Caring for an older adult with incontinence can be challenging for both the person experiencing it and the person helping them. Accidents may cause embarrassment, disrupt routines and make everyday activities such as dressing, sleeping or leaving the house feel more complicated.
The goal of incontinence care isn't simply preventing leaks. It's helping the person remain comfortable, clean and involved in their own care while preserving as much privacy and independence as possible.
Incontinence also shouldn't automatically be dismissed as a normal part of getting older. Changes to the bladder become more common with age, but urinary incontinence can have many causes and can often be treated or better controlled. If incontinence is new, worsening or hasn't been medically evaluated, talk with the person's healthcare provider.
Note: This guide focuses primarily on urinary incontinence in older adults. Bowel incontinence can have different causes and treatments and should also be discussed with a healthcare professional.
How to Manage Incontinence in an Older Adult
Effective incontinence care usually involves several things working together: identifying the cause, establishing a toileting routine, choosing the right protection, making clothing easier to manage, protecting the skin and creating an environment where the person can get to the bathroom safely.
Here are practical steps caregivers can take.
1. Start With a Medical Evaluation
If an older adult develops urinary incontinence, the first step should be discussing it with a healthcare provider.
Incontinence can have different causes, and the appropriate treatment depends on the type of bladder-control problem involved. Healthcare providers may ask about symptoms, medications and bathroom habits and may perform tests to identify what is contributing to the problem.
Don't assume that leaking urine is simply an unavoidable consequence of aging.
A medical evaluation is especially important when incontinence appears suddenly or is accompanied by symptoms such as pain while urinating, blood in the urine, cloudy urine, trouble urinating or a major change in urinary frequency.
2. Establish a Regular Toileting Routine
Waiting until an older adult urgently needs the bathroom can make accidents more likely, particularly when mobility or cognitive changes make it difficult to get there quickly.
A regular toileting schedule may help.
Timed voiding involves using the bathroom at planned intervals rather than waiting for urgency to become severe. Depending on the individual, a healthcare professional may recommend bladder training or another scheduled approach.
For caregivers, that may mean:
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Offering regular bathroom opportunities.
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Building bathroom visits into the person's normal daily routine.
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Allowing enough time so the person doesn't feel rushed.
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Keeping track of when accidents happen to identify patterns.
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Asking a healthcare professional whether a bladder diary or timed-voiding schedule would be appropriate.
A predictable routine may also be especially helpful for someone experiencing memory changes.
3. Make the Bathroom Easier to Reach and Use
Sometimes the bladder isn't the only issue.
An older adult may know they need to use the bathroom but be unable to get there or manage clothing quickly enough because of arthritis, weakness, limited mobility or another condition. This is known as functional incontinence.
Look at the entire path to the bathroom.
Consider whether you can:
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Keep hallways and pathways clear.
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Improve nighttime lighting.
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Make the bathroom easy to identify.
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Keep frequently used items within reach.
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Choose clothing that can be opened and removed quickly.
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Discuss appropriate bathroom safety equipment with the person's healthcare or occupational therapy team when needed.
For someone with significant mobility limitations, a healthcare professional may also recommend equipment or changes to make toileting safer.
4. Choose the Right Incontinence Products
Absorbent products can help manage leaks while the underlying cause is being evaluated or treated.
The appropriate product depends on the frequency and volume of leakage as well as the person's mobility, dexterity and whether they manage toileting independently or receive caregiver assistance.
Options can include:
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Absorbent pads or liners.
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Incontinence underwear.
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Adult briefs.
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Washable absorbent underwear.
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Waterproof protection for beds or chairs.
NIDDK identifies absorbent underwear, briefs, pads and furniture protection among the products that can help people manage urinary leakage.
The best product is the one that provides adequate protection while remaining comfortable and manageable for the person using it.
5. Make Clothing Easier to Manage
Clothing is an often-overlooked part of incontinence care.
Traditional pants may need to be pulled completely down or removed during product changes. If the person has limited mobility or requires assistance, that can make every bathroom visit or change more physically demanding and time-consuming.
Look for clothing that:
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Opens easily.
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Requires less bending or pulling.
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Provides enough room for an absorbent product when needed.
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Can be managed while seated if necessary.
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Allows caregivers to provide assistance without unnecessary undressing.
Joe & Bella's adaptive clothing for incontinence is designed specifically around these challenges.
CareZips® adaptive pants use side and inseam zippers to provide easier access during toileting or incontinence-product changes without requiring the pants to be fully removed. The adaptive features remain discreet when the pants are closed, so they still look like everyday clothing.
For someone who needs frequent changes or caregiver assistance, changing the clothing can sometimes make the entire routine easier.
6. Protect the Skin
Frequent exposure to moisture can irritate skin, so skin care is an important part of managing urinary incontinence.
After an accident or product change, gently clean and dry the area and change wet clothing or absorbent products promptly.
Products specifically designed for incontinence-related skin care, including cleansers and barrier creams, may also be helpful. NIDDK recommends discussing appropriate skin cleaners and creams with a healthcare professional.
Watch for persistent redness, irritation, sores or other skin changes and contact the person's healthcare provider if you're concerned.
7. Protect Beds, Chairs and Clothing
Accidents happen even with a good care routine.
