’s usually older people with mobility difficulties who suffer functional incontinence (either urinary or faecal), it can happen to anyone with a disability who finds it difficult to reach a toilet in time. Another factor is that public toilets aren’t always disability friendly. 

Fortunately, there are some steps you can take to protect against functional incontinence that can mean the difference between having accidents and staying dry.

What causes functional incontinence?

Functional incontinence is more a condition of circumstance. It occurs if you have difficulty in reaching the toilet or being able to remove clothing quickly enough, or to transfer from a wheel chair to a toilet in time. Some causes of functional incontinence include:

  • Blindness or poor eyesight — sometimes unfamiliar surroundings can provide obstacles that prevent clear access to a toilet.
  • Mobility impairment — being in a wheelchair can make getting to the toilet difficult.
  • Musculoskeletal conditions — primarily arthritis but other musculoskeletal conditions could prevent quick enough access to a toilet.
  • Neurological conditions — specific neurological conditions including Parkinson’s disease and Multiple Sclerosis (MS) may cause both functional incontinence and urge incontinence and occur because damage to the nervous system makes urine control difficult.
  • Mental illness — functional incontinence may arise from problems with thinking or communicating properly. For example, having dementia may make it difficult to think clearly enough to plan a trip, or even recognise the need, to use the toilet. Likewise, if you’ve severe depression you can lose all desire to take proper care of yourself, including using a toilet.
  • Medications — some medications, like strong sedatives, can cause grogginess, so you don’t recognise the need to use the toilet until it's too late.
  • Temporary illnesses and injury — even a temporary setback such as severe back pain or a broken leg can result in functional incontinence if you don’t plan ahead about going to the toilet.

Functional incontinence treatment 

Functional incontinence is best treated by looking at the medical conditions that cause or contribute to the problem, as well as looking at your environment so you can improve accessibility to the toilet.

If you suffer from a medical condition that is causing functional incontinence, getting treatment that improves your condition and in turn gives you quicker access to the bathroom should be a priority.

The key, of course, is preventing episodes from occurring in the first place. That said there are some things you can do to manage functional incontinence. Here are a few techniques and tips to help you reduce the risk and perhaps avoid accidents both at home and when you’re out.

  • Bladder training — this involves scheduling the amount of time between trips to the toilet. Initially you start by going every couple of hours. However, if you feel the urge to go between trips, you should stand or sit still, contract your pelvic muscles, and concentrate on making the urge to urinate go away. You should slowly increase intervals until you are able to go three to four hours without using the toilet.
  • Pelvic muscle exercises — also called Kegel exercises, these are designed to strengthen the muscles that support the bladder and urethra to prevent leakage. Kegel exercises focus on isolating and contracting your pelvic muscles which, with practice, may be helpful in preventing accidents as you try to get to the toilet.
  • Walking — can be helpful because it improves your sense that your bladder is filling and helps you recognise the need to urinate and head toward the toilet before it's too late.
  • Scheduled, timed, or prompted peeing — if you make regular, scheduled trips to the bathroom, you may be less likely to have to go in a hurry.

Also consider these handy tips that could further help prevent functional incontinence:

  • One of the most obvious things to do at home is to ensure the path to your bathroom is clear and there are no obstacles that could prevent easy access. You might also want to think about leaving the bathroom door open and lights on at all times so it is easy to find and use.
  • Zips, clasps, belts and buttons can be a huge hindrance if you need to get to the toilet quickly, so make sure your clothing is easy to remove. For example, if you wear trousers, try elasticated waists.
  • If you’re new to or having trouble transferring from a wheelchair to toilet, have a family member or friend with you who can help. If you’re at home, consider having devices such as grab bars and a raised toilet seat installed to help make it easier to use.
  • When you’re out, make it a point to know where the toilets are. That way you won’t have to waste time asking for directions if you need to go.

Depend® has a range of incontinence aids for men and women specifically designed to absorb bladder leakage and give you confidence when you’re with family and friends or out and about.

Other types of incontinence

Overflow incontinence > Stress incontinence > Bowel (fecal) incontinence > Enuresis incontinence > Urge incontinence  >