Elderly Incontinence Care Guide for Caregivers

Jul 22, 2026

As a caregiver, incontinence management in elderly adults, like your parents, might feel overwhelming; the extra laundry, the midnight changes, and the feeling of not-knowing-what-to-do.

Urinary incontinence affects a lot of people, especially as they get older.¹ It is unplanned, but with the right approach, you could help your loved one feel comfortable and confident again.

This guide walks you through everything, from causes and types to behavioral strategies, products, and when to see a doctor.

Common Causes of Urinary Incontinence in Older Adults

To know the causes, we need to know what urinary incontinence is. It means that a person leaks urine involuntarily.² So, the big question is, what causes urinary incontinence in older adults?

The bladder, a hollow organ in the lower stomach, is a key part of the urinary system, which also includes the kidneys, ureters, and urethra.²

When you pee, the bladder muscles contract to push urine into the urethra, while the muscles around the urethra relax to let the urine exit the body.² If these muscles aren't functioning properly, it can lead to urine leakage, or urinary incontinence.²

There are several reasons why this might happen, such as urinary tract infections (UTIs), vaginal infections or irritations, and constipation. Some medications can also cause temporary bladder control issues.²

However, if incontinence persists, it might be due to:²

• Weak bladder or pelvic floor muscles
• Overactive bladder muscles
• Nerve damage from conditions like multiple sclerosis, diabetes, or Parkinson's disease
• Mobility issues from diseases like arthritis, which can make it hard to reach the bathroom in time

And in people assigned male at birth (AMAB), urinary incontinence is often linked to issues with the prostate gland.

Common causes include:²

• Prostatitis, which is inflammation of the prostate
• Nerve or muscle damage resulting from surgery
• An enlarged prostate (AKA benign prostatic hyperplasia), which typically occurs as men age and causes the prostate to grow

If you notice worsening or persistent incontinence, it could be worth seeing a doctor.³

Understanding Why Elderly Adults Experience Urinary Incontinence

Incontinence in the elderly is not merely an inevitable part of aging.² It happens because of a combination of factors that a few lifestyle changes and a doctor’s visit could help manage.^2,4

As we get older, our bodies undergo several changes that may lead to urinary incontinence. As you age, muscles that support the pelvic muscles that help control the bladder can weaken, leading to incontinence.^2,4

Changes in bladder function, such as decreased capacity and increased urgency, are also part of the aging process. Hormonal fluctuations, especially during menopause, can further impact bladder control.³

Incontinence isn't just a physical issue; it may also have psychological effects.⁵ Many elderly adults feel embarrassed or angry by their condition especially if they were independent before, leading to emotional distress and low self-esteem.⁵

These feelings can complicate caregiving, as caregivers may need to provide additional emotional support and address these sensitive issues with compassion.

It could help to create a safe space for honest, non-judgmental conversations rather than waiting for your loved one to raise the subject.

For those with mobility limitations, reaching the bathroom in time could be a challenge, making incontinence more difficult to manage.

Additionally, cognitive impairments, such as those seen in dementia, may further complicate bladder control by affecting the individual's awareness and ability to respond to the urge to pee.⁴

Understanding these physiological, psychological, and lifestyle factors can help caregivers provide better support and develop effective strategies to manage urinary incontinence in elderly adults.

Types of Urinary Incontinence Caregivers Will Encounter

Incontinence may show up in different ways depending on the type your loved one has.³

• Stress incontinence: You might notice leaks when your loved one is coughing, sneezing, laughing, or lifting objects.³ It might happen because their pelvic floor muscles or urethra sphincter are weak.⁶
• Urge incontinence: Your loved one might rush to the bathroom after an intense urge to pee.³ It is one of the most common types in older adults.⁷
• Mixed incontinence: Your loved one might have both stress and urge incontinence.³ It's often common in elderly women.⁸
• Overflow incontinence: When their bladder doesn't empty fully, pee might leak or dribble out later on, causing incontinence in elderly men.³ It often happens because of prostate issues.⁹
• Functional incontinence: Sometimes conditions like arthritis or dementia, or practical barriers like a bathroom that’s far away may make it harder to get to the toilet in time.³

If you're unsure which type of incontinence your loved one has, a doctor could help both with diagnosing and managing the type of incontinence.

