Incontinence Advice

Functional Incontinence: What is it, and what can be done?

Functional incontinence can disrupt daily life, leading to frustration and embarrassment. Understanding its causes, signs, symptoms, and treatments can ease peace of mind and help manage the condition.

Functional (urinary) incontinence is a lesser known form of incontinence when compared to urinary, stress, or mixed incontinence. It is commonly linked with being unable to reach the toilet in time. Fortunately, this article will cover functional incontinence in depth so that you thoroughly understand its meaning, from its causes, signs, symptoms, to treatments available to manage the condition.

Key points:

Understand what functional incontinence is and who is at risk.
Common causes and symptoms to watch for.
Effective treatment options and management strategies.
Tips for preventing accidents and improving quality of life.

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What is functional incontinence?

Functional incontinence, a specific type of urinary incontinence, significantly impacts those with mobility challenges or cognitive impairments. This condition occurs despite the individual's awareness of the need to urinate but results from their inability to reach the toilet timely.

Such delays can lead to unintended urine leakage or even a complete loss of bladder control. The implications extend beyond physical discomfort, often leading to embarrassment and additional skin irritation. If this happens, use these incontinence skin care products.

Signs of functional incontinence

Recognising the signs of functional incontinence can help to prevent the condition from getting worse, allowing your healthcare professional to offer a quicker diagnosis. Key indicators include:

Consistent dribbling or leakage of urine.
Involuntary complete bladder emptying.
The inability to hold urine long enough to reach a bathroom.
Noticeable urine odour on clothing or in the living area.

These signs and symptoms not only affect physical health but can also severely impact a person's emotional and social life.

Causes of functional incontinence

Functional incontinence can also arise from various factors that impair the ability to use the toilet by yourself. These may include include:

Cognitive disorders: Conditions like dementia or intellectual disabilities that disrupt the processing of the need to use the toilet.
Neurological disorders: Diseases such as multiple sclerosis, Alzheimers, or Parkinson’s disease, which may affect nerve functions essential for bladder control.
Physical limitations: Arthritis or other conditions that limit mobility or the ability to quickly remove clothing.
Environmental barriers: Obstacles such as poor lighting, stairs, or crowded spaces can hinder quick access to toilet facilities.
Medications and health conditions: Certain drugs, like diuretics or sedatives, and conditions like urinary tract infections (UTIs) or constipation, can exacerbate or lead to incontinence episodes.

Who is at risk of functional incontinence?

Functional incontinence can affect anyone but is more prevalent among specific groups:

Those with cognitive or neurological impairments.
Older adults, particularly those over 65, are more susceptible, making it the most common type of incontinence in nursing home residents.
People who are less physically active or have conditions affecting muscle and joint functions (e.g., weak pelvic floor muscles, thinning in vaginal tissues, etc.)
Those on medication that include diuretics or sedatives.

Diagnosing functional incontinence

Diagnosing functional incontinence begins with a thorough evaluation to differentiate it from other types of urinary incontinence. Health professionals often conduct a detailed medical history review and physical examination.

Key diagnostic tools may include:

Urinalysis: To check for infections or other underlying conditions.
Bladder Diary: Patients may be asked to record their liquid intake, frequency of urination, and instances of leakage.
Mobility and Cognitive Assessments: These help determine if physical or mental impairments contribute to incontinence.

Once the diagnosis of functional incontinence is confirmed, treatment focuses on managing both the symptoms and the underlying causes.

Improving accessibility

A simple and effective way to improve control of functional incontinence is by improving living conditions for the environment of the individual. This is extremely beneficial for those caring for the elderly and will need to communicate this using different methods, especially when caring for loved ones.

Creating an environment that allows for quick and easy toilet access is vital. Here are some effective strategies to adopt:

Home Modifications: Install grab bars, raised toilet seats, and adequate lighting to navigate easily to and within the bathroom.
Clothing Adjustments: Opt for garments with simple fastenings or elastic waists to facilitate quick changes.
Just Can't Wait: For public environments, using a FREE just can’t wait card will allow the individual to access a public toilet quickly and with ease.

Behavioural treatments

Behavioural techniques play a crucial role in managing functional incontinence:

Bladder training:

This involves increasing the intervals between bathroom visits systematically. Starting with visits every two hours, the goal is to extend the time gradually, allowing the bladder to build capacity and control.