Waterproof mattress protectors and absorbent pads can reduce cleanup and help protect beds, chairs and other furniture.
Keeping extra clothing, bedding and incontinence products easily accessible can also make accidents less stressful when they occur.
For soiled clothing, treat urine odor promptly rather than allowing damp garments to sit for long periods. Joe & Bella's guide on removing urine smell from elderly clothing provides additional laundering and odor-management tips.
8. Plan for Nighttime Incontinence
Nighttime can present additional challenges because the bathroom may be farther away, lighting is reduced and the person may be less steady after getting out of bed.
Create a nighttime plan based on the individual's needs.
That might include:
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Keeping the route to the bathroom clear.
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Using adequate nighttime lighting.
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Choosing an appropriate overnight absorbent product.
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Using waterproof mattress protection.
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Keeping replacement products and clothing nearby.
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Making sure clothing is easy to remove quickly.
Don't dramatically restrict water on your own in an attempt to prevent nighttime accidents. NIDDK recommends discussing fluid timing and appropriate intake with a healthcare professional and specifically cautions against reducing fluids to the point of dehydration.
9. Preserve Privacy and Dignity
How caregivers respond to an accident matters.
Avoid scolding, joking about the situation or talking about the person's incontinence in front of others without their permission.
Whenever possible:
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Provide privacy during toileting and changing.
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Tell the person what you're doing before helping.
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Offer choices.
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Encourage them to do whatever portions of the routine they can manage themselves.
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Keep your tone matter-of-fact rather than treating an accident like a crisis.
Incontinence is common, but many people feel embarrassed discussing it.
Treating it as a manageable health issue can help reduce some of that embarrassment.
How to Talk to an Older Parent About Incontinence
Talking about incontinence with a parent or another older loved one can feel uncomfortable.
Choose a private moment rather than bringing it up immediately after an accident.
Try approaching the conversation around comfort and problem-solving rather than loss of ability.
For example, you might say that you've noticed getting to the bathroom has become more difficult and ask whether there's anything you could change to make it easier.
Then listen.
The person may be worried about losing independence, embarrassed about accidents or reluctant to admit that they need help.
Include them in decisions about:
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Which products they use.
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What clothing they wear.
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When they receive help.
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Bathroom routines.
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Conversations with healthcare professionals.
If incontinence hasn't been medically evaluated, encourage them to bring it up with their healthcare provider. Healthcare professionals routinely discuss bladder problems, even though patients may find the subject embarrassing.
What Causes Incontinence in Older Adults?
Urinary incontinence isn't one single condition with one cause.
Different types of urinary incontinence include:
Stress Incontinence
Urine leaks when pressure is placed on the bladder, such as while coughing, sneezing, laughing or exercising.
Urge Incontinence
The person develops a sudden, strong need to urinate and cannot reach the bathroom before leakage occurs.
Overflow Incontinence
The bladder doesn't empty completely, causing urine to leak from an overly full bladder.
Functional Incontinence
The person's bladder may function normally, but another issue—such as arthritis or impaired mobility—prevents them from reaching or using the toilet in time.
Older adults can experience incontinence for many reasons, including urinary tract infections, constipation, neurological conditions, prostate problems and changes affecting the bladder or pelvic floor.
Because the cause matters to treatment, new or ongoing incontinence should be discussed with a healthcare professional.
Can Incontinence in Older Adults Be Treated?
Often, yes.
Treatment depends on what is causing the incontinence and which type the person has.
Depending on the situation, a healthcare professional may recommend approaches such as:
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Bladder training.
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Timed voiding.
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Pelvic floor exercises.
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Lifestyle changes.
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Medication.
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Medical devices.
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Treatment of an underlying condition.
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Procedures or surgery in some cases.
Care products such as absorbent underwear and adaptive clothing help manage incontinence, but they aren't treatments for the underlying medical cause.
That's an important distinction.
Making Incontinence Care Easier
Managing incontinence in an older adult often requires a combination of healthcare, practical routines and the right products.
Start by understanding the cause rather than assuming that leaking is simply part of aging. Then look at the entire daily routine: getting to the bathroom, removing clothing, changing products, cleaning the skin and getting dressed again.
Small changes can make those steps easier for both the older adult and the caregiver.
If clothing is one of the barriers, explore Joe & Bella's adaptive clothing for incontinence, including CareZips® adaptive pants designed to provide easier access for toileting and product changes while maintaining the look of everyday clothing.
Most importantly, involve the person in decisions about their care whenever possible. Managing incontinence is about more than staying dry, it's also about preserving privacy, comfort and independence.
About the Author:
Nurse Taylor Thoen Donaldson is Joe & Bella's Chief of Customer Happiness and a former geriatric nurse. Known to our customers as "Nurse Taylor," she brings a frontline caregiver's perspective to everything we do, helping ensure our products hold up not just in concept, but in the daily reality of getting someone dressed with limited time, limited mobility, and a lot on the line. Have a question or a topic you'd like her to cover? Just reply to this email.
A note from Joe & Bella: Our content is intended for general informational purposes only. While we share insights from our own Nurse Taylor and other health and wellness experts, please know that they are not your healthcare provider and nothing here should be taken as medical advice, diagnosis, or treatment. Every person's situation is different. Please consult your own physician, nurse, or healthcare professional before making any decisions about your health or the care of a loved one.