Effective Treatments and Solutions for Managing Incontinence in Seniors

When it comes to managing incontinence in seniors, there are plenty of options available, ranging from everyday practical solutions to medical treatments.

Here's a friendly guide to some of the most effective strategies that caregivers can easily put into action.

Bladder Training

If your loved one deals with sudden, hard-to-ignore urges to pee, bladder training could really help.¹⁰ It works by stretching the time between their toilet visits, so their bladder learns to hold on a little longer.¹⁰

Here's how to work through bladder training with an elderly parent together:

• Start with a few days of tracking: Jot down every toilet visit for a few days.¹⁰ Keeping a bladder diary helps you get a feel for how often your loved one takes a bathroom break and how long they can go without one.¹⁰
• Build a schedule around it: Take the time they currently wait between visits and add about 15 minutes.¹⁰ For example, if they're going every 30 minutes, aim for 45 minutes instead.
• Help them ride out the urge: When an urge hits before the scheduled time, encourage them to sit still, breathe slowly, and gently squeeze their pelvic floor muscles.¹¹ It could help the urge pass within 30 to 60 seconds.¹¹
• Nudge the time forward, slowly: Every week or so, add another 15 to 30 minutes to the interval.¹² The goal is to get to 3 to 4 hours between visits.¹³
• Give it time: It could take 6 to 12 weeks to see real progress.¹³

Using absorbent products, like TENA’s designed specifically for male and female comfort while doing bladder training, could help your loved one stay comfortable and confident while both of you work towards longer intervals.

Prompted and Timed Voiding

If your loved one has dementia or memory issues, they may simply not notice the urge to pee anymore, or not be able to act on it in time.¹⁴

That's where prompted and timed voiding comes in:

• Timed voiding: Every two hours or so, you could gently guide your loved one to the bathroom, even if they don’t feel the need to go.¹⁵
• Prompted voiding: Every couple of hours, ask whether they need to go and encourage them to try, even if they say they're fine.¹⁴

Both may help with bladder leaks, but it’s important to be patient and use a calm tone; rushing them to the bathroom won’t get the job done.^14,15

Strengthening Pelvic Floor Muscles

Keeping pelvic floor muscles strong is important for better bladder control, especially for seniors dealing with stress and mixed incontinence.^2,16

These muscles play a vital role in supporting the bladder and keeping things working as they should.² When they're not as strong, it can lead to leaks; but the good news is that regular exercises can make a big difference.

How to encourage pelvic floor exercises for your loved one:

• Provide gentle reminders
• Celebrate progress
• Be patient

Guide to Pelvic Floor Exercises for Seniors

Kegel exercises are a great way to strengthen the pelvic floor muscles, which support the bladder and help control urination.¹⁷

Here’s a simple guide to help caregivers walk seniors through these exercises:¹⁷

1. Find a comfortable position sitting or lying down
2. Ask your loved one to imagine they are stopping the flow of urine
3. Hold the contraction for 3 seconds, then relax for the same time
4. Aim for three sessions of up to 15 reps throughout the day

If it feels tricky for them, it could help them to see a physiotherapist.

Behavioral and Lifestyle Adjustments for Better Bladder Control

Simple lifestyle changes may significantly impact bladder control. These adjustments can be easily implemented and make a noticeable difference in managing urinary incontinence.

Let’s look at some incontinence solutions for the elderly.

