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Carol Bradley Bursack, Published October 19 2013

Minding our Elders: Dad tries to ignore incontinence issue

DEAR CAROL: My dad is 76. He was diagnosed with aggressive prostate cancer five years ago, so he had surgery. The surgery saved his life, but it’s done a job on his ego. The biggest issue is occasional but unpredictable incontinence. I’ve tried to tell him that I know there are pads to use for this but he says that his mom had him in diapers and no one is making him go back to that. He gets upset when he has an accident, but downright angry when I suggest protecting himself against it. He’s gotten so he won’t go out and do things he used to enjoy because he may have an accident. How can I help him? Jeffery

DEAR JEFFERY: Lack of bladder and/or bowel control is a cruel slap in the face for otherwise healthy, active seniors. While for women, having had children and going into menopause can be the culprits, men tend to be most at risk after prostate surincontinencegery. Newer surgeries are producing better results than ever before, but your dad may have had the surgery before the newer methods were common. Even with new methods there is some risk of incontinency. Your sensitivity to your dad’s problem is a good sign. His dignity is at risk, at least from his point of view, and you want to help him preserve that.

Having accidents is not very adult or dignified, but it’s also very difficult for an adult to admit the need for protective pads. Do you happen to know if he has any friends with the same issue? I’m sure his doctor has told him how to handle potential incontinence, but it sounds as though your dad prefers to live in denial rather than deal with it. A discussion with a male peer could help enormously. As with most difficult things, when we know we’re not alone it’s easier to cope with tough issues.

Your best approach is to be very open and matter-of-fact about the issue. Let him know that you and most other people are well aware that incontinence is not uncommon. That’s the reason protection has improved over these later years. There are male specific pads that can be worn without their presence being known to others.

Somehow, your dad has to be convinced that having an accident in public will be more humiliating than starting to wear protective pads. Once he accepts that this is an issue that he can deal with without potential humiliation, his quality of life should improve and he’ll likely become more social again. If you have no luck yourself and there’s no special friend who can convince him, perhaps he should see a gerontologist who can discuss the issue with him. The right doctor may be able to help him understand that there’s no need for shame.

Carol Bradley Bursack is the author of a support book on caregiving and runs a website supporting caregivers at www.mindingourelders.com. She can be reached at carol@mindingourelders.com.