A man walks into a doctor’s office for his monthly check up with his daughter. During the examination, the doctor asks how his nightly incontinence is.
“Its fine,” says the old man. “I just get up and go to the bathroom, and God turns on the light for me.”
The doctor finishes up the examination, and then calls in the daughter to tell her about the God-light thing.
“Oh, my God!” says the daughter. “He’s been using the fridge again!”
I burst out laughing when I heard that joke. In our office you learn to be a connoisseur of incontinence and diaper jokes. It’s just how we cope. The truth is we talk about incontinence all day, so sometimes our sense of normal conversational boundaries gets a bit skewed.
I guess that’s why I sometimes still get surprised by healthcare professionals who don’t talk about incontinence with their patients. I always figured they spent their lives mired in blood work, strange abscesses and bladder problems, they had to be used to it by now!
Turns out, I was wrong. Most doctors don’t talk to their patients about incontinence. Whether it’s because of shame, embarrassment or obliviousness, it doesn’t happen nearly as often as it should. According to the National Association for Continence there are 25 million incontinent adults in America today – the notion that only a fraction of those people ever talk to their doctor about a treatable health issue is, frankly, kind of scary.
So, with those thoughts in mind, we’ve pulled together our top four tips for doctors when they need to ask their patients about the bladder.
#1: Incontinence doesn’t mean they have a problem with their bladder.
There are lots of medical and congenital conditions which can impair the physical function of a person’s urinary system. But most people’s incontinence isn’t caused by a physical impairment. Many older gentlemen simply can’t reach the bathroom in time or are losing the muscle strength to hold it. So change your expectations and understand that you aren’t limited to discussing incontinence only when its associated with another diagnosis.
#2: If there is a caregiver involved, ask them too!
As family members age, they may increasingly have a partner or caregiver go to the doctor’s office with them. They may also employ part-time care assistants to help with household chores. These caregivers are a resource for patients but also for their healthcare professionals. They can provide an objective response that may be more informed and may be able to recall events in greater detail. Additionally, if they are cleaning up after an incontinent person, they have a strong incentive to look for options without the embarrassment.
#3: If you see something, say something.
If you notice a patient is wearing a diaper or pad, say something! If you noticed dried urine stains on their pants, say something. If you smell ammonia or urine when you’re near him, say something.
Sensing a theme here? I know you may be uncomfortable, but I swear, it gets easier with time. And just know that your patient is probably even more embarrassed than you are. But that doesn’t make the conversation less necessary.
#4: Get informed on the options!
Great, you’ve started that conversation; your patient has a problem, now what?
It’s important to know what options are available for managing incontinence. It’s not just diapers and pads any more. There are healthier options that are covered by most private insurance plans and by Medicare. I won’t bore you with all the options here but I would recommend checking out the article below on incontinence management options.
And since you sat through all that, here is another incontinence joke:
Two elderly gentlemen from a retirement center were sitting on a bench under a tree when one turned to the other and said:
“Slim, I’m 83 years old now and I’m just full of aches and pains. I know you’re about my age. How do you feel?”
Slim said, “I feel just like a newborn baby.”
“Really? Like a newborn baby?”
“Yep. No hair, no teeth, and I think I just wet my pants.”