Scheduled voiding:

For those with severe cognitive issues (see above), setting a regular schedule for toilet visits can prevent urgency and accidents. Being aware of how many times a day you should wee will aid in calculating whether irregular toilet visits are impacting the voiding issue.

Physical Therapies

Strengthening the pelvic floor muscles is essential for improving bladder control. Here are some recommended methods to try in a daily routine:

Pelvic Muscle Exercises (Kegels): These exercises strengthen the pelvic floor muscles, supporting the bladder and urethra. Identifying the right muscles during urination—by attempting to stop the flow mid-stream—is the first step. These can be performed for both men and women of different age groups. Be sure to not overtrain or over perform these. View our kegel exercises guide for men for more info.
Electrical Stimulation: Devices that deliver mild electrical pulses to stimulate muscle contractions can improve pelvic floor strength and effectiveness.
Vaginal Weights and Pessaries: These tools help train pelvic muscles by providing resistance and support, respectively, which is particularly beneficial in cases of stress incontinence (SUI).

Medical and surgical treatments

When behavioural and physical therapies are not enough to manage functional incontinence, medical interventions might be considered. Certain drugs can increase bladder capacity and reduce the frequency of contractions.

However, in severe cases, surgical options might be explored to improve the structural support of the bladder and urethra. An appointment with a healthcare professional should be scheduled first to determine which option to adopt.

Choose MoliCare® to manage functional incontinence

For those that urgently need assistance with maintaining bladder and bowel control, our wide range of incontinence products are hugely absorbent, comfortable and discreet. Our pads and liners, suitable for male incontinence and female incontinence of different levels, provide security against leaks, preserving dignity and hygiene.

How to prevent functional incontinence

While it's not possible to prevent the root causes of functional incontinence—such as neurological, muscular, or cognitive conditions—it is still possible to manage the condition effectively and mitigate its impact on daily life.

If you're dealing with a chronic condition that leads to functional incontinence, it may be a persistent part of your life.

Engaging with a healthcare provider to discuss optimal management strategies is crucial for maintaining quality of life.

Self-care methods

Managing functional incontinence involves daily practices and lifestyle adjustments that can significantly improve comfort and control:

Bladder Diary: Keeping track of fluid intake, frequency and timing of urination, and leakage incidents can provide valuable insights for adjusting habits and treatment approaches.
Diet: Avoid foods and drinks that irritate the bladder like caffeine, alcohol, and spicy foods that affect urinary frequency and urgency.
Weight: Maintaining a healthy weight reduces pressure on the bladder and pelvic floor muscles, easing the symptoms of functional incontinence.
Exercise: Routine walking not only strengthens the pelvic muscles but also helps recognise the signs of a filling bladder, allowing timely bathroom visits.
Smoking: Quitting smoking can decrease coughing fits, thereby reducing stress on pelvic floor muscles and improving incontinence symptoms.

When to consult a healthcare professional

It’s important to consult a healthcare professional as soon as symptoms of functional incontinence arise. Early diagnosis and intervention can prevent complications and improve outcomes. Discuss with your doctor the following information that will be integral to your diagnosis:

The potential causes of your symptoms and any necessary tests to confirm functional incontinence.
Recommended lifestyle adjustments and treatments.
Monitoring and managing the condition both at home and while away.
Any other symptoms to watch out for that might indicate complications or the need for different prevention methods.

FAQs

Can functional incontinence be cured?

Functional incontinence itself is not usually curable because it is often caused by underlying chronic conditions such as neurological disorders, cognitive impairments, or physical limitations. Treatment focuses on managing symptoms and improving quality of life.

What are examples of functional incontinence?

Examples of functional incontinence include situations where a person cannot reach the bathroom in time due to physical barriers (e.g., stairs, distant toilets or restrooms), cognitive challenges (e.g., Alzheimer's disease), or mobility restrictions (e.g., arthritis, Parkinson's disease).

What medication is used for functional incontinence?

There are no specific medications to treat functional incontinence directly; however, medications may be prescribed to address symptoms or related conditions. For example, anticholinergics or mirabegron may be used to manage urge symptoms, while other medications might be used to treat associated conditions like urinary tract infections or constipation.

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