Compliments of
John Verster
Changing Places Vancouver
Volume 11 Edition 8
Addressing Incontinence

Incontinence, or the loss of bladder or bowel control, affects over 1.5 million Canadians: one in five Canadians over 65, more than half of all seniors in long-term care, and women more than men. Incontinence, in most cases, can be successfully treated, managed, or even cured. However, embarrassment, frustration, fear and social stigma prevent most people from discussing incontinence.
The incontinence may be a result of infection, especially of the urinary tract; injury, such as a hip fracture; surgery, particularly prostate surgery; chronic illness, such as diabetes and heart disease. Or it may be a bad reaction to medication. ‘Accidents’ or urine loss when a person laughs, coughs, or sneezes may be related to pelvic or sphincter muscle weakness.
Diuretics are foods and medications that cause the body to shed water and may increase a person’s frequency or urgency to urinate and lead to incontinence. Caffeine: found in coffee, tea, cola, cocoa, beer, chocolate and soft drinks is a known diuretic. Several medications have a diuretic effect.
Constipation can be a major cause of urinary incontinence in the elderly. A full bowel can block the flow of urine or cause urine to stay in the bladder. People with constipation may also exhibit bowel incontinence.
Dark, strong-smelling urine can be a sign of dehydration. If a person is not getting enough liquids (about six cups daily), the urine may become so concentrated that it irritates the bladder and may cause bladder or urinary tract infections.
Confusion may occur as a side-effect of medication. Parkinson’s Disease, stroke, and spinal cord injury may affect the brain so that it does not give a person enough warning time to get to the toilet before the bladder or bowel is emptied. Brain tumours may affect people’s ability to empty their bladder or bowels without help.
People in the early stages of Alzheimer Disease and other dementia may forget where the bathroom is or how to use it. In the middle and later stages of dementia, people lose the interest and ability to look after themselves