Toilet troubles
Adult incontinence can significantly impact lifestyle, and women are more likely to be affected, writes Meera Murugesan
SHANTI, a 48-year-old mother of four, always wears a sanitary pad and keeps a change of underwear in her handbag. She dreads travelling or dining at places where restrooms are not located nearby. She has a problem, one she has kept to herself for the last few years due to shame and embarrassment, although it has significantly affected her life.
Shanti is one of the many women over the age of 40 in Malaysia who suffer from adult incontinence.
The condition affects one in three women over 40 and one in 10 men over 65 but only 31 per cent have sought medical help.
Like many with the condition, Shanti is just too ashamed to talk about it, even to her loved ones, or to seek medical treatment.
Instead, she copes as best as she can, wearing sanitary pads all the time to absorb urine leakage and avoiding places or circumstances where she may not be able to access a toilet easily.
“I’m trying to cope as best as I can. It’s not a problem I feel comfortable talking about. I don’t want people to think I’m an invalid,” she says.
Shanti has also stopped travelling for holidays or family weddings. She has a phobia of leaving the house due to her incontinence.
Like Shanti, 36-year-old Anne also has problems holding her bladder. She has to urinate very often and has been suffering from the problem for the past 10 years.
She once had an extremely humiliating incident when she was on the way to a meeting and got stuck in traffic.
When she reached her destination, she tried to rush to the toilet but ended up wetting her pants and having to clean herself up before her meeting.
Anne has not sought medical advice or treatment but is trying to manage the problem on her own.
She goes to the toilet frequently, even if her bladder only feels slightly full to avoid any accidents.
“My job requires me to be out and about so it does make the situation more difficult. When I’m in the office, it’s more manageable because I can go to the toilet anytime,” says Anne.
THE PROBLEM WITH INCONTINENCE
Incontinence occurs when there is involuntary loss of urine. Though not life-threatening, this prevalent problem can hugely affect a person’s quality of life and women, particularly those above 40 are much more likely to suffer from the problem. It’s estimated that 1.4 million Malaysians have the condition.
Urinary leakage is not a disease. It is a symptom caused by underlying health conditions and without proper awareness of the condition, many remain embarrassed and avoid pursuing medical help.
For the elderly, it does help if children or caregivers watch out for signs of incontinence and get them necessary help.
Dr Andrew Yap says he first noticed signs that his mum, Mary Hii, could be suffering from adult incontinence when he returned home from studying overseas in 2008.
His mum, 62, had always been an active person but she started to cut back on her daily exercise routine. Long car journeys or other forms of travel also made her apprehensive.
Dr Yap later came to know that she was also using sanitary pads to contain urine leakage.
“By the time I came to know about it, she had been suffering and coping with the condition for almost five to seven years, probably even during my secondary school
In my mum’s case, she was suffering despite having a problem that could be fixed. Dr Andrew Yap
years but she never spoke about it to anyone.”
In Hii’s case, her incontinence was caused by a growth in the wall of her uterus. It required surgical intervention and since then, the problem has been significantly reduced.
She is back to her old self and is even planning to travel and be part of a charitable mission to Tanzania soon.
“In my mum’s case, she was suffering despite having a problem that could be fixed,” says Dr Yap.
Juriah Jalalus Shuti’s mother, Aminah, 75 has been suffering from incontinence for the past four years.
Juriah first suspected something wrong when her mother started changing her clothes often and going to the toilet all the time.
Juriah also noticed that there was a constant stench of urine in her mum’s house.
In addition, Aminah did not want to travel on long journeys and was generally anxious about going out of the house.
Her sleep patterns were also affected because she was constantly waking up to use the toilet.
“At that time, I dismissed the thought that she could be having incontinence because she had always been a strong, tough lady in control of her life. It didn’t seem possible that she was struggling with such an issue.”
After discussing things with her siblings, Juriah realised that all of them had noticed similar symptoms in their mum and it was time to do something about it.
In 2016, after much persuasion, Aminah moved in with Juriah so she could be under the care of the family. She also started wearing adult diapers and it has helped her cope significantly with her incontinence.
Juriah says the fact that her mum doesn’t have to worry about “accidents” anymore has made her more confident about going out, socialising and resuming her daily activities.
“As a caregiver, I definitely appreciate having tools and resources available to help me understand urinary incontinence better. If my siblings and I had not noticed the signs, it probably would have taken longer for Mak to get to where she is today — free to carry out her daily activities and even travel without worries,” says Juriah.