Fluid Management

It might seem like cutting back on fluids could help with leaks, but it may actually make things worse.¹¹

When your loved one doesn’t drink enough, their pee may become more concentrated, irritating the bladder and triggering more urgency, not less.¹¹

Instead, it might be helpful to find a balance.¹¹ Aim for around four to eight glasses of water a day, sipped steadily throughout the day rather than all at once.¹¹

And if you notice your loved one waking up multiple times at night to use the toilet, try reducing how much they drink in the two to three hours before bed.¹¹ Make sure they drink most of their fluids during the morning and afternoon instead.¹¹

Constipation Management

Constipation could be making your loved one's leaks feel worse.18 When their bowel is full, it puts pressure on the bladder, which could trigger sudden urgency and make leaks harder to manage.¹⁸

You could help them with a diet high in fiber, enough fluids, and some gentle movement.¹⁸ But, if they are constantly constipated, it could be worth talking to their doctor.¹⁸

Medication Review

Some medications that help your loved one with other issues may cause or worsen incontinence.²

If you notice leaks after starting a new medication, it could be worth asking their doctor for an alternative plan or a review.²

Weight Management

Extra weight could add pressure on their bladder, which may make leaks more frequent.²

It might be helpful to encourage them to maintain a healthy weight to help with symptoms.²

Managing the Environment to Reduce Functional Incontinence

A few simple changes around the home could make a real difference when every second counts for them to use the bathroom, some include:

• Keep pathways to the bathroom clear at all times.
• Add a nightlight or motion-activated lighting along the route for safe trips to the bathroom at night
• Consider a raised toilet seat, safety frame, or bedside commode to reduce transfer time and effort
• Switch to clothing with elastic waistbands or Velcro fastenings
• Consider opting for a male or female urinal to help if they have mobility issues.

Using Absorbent Pads or Briefs for Managing Incontinence

Absorbent products like pads, guards, underwear, and adult briefs are practical tools for managing incontinence day to day.

Finding the right one comes down to three simple questions:

• What is the level of leakage? Light leaks may need a pad or liner. Moderate to heavy leakage may need more absorbent options like underwear.
• How mobile is your loved one? Someone who is mobile and continent-aware may prefer incontinence underwear. It looks and feels more like regular underwear and supports their independence. But, if they need help getting around, an adult brief might be best.
• Is this for daytime or overnight use? Daytime products are usually discreet and comfortable to wear under clothing. Overnight products need maximum absorbency and a secure fit to handle longer periods without a change.

Once you have the right product, a few things to keep in mind:

• Fit matters: A snug, well-fitted product helps prevent leaks and stays comfortable throughout the day. Our guide to absorbent products can help you find the right fit
• Skin health: Change products regularly to prevent irritation and keep skin healthy. Find out how often to change a pad.

Not sure where to start? TENA's product finder can match your loved one to the right product based on their needs

Managing Nighttime Leaks

Nighttime incontinence could affect both you and your loved one sleep, but a consistent evening routine could make a real difference.

A few things worth building when managing nighttime leaks in the elderly:

• Reduce fluids two to three hours before bed but help them stay hydrated during the day.¹¹
• Layer up the bed with a waterproof mattress protector.
• Make use of products that offer overnight protection such as TENA ProSkin Overnight Stretch Briefs
• Keep the path to the bathroom safely lit and clear of trip hazards

Skin Care for Elderly Adults with Incontinence

Your loved one's skin health is just as important as any other part of their care.

When their skin stays in contact with urine for too long, it may become irritated, causing incontinence-associated dermatitis (IAD).¹⁹

If left unmanaged, it could worsen or cause painful sores.¹⁹ But a simple routine at each change could go a long way.

