How to Talk to an Elderly Parent About Incontinence

You noticed the smell in the car. Or the extra towels in the laundry, the pad wrappers in the bathroom trash, the way your mom now plans every outing around where the restrooms are. Maybe she quietly stopped going to her card game. You’re fairly sure she’s having bladder leaks, she hasn’t said a word, and you have no idea how to bring it up without embarrassing her.

Two things make this easier. Bladder leaks are common in older adults, and they can often be stopped or controlled. And the conversation goes much better when you treat it like any other health problem instead of a secret or a failure. Below: how to raise it, which words to use and avoid, what a doctor can do, and the changes at home that help most.

This is one of the harder topics in a larger set of family conversations. Our guide on how to talk to aging parents about their future covers the rest, from money to legal papers.

The short version: Talk privately, keep it matter-of-fact, and steer toward a doctor visit, because leaks often have a cause that can be treated.

• Choose a private, unhurried moment, never in front of other people.
• Start with what you’ve noticed and that you care, not with blame.
• Use respectful words such as “leaks,” “bladder control” or “protective underwear.”
• Explain that this is common and often fixable.
• Offer to set up the appointment and go along if they want you there.
• Make home easier right away: a lit path to the bathroom and the right supplies.

Why it’s worth bringing up, even though it’s awkward

It’s tempting to quietly buy a mattress cover and say nothing. But incontinence affects far more than laundry, and staying silent usually means your parent is coping with it alone.

• Falls: rushing to the bathroom, especially at night in the dark, is a setup for a fall.
• Skin: staying damp for long stretches is hard on skin.
• Isolation: many people stop going out, seeing friends or attending services because they’re afraid of an accident in public.
• A hidden infection: leaks can be a sign of a urinary tract infection, and in older adults that kind of infection can show up as sudden confusion. A sudden change in bladder habits along with a change in thinking deserves a prompt call to the doctor.

According to the National Institute on Aging, urinary incontinence is more common in older people, especially women, and it can often be stopped or controlled. That’s the most important thing your parent needs to hear from you.

What causes bladder leaks in older adults

You don’t need to figure out the cause yourself, but knowing the possibilities helps you make the case for a checkup. Some causes are short-term and often clear up once they’re treated:

• Urinary tract infections
• Vaginal infection or irritation
• Constipation
• Side effects of certain medications

Longer-lasting leaks can come from weak bladder or pelvic floor muscles, overactive bladder muscles, nerve damage, an enlarged prostate that blocks the flow of urine, or pelvic organ prolapse.

Doctors also sort incontinence into types, which point toward different fixes:

• Stress incontinence: leaking when coughing, sneezing, laughing or lifting.
• Urge incontinence: a sudden, strong need to go that’s hard to hold.
• Overflow incontinence: small amounts leaking from a bladder that doesn’t empty well.
• Functional incontinence: normal bladder control, but trouble getting to the toilet in time, often because of arthritis or other problems moving quickly.

Functional incontinence is worth noticing, because making the bathroom easier and faster to reach goes straight at the problem. If memory problems are also part of the picture, raise that with the doctor too. Our post on talking to a parent about memory loss can help with that conversation.

How to talk to an elderly parent about incontinence: timing, place and words

Pick your moment carefully. A calm, private time with nowhere to rush off to works best: a drive, a walk, a quiet cup of coffee at their kitchen table. Avoid bringing it up right after an accident, when embarrassment is at its peak, and never in front of a spouse, grandkids or anyone else.

Think about who should start the conversation. Some parents find this easier to discuss with a child of the same gender, with their spouse, or with a doctor or nurse they trust. There’s no rule here. Go with whoever your parent is most comfortable with.

Words matter here more than almost anywhere. Skip “diapers,” which can sound childish. Say “leaks,” “bladder control,” “protective underwear,” “briefs” or “pads.” Then keep your tone as ordinary as if you were talking about a sore knee. A few ways to open:

• “Mom, can I bring up something a little personal? I’ve noticed you’re running to the bathroom a lot lately and changing clothes more often. Is your bladder giving you trouble?”
• “This is really common, and from what I’ve read it’s often treatable. I’d hate for you to put up with it if you don’t have to.”
• “You don’t have to tell me any details. I just want to help you get it looked at.”
• “I noticed you stopped going to choir. Is worrying about getting to a bathroom part of the reason?”

And a few swaps that keep it respectful:

• Instead of “You need to start wearing diapers,” try “They make thin protective underwear now that nobody can see under clothes. Want to try a couple of kinds?”
• Instead of “The couch smells,” try “I noticed a few wet spots on the couch. Has that been bothering you too?”
• Instead of “Why didn’t you tell me?” try “I’m glad we’re talking about it. Lots of people keep this to themselves.”
• Instead of “That’s just what happens when you get older,” try “It’s common as people get older, but it’s often something a doctor can help with.”

If your parent denies it or gets upset

Don’t be surprised if the first answer is “I’m fine” or a sharp change of subject. Shame is powerful, especially for a generation that didn’t talk about bodies. Pushing harder in the moment almost always backfires.

Instead, back off kindly and leave the door open: “Okay. I won’t push. If it ever starts to bother you, I’m here, and we can call the doctor together.” Then let some time pass and try again in a different setting, or ask someone else to raise it, such as their spouse, a sibling or their doctor.

Meanwhile, you can make quiet, practical changes without a big discussion: a waterproof mattress protector on the bed, a few packages of pads in the bathroom cabinet, a night light in the hallway. Many people start using supplies once they’re simply there. For more on handling a firm “no” about any kind of help, see empathy-driven ways to respond when a senior refuses care.

