Urinary incontinence, the involuntary loss of urine, affects an estimated 25 million Americans, mostly women. For most, incontinence is the result of problems controlling the bladder. For people with a type called functional incontinence, however, the problem lies in getting to and using the toilet when the need arises.
Causes and Symptoms of Functional Incontinence
There are many possible causes of functional incontinence. Often, the cause is a problem that keeps the person from moving quickly enough to get to the bathroom, remove clothing to use the toilet, or transfer from a wheelchair to a toilet. This includes musculoskeletal problems such as back pain or arthritis, or neurological problems such as Parkinson's disease or multiple sclerosis (MS). Further compounding the problem, restroom facilities aren't always easy to get to or may not be set up for people with disabilities.
In other cases, functional incontinence may result from problems with thinking or communicating. A person with Alzheimer's disease or other forms of dementia, for example, may not think clearly enough to plan trips to the restroom, recognize the need to use the restroom, or find the restroom. People with severe depression may lose all desire to care for themselves, including using the restroom.
Sometimes medications can cause functional incontinence. For example, if strong sedatives cause grogginess, the person may not recognize the need to use the restroom until it's too late.
Although there are several types of incontinence, doctors suspect a diagnosis of functional incontinence when there are other medical conditions that make getting to the bathroom difficult. However, a physical exam, medical history, and medical tests may be necessary to confirm the diagnosis or determine if other forms of incontinence are present that require treatment. For example, Parkinson's and multiple sclerosis incontinence may be caused by both functional incontinence and urge incontinence that occur because damage to the nerves makes urine control difficult.
Diagnosis and Treatment of Functional Incontinence
Treating functional incontinence requires treating the medical conditions that cause or contribute to the problem. For example, appropriate treatment for arthritis may make it easier to get to the bathroom quickly.
Treatment also requires addressing factors in the environment to improve accessibility.
If you suffer from functional incontinence, there are things you can do to reduce your risk of accidents. At home, make sure your bathroom is accessible and the route from your bathroom is uncluttered, which could help you avoid delays or falls. When out and about, know where the restrooms are, so you will not have to take time to ask directions or locate one when you need to go. Wear clothing that is easy to remove. For example, if arthritis in your fingers makes it difficult to work zippers, wear pants with elastic waists. If you have trouble transferring from a wheelchair to toilet, try to have someone with you who can help.