Some skin care incontinence tips for the elderly include:

• Check and change regularly, at least every two hours.²⁰
• Cleanse gently after each change with a pH-balanced, fragrance-free cleanser or pre-moistened incontinence wipes.¹⁹
• Avoid regular soap, a pH-balanced cleanser is a much gentler option for the skin.¹⁹
• Apply a barrier cream with zinc oxide after each cleanse to help protect the skin.¹⁹
• Check the skin during each change for any redness, rash, or broken areas.¹⁹
• If you notice any persistent redness or broken skin, it may be worth seeing a doctor.¹⁹

The Role of Catheters in Managing Urinary Incontinence

Their doctor might recommend urinary incontinence devices like catheter for elderly patients.⁴

They may be especially useful for those with severe incontinence or limited mobility and these work by draining urine from the bladder.⁴

For catheters, their doctor might consider one of the following options:

Intermittent Catheter

Your loved one's continence nurse or doctor might teach you how to insert a thin tube to drain their bladder, then remove it straight away.²¹

You could do it at set times throughout the day to help them empty their bladder completely when they have overflow incontinence.²²

Indwelling (Foley) Catheter

Your loved one’s doctor places it to help your loved one's bladder drain continuously into a collection bag outside their body.²¹

They might help with severe incontinence or urinary retention, or limited mobility.

You might need to monitor them regularly, though, because there is a risk of infection.²³

While catheters can be effective, they also come up with potential downsides. That’s why you might need some training on catheter care in the elderly to minimize risks and ensure comfort.

Need more incontinence tips for your loved one incontinence? Check out our essential tips for an overactive bladder.

When to Involve a Healthcare Professional

Don't hesitate to reach out to a doctor if you notice any of the following:

• Incontinence worsens or appears suddenly.²⁰
• There is blood in their pee at any point.²⁴
• They experience pain or burning when they pee.²⁵
• They are suddenly unable to pee at all; this needs urgent care.²⁶
• A doctor has never looked into the cause of their incontinence.
• Your loved one seems distressed, or their quality of life is low.

A doctor could refer your loved one to a specialist, such as a urologist or geriatric medicine team, depending on their needs.

Many areas also have dedicated continence services where trained specialists can carry out a full assessment and help put the right plan in place.

Supporting Elderly Loved Ones with Incontinence Challenges

Caring for a loved one with incontinence isn't just about managing the physical aspects; it's also about providing emotional support.

It's really important to talk openly about incontinence without any awkwardness. Creating a safe, judgment-free space may make a world of difference in how they feel about their condition.

Keeping their dignity intact is key. Little things, like ensuring privacy and choosing discreet products, go a long way. Involve them in care decisions to help ease any discomfort or shame they might be feeling.

Being a compassionate and patient caregiver means acknowledging that incontinence can be emotionally challenging. Offering gentle reassurance, using positive language, and showing understanding can help them feel respected and supported.

Also, don’t minimize yourself in the process. Caregiving has a lot of mental and emotional challenges that could take a toll on anyone. It might even feel like you don’t have space to catch your breath.

But, you cannot give your best when you are running empty, and that's why taking care of yourself is just as important.

You don't have to take on the burden alone. It's worth asking family members to share the load, finding out about community nursing or personal care services in your area, and connecting with a caregiver support group.

If you are feeling overwhelmed, speaking to your own doctor is a reasonable and important step. Asking for help isn't a sign of failure, but strength; you only want to give your loved one the best.

FAQs

What Is the Most Effective Treatment for Urinary Incontinence in Elderly Adults?

The right approach often depends on the type of incontinence your loved one has.²

Bladder training may help with urge incontinence, pelvic floor exercises could work better for stress incontinence, and environmental changes tend to help most with functional incontinence.^3,10,16

A doctor could help identify what's behind the symptoms and suggest the most suitable plan.

How Can I Help an Elderly Person with Incontinence at Home?

There are practical everyday ways you could do day to day to make things more comfortable for your loved one.

To protect their dignity, and make a difference you could try: A regular toileting schedule, pelvic floor exercise support, environmental modifications, fluid and diet management, appropriate product use, skin care, and emotional support. ^2,11,14,18

Is Urinary Incontinence a Normal Part of Aging?

Incontinence is common in older adults, but it is not an inevitable or untreatable part of aging.²

In some cases, it may happen because of infections or certain medication.21 Still, you and your loved one don't have to accept bladder leaks as just part of getting older; there is help available.

What Products Are Best for Elderly Adults with Heavy Incontinence?

