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Tuesday, 10 April 2018 08:00

How to deal with bed wetting in the elderly

If you have an elderly loved one suffering from bed wetting, also known as nocturnal enuresis (NE), it’s far more common than you think.

Bed wetting is essentially characterised as an involuntary release of urine during periods of sleep, which can cause embarrassment, frustration and anxiety in its sufferers. While there are numerous different causes of NE, some of the most common include the likes of:

  • Diabetes
  • Urinary tract infection
  • Urinary tract stones
  • Prostate cancer
  • Prostate enlargement
  • Bladder cancer
  • Sleep apnoea
  • Neurological disorders
  • An acute emotional or anxiety disorder

Understanding bed wetting

One of the best ways to actually diagnose the cause of bed wetting is by tracking its frequency, your loved one’s pre-bedtime habits and any other symptoms they may be displaying.

The easiest way to do this is to actually draw up a diary, noting daily habits, routines, any unusual symptoms and urination frequency. It's alos important to note the types of beverages they drink and the number of wet nights vs. dry nights. These findings can then be presented to their doctor for analysis.

A doctor should be able to assist with making a diagnosis, while also ruling out underlying, more sinister health issues.

During the appointment your loved one will also undergo a physical exam, a neurological evaluation, uroflowometry (urinating into a specialized funnel) as well as post-void residual urine measurement to measure the amount of urine left in the bladder.

Possible treatments for bed wetting

If your loved one is diagnosed with adult onset NE, this means that they will need to visit a specialist for advice and prescription of certain treatments for this disorder. These specialists include a urologist or sleep disorder specialist.

Some of the following treatments would be recommended:

1. Keep track of daily fluid intake

A specialist may tell you to closely monitor and cut back the amount of liquids your loved one drinks in the late afternoon / evening. Additionally, reducing diuretic drinks such as coffee, tea and alcohol throughout the day can also help reduce instances of bed wetting.

2. Training the bladder

Only on advice from a doctor or specialist should a loved one try this technique. It involves slowly increasing the capacity of the bladder by drinking large amounts of fluids and refraining from urinating for as long as possible (2-3 hours where possible). Through this training, the bladder capacity is increased, reducing the frequency of urination and NE. If a loved one suffers from an enlarged prostate, consult with a specialist before trying this technique!

3. Set-up an alarm system

There are several alarm systems which have been created for the purpose of interruption of sleep during bed wetting. When a sensor detects wetness, a sounding or vibrating alarm goes off, waking your loved one from their sleep. This allows them to get out of bed and finish urinating in the bathroom. This leads to a conditioning of the body to learn to control the urge to urinate while asleep.

Alternatively, a simple alarm clock could be set for a random time during the night, waking up your loved one and reminding them to go urinate if they feel the need. However, the waking time must remain at random so the body doesn’t grow accustomed to waking and emptying the bladder at a set time each night.

4. Prescription medications

There are numerous prescription medications which can be taken to lower the frequency of wet nights. However these medications are best used in conjunction with any of the above therapies. It’s also important to keep in mind that medications simply treat the symptoms of NE, and do not address the underlying condition. Before medications are prescribed think about the fact that the body can also work up a tolerance to them, which could eventually render them ineffective.

While a loved one may be embarrassed by their condition, it is nothing to be ashamed of. Nocturnal enuresis can most certainly be cured and managed, it may just take some time to find the right doctor and establish a new behavioural pattern.  

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