Nocturnal enuresis (NE), more commonly known as bedwetting, is the involuntary voiding of urine during sleep. When we think of bedwetting, we think of it as a condition mainly confined to children. It is true that that's the group more often associated with nocturnal enuresis; but, as we age bedwetting once again can be a problem for elderly adults. According to Journal Age and Aging, 2.4% of older people 75 years of age or older living at home have nocturnal enuresis.
There are any number of causes of bedwetting in elderly adults. At its least, adult bedwetting is embarrassing and inconvenient; at its worst, it can be indicative of a more serious urinary tract problem. To help your health care provider properly determine a reason and perhaps a treatment plan for elderly bedwetting, it is helpful to document the following over a two-day period:
- Take note of what time you normally urinate during the day and at night.
- Make a note of the time of day or night that any accidents occur.
- Try to approximate the volume of urine each time you void during the day or night, and record it.
- Make note of what you drink, types of beverages, when you drink them, and how much.
- Document your urinary stream: Is it strong and steady or do you have difficulty beginning and maintaining a stream? Is there dribbling?
- Have you had a history of urinary tract infection (UTI) or other urinary problems?
- Have there been other symptoms at night associated with your bedwetting, such as night sweats?
When senior bedwetting is found not to have been caused by any physiological dysfunction of the urinary system, one of the most effective methods of treatment is to use a bedwetting alarm. A bedwetting alarm is a device that will cause the individual to arouse from sleep as soon as a wetness incident starts. There are many such alarms that incorporate vibrating sensations or audible alarms triggered by wet-detection devices that are attached to the underwear or a special pad on top of the bedding. The concept of the alarm treatment uses classic conditioning technique.
Once the individual is awoken by the alarm, he or she should be able to consciously stop the flow of urine, get up and complete urination in the bathroom. Eventually the body is conditioned to awake upon feeling the urge to urinate before having a bedwetting accident. This treatment does take some time to work, many weeks in some individuals, and requires perseverance and commitment. It is most effective when the individual does not have diminished bladder capacity and therefore is awakened many times during the night by the alarm. In the person who has been experiencing just one or two bedwetting episodes at night, the alarms have proven quite effective in helping the user overcome the condition.
Other non-drug techniques and treatments
Monitoring intake of fluids: Decreasing the amount of fluid intake in the late afternoon and hours just before bed will decrease the bedwetting episodes at night
- Bladder Volume Training: This is a technique where elderly bedwetters are trained to increase their bladder capacity by drinking a lot during the day and avoiding urination as long as possible, gaining greater bladder control
- Waking: Setting an alarm at random times every night to wake and urinate. It is important to use different times so you do not condition the body to urinate at a specific time every night, which can actually lead to bedwetting at that time!