For heavy incontinence, the right product depends on your loved one's mobility.

Adult briefs with tape fastenings work well for those who need a little help moving around, while pull-on underwear with maximum absorbency suits more active individuals.

Also, if they need nighttime protection, overnight briefs could help get them a restful night, and a waterproof mattress protector adds a useful backup layer.

How Often Should I Change Incontinence Pads for an Elderly Person?

You could try checking in every two hours during the day and changing products as soon as they get wet or soiled.²⁰ Adding an overnight product could help manage longer stretches without a change.

When it's changing time, gently clean the skin and apply a barrier cream to help protect their skin's health.¹⁹

While you're at it, keep an eye out for any redness or skin breakdown. If you spot anything, it's worth getting a nurse or doctor to take a look.¹⁹

When Should I Take an Elderly Person to the Doctor for Incontinence?

It's worth seeing a doctor if incontinence starts suddenly or gets noticeably worse, if there is blood in their pee, or if they experience pain or burning when they pee.^20,24,25 But if they are unable to pee at all, seek urgent care straight away.²⁶

It's also a good idea to get an assessment if they have never gotten one, if home care doesn't seem to be helping, or if incontinence is affecting your loved one's quality of life.

Can Dementia Cause Urinary Incontinence?

Dementia could affect incontinence in several ways. Your loved one may no longer notice the urge to pee, struggle to find or reach the bathroom in time, or, in later ages, experience changes in how their brain communicates with their bladder.^14,27

You could help them with tips such as prompted voiding, simple environmental changes like clear pathways, and the right absorbent products.¹⁴

Are Kegel Exercises Effective for Elderly Adults?

Yes, pelvic floor exercises could be helpful for stress and mixed incontinence.¹⁷ Although it might take 15 to 20 weeks of regular practice before you might see progress.¹⁷

If your loved one is having trouble identifying the right muscles, a pelvic floor therapist might be able to help.

References

1. McDaniel C, Ratnani I, Fatima S, Abid MH, Surani S. Urinary Incontinence in Older Adults Takes Collaborative Nursing Efforts to Improve. Cureus [Internet]. 2020 Jul 12;12(7). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7419143/

2. Cleveland Clinic. ‘Incontinence: Leakage, causes, diagnosis, treatment and prevention’. 2023. Accessed 23 September 2024. Available from: https://my.clevelandclinic.org/health/diseases/17596-urinary-incontinence

3. MayoClinic. ‘Urinary Incontinence’. 2023. Accessed 10 September 2024. Available from: https://www.mayoclinic.org/diseases-conditions/urinary-incontinence/symptoms-causes/syc-20352808

4. NIH. ‘Urinary Incontinence in Older Adults’. 2022. Accessed 10 September 2024. Available from: https://www.nia.nih.gov/health/bladder-health-and-incontinence/urinary-incontinence-older-adults

5. Heyman, S. ‘Psychological and cognitive variables affecting treatment outcomes for urinary and fecal incontinence’. 2004. Accessed 10 September 2024. DOI: 10.1053/j.gastro.2003.10.040

6. Cleveland Clinic. Stress Incontinence: Causes, Symptoms and Treatment [Internet]. Cleveland Clinic. 2025. Available from: https://my.clevelandclinic.org/health/diseases/22262-stress-incontinence

7. Urinary Incontinence [Internet]. Medlineplus.gov. National Library of Medicine; 2024. Available from: https://medlineplus.gov/urinaryincontinence.html

8. Vesentini G, O’Connor N, Elders A, Le Berre M, Nabhan AF, Wagg A, et al. Interventions for treating urinary incontinence in older women: a network meta-analysis. Cochrane Database of Systematic Reviews. 2022 Aug 9;2022(8).

