Medical Q&As

Elderly incontinent - help?

I am caring for a lady in her eighties who constantly smells of stale urine. The smell follows her wherever she goes and clings in her bedroom. She does not wear underwear and rarely changes her clothes. I am too embarrassed to tell her to clean herself up. What is the best way to approach the problem?

I would suggest that you contact the public health nurse for the locality in which this lady is living. The nurse may already be aware of the problem but your contact could provide additional useful information. Perhaps this lady is not known to the public health service and your contact could put her in touch with a support service that could be very useful to her. It would also be appropriate to contact her GP and inform him of your concerns. Clearly this lady has urinary incontinence but this may simply be part of a greater problem such as dementia. I think she needs to be assessed in a department of medicine for the elderly and contacting the GP and public health nurse would be a useful first step in achieving this. If the problem is simply one of incontinence a great deal can be done to help her. In addition there are several voluntary groups in existence such as Friends of the Elderly that can provide very valuable social support and companionship to older people.