Not the most glamorous of topics, I know. However, up to 60% of patients who have a stroke and/or brain injury will leave the hospital with some type of urinary incontinence. This is often caused by the muscles of the bladder becoming weak and/or the center of the brain that is impacted by a hemorrhagic, ischemic stroke or traumatic brain injury no longer recognizing the urge to urinate.
What does this mean for the unpaid family caregiver? While managing urinary incontinence during the day may not be too bad, if you are using disposable briefs and you are up and able to change them frequently, the overnights can be a whole different story.
If an adult has urinary incontinence, often the amount of urine the void (or go) overnight is more than most briefs can handle. This will ultimately lead to issues with getting up several times a night, multiple bedding and clothing changes, issues with wounds and/or skin irritation, urinary tract infections, along with the loss of dignity for the person who is having the issues with incontinence.
First I would like to mention, that while this may be an issue when you initially come home, it doesn’t mean this will last forever for those who have had a stroke or brain injury. There are things to decrease incontinence, including medications, bowel and bladder training and just giving the brain some time to heal.
Mark had incontinence for the first year and a half to two years after his brain injury. Then it slowly started to decrease and now after seven years, we are still free from incontinence.
If you are caring for someone who has a disease that will progressively get worse, this issue will likely be on your horizon if it is not already. Don’t lose hope though. I am going to share some things that have helped many of my patients and families deal with incontinence and still maintain a good night’s sleep for all!
For men, there is an option of a condom catheter. This is exactly what it sounds like! You just place a condom like device over the penis and it has an outlet at the end. This outlet is then attached to a catheter tube and it drains overnight into a bag. In the morning, you simply remove the catheter and empty the bag and return to using briefs.
There are only two sizes of condom catheters, so they are generally easy to fit. Another hack I can tell you is if you buy “skin prep” wipes and wipe those over the area the catheter will be placed on, it will increase the stickiness and will ensure the catheter stays on better until you are ready to remove it.
For women, there is a device called a PureWick system. These are basically an external catheter made for women. Again, a drain moves the urine to tubing and then into a bag, that can be emptied in the morning. Then you can use briefs again for the day.
These tools may or may not be covered by insurance. If they are not, here’s my recommendation. Contact the person’s primary provider and ask them to writer a “medical order” that they are medically neccesary for maintaining skin integrity, decreasing infections, and decreasing fall risk (the individual having to get up multiple times a night to use the bathroom). Then if the insurance still denies it, call the 800 number on the back of your insurance card, request a patient advocate, and tell them you would like to appeal the decision.
If you are still unable to get insurance to pay for this, my final suggestion would be to find a local support group in your area. Ask other caregivers where they purchase their incontinence supplies. Honestly, there is no better resource than people who have been doing this for a while and know the best prices in town for things you may need in your caregiver journey!
I have listed links above to help you to find out more about these items. There are also many places you can purchase items online. Including Amazon. I will put my storefront link below and you can find these items can be at your door in a few days. (I do receive a commission on anything you purchase in my storefront on Amazon.)
Always, if you have any other questions or things I can help you with, please do not hesitate to reach out to me.
Thank you for all you do caregivers!