9. Cherney K. Overflow Incontinence: What Is It and How Is It Treated? [Internet]. Healthline. 2017. Available from: https://www.healthline.com/health/overactive-bladder/overflow-incontinence

10. Regain Control with Bladder Training [Internet]. Cleveland Clinic. 2023. Available from: https://health.clevelandclinic.org/bladder-training

11. WebMD Editorial Contributors. Urge Incontinence Tips [Internet]. WebMD. 2023. Available from: https://www.webmd.com/urinary-incontinence-oab/oab-tips

12. Rocha AK, Monteiro S, Campos I, M Volpato, D Verleun, L Valim, et al. Isolated bladder training or in combination with other therapies to improve overactive bladder symptoms: a systematic review and meta-analysis of randomized controlled trials. Brazilian Journal of Physical Therapy [Internet]. 2024 Jul 1 [cited 2024 Sep 26];101102–2. Available from: https://pubmed.ncbi.nlm.nih.gov/39106788/

13. Watson S. Bladder Training Techniques [Internet]. WebMD. 2023. Available from: https://www.webmd.com/urinary-incontinence-oab/bladder-training-techniques

14. York Morris S. Dementia and Incontinence: Causes, Management Tips, and More [Internet]. Healthline. 2023. Available from: https://www.healthline.com/health/dementia/incontinence-care#causes-and-risks

15. Dunkin MA. Functional Urinary Incontinence: Symptoms, Causes, and Treatments [Internet]. WebMD. 2023. Available from: https://www.webmd.com/urinary-incontinence-oab/functional-incontinence

16. NIH. ‘Kegel Exercises’. 2021. Accessed 10 September 2024. Available from: https://www.niddk.nih.gov/health-information/urologic-diseases/kegel-exercises?dkrd=/health-information/urologic-diseases/bladder-control-problems-women/kegel-exercises

17. Cho ST, Kim KH. Pelvic floor muscle exercise and training for coping with urinary incontinence. Journal of Exercise Rehabilitation [Internet]. 2021;17(6):379–87. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8743604/

18. Ames H. Are constipation and frequent urination related? [Internet]. Medicalnewstoday.com. Medical News Today; 2025 [cited 2026 Jun 10]. Available from: https://www.medicalnewstoday.com/articles/can-constipation-cause-frequent-urination

19. Silver N. Incontinence-Associated Dermatitis: Symptoms, Treatment, and More [Internet]. Healthline. 2017. Available from: https://www.healthline.com/health/overactive-bladder/incontinence-associated-dermatitis

20. WebMD Editorial Contributors. Urinary Incontinence and Alzheimer’s Disease [Internet]. WebMD. 2024. Available from: https://www.webmd.com/alzheimers/urinary-incontinence-alzheimers

21. Brown S. What Are the Types of Catheters? [Internet]. WebMD. WebMD; 2025. Available from: https://www.webmd.com/urinary-incontinence-oab/catheter-types

22. Cleveland Clinic. Overflow Incontinence: Causes, Symptoms & Treatment [Internet]. Cleveland Clinic. 2024. Available from: https://my.clevelandclinic.org/health/diseases/22162-overflow-incontinence

23. Cleveland Clinic. What is a foley catheter? [Internet]. Cleveland Clinic. 2023. Available from: https://my.clevelandclinic.org/health/treatments/foley-catheter

24. Santos-Longhurst A. Blood in Urine: 9 Causes and When to Call a Doctor [Internet]. Healthline. 2025. Available from: https://www.healthline.com/health/blood-in-urine-male-no-pain

25. Cleveland Clinic. Dysuria (Painful Urination): Treatment, Causes & Symptoms [Internet]. Cleveland Clinic. 2020. Available from: https://my.clevelandclinic.org/health/symptoms/15176-dysuria-painful-urination

26. Cleveland Clinic. Urinary Retention Causes & Treatment [Internet]. Cleveland Clinic. 2024. Available from: https://my.clevelandclinic.org/health/diseases/15427-urinary-retention

27. Dias AL. What to know about dementia and bladder control [Internet]. Medicalnewstoday.com. Medical News Today; 2022. Available from: https://www.medicalnewstoday.com/articles/dementia-and-overactive-bladder#why-it-happens