What the doctor may do

A primary care doctor is the right first stop. Offer to make the appointment, drive, or sit in the waiting room, whatever your parent prefers. If they’d rather go alone, respect that. If they won’t go at all, our post on what to do when an elderly parent refuses to go to the doctor can help.

It helps to arrive with a few notes: when the leaks happen, how often, what your parent usually drinks and when, and a list of every medication and supplement they take. The doctor may:

• Ask your parent to keep a bladder diary for a few days, noting bathroom trips and leaks.
• Review medications, since some can cause bladder problems.
• Check for an infection or constipation.
• Refer your parent to a urologist, a doctor who specializes in urinary problems.

Treatment depends on the type and the cause. Options include pelvic floor (Kegel) exercises, bladder training and techniques for holding off a sudden urge, medications, bulking injections, devices and, in some cases, surgery. One thing to ask about directly: some medications for overactive bladder have been linked to a higher risk of cognitive decline in adults over 65, so it’s worth asking the doctor which option fits your parent best.

Practical changes at home that help right away

Whatever the doctor recommends, a few changes at home can cut down on accidents and nighttime falls almost immediately:

• A clear, lit path: night lights from the bed to the bathroom, and no rugs, cords or furniture in the way. Our room-by-room safety checklist helps with the rest of the house.
• Bathroom help: a raised toilet seat and grab bars make sitting down and standing up easier and quicker.
• Easy clothing: elastic waistbands and simple closures instead of tight zippers and small buttons.
• A bathroom routine: regular trips, such as after meals and before bed, instead of waiting for urgency.
• Smarter drinks: water instead of other drinks, fewer drinks right before bedtime, and going easy on alcohol.
• Preventing constipation, which is one of the common causes of leaks.
• Protection for furniture and beds: washable or disposable pads and a waterproof mattress cover.

Some people respond to leaks by drinking much less all day long. The National Institute on Aging’s advice is narrower than that: choose water over other drinks and limit drinks before bedtime. Ask your parent’s doctor how much they should be drinking, rather than cutting back on your own.

Supplies, products and who pays

Let your parent choose. Products range from thin pads and liners to protective underwear that pulls on like regular underwear, plus overnight briefs and bed pads. Buying a few small packages to test beats committing to a case of the wrong thing. Our guide to incontinence products and care at home goes through the options in detail.

Coverage surprises a lot of families. Original Medicare doesn’t cover incontinence supplies or adult diapers. In New York, Medicaid can cover disposable briefs and liners when the ordering doctor or other practitioner documents the medical need, so ask about a prescription if your parent has Medicaid.

When a personal care aide can help

Using the bathroom is one of the basic daily activities a personal care aide helps with, along with bathing and dressing. An aide can help with changing and clean-up, keep an eye on skin, keep a bathroom routine on track and take care of the extra laundry.

For many families, this is less about the work than about the relationship. Plenty of parents would rather have a trained professional help with something this private than their own son or daughter, and it lets you go back to being their child instead of their caregiver. A personal care aide can help with bathing too; if that has become a struggle as well, see our post on gentle bathing and hygiene help for seniors. Keep in mind that Medicare doesn’t pay for this kind of ongoing personal care, while Medicaid can for people who qualify.

Frequently Asked Questions

What do you do when an elderly parent becomes incontinent?

Start with a doctor visit, since leaks often have a treatable cause such as an infection, constipation or a medication side effect. Meanwhile, make the bathroom easy to reach, especially at night, set up the right supplies, and consider a personal care aide if your parent needs hands-on help.

How do I tell my elderly mother she smells of urine?

Do it privately and gently, and focus on her comfort rather than the smell itself: “I’ve noticed you might be having some leaks. Is that bothering you?” Then offer practical help, like a doctor’s appointment and trying a few products, so the conversation ends with a plan instead of embarrassment.

Is incontinence a normal part of aging?

It’s more common as people get older, especially in women, but that doesn’t mean your parent just has to live with it. Bladder leaks can often be stopped or controlled once the cause is found, so it’s always worth a checkup.

Does Medicare pay for adult diapers?

No. Original Medicare doesn’t cover incontinence supplies or adult diapers. New York Medicaid can cover disposable briefs and liners when a doctor or other practitioner orders them and documents the medical need.

Should my parent drink less water to stop leaks?

Not without asking the doctor first. The National Institute on Aging suggests choosing water over other drinks and limiting drinks before bedtime, which is different from drinking less all day. The doctor can say how much your parent should be drinking.

Handled with care, this conversation is usually a relief for everyone, especially your parent, who has probably been worrying about it alone. If your parent needs hands-on help with toileting, bathing or dressing, Rockaway Home Care’s personal care aides can take that on with discretion, and our team can explain how Medicaid home care works in New York.

This article is general information, not medical advice. Talk with your parent’s doctor about any new or worsening bladder symptoms.

More on talking with aging parents

• How to Talk to Aging Parents About Their Future
• The 40/70 Rule: When to Start Talking With Aging Parents
• Questions to Ask Aging Parents: A Planning Checklist
• How to Talk to Aging Parents About Money and Paying for Care
• How to Talk to a Parent About Memory Loss (and Getting Checked)
• Health Care Proxy vs. Power of Attorney in New York
• Elderly Parent Refuses to Go to the Doctor? What to Say and Do
• How to Talk to Parents About Assisted Living (and Staying Home)
• Elderly Parent Moving In With You? What to Discuss First

Helpful resources

• National Institute on Aging: Urinary incontinence in older adults
• Medicare: Incontinence supplies and adult diapers coverage
• Medicare: Long-term care coverage
• NY Connects: long-term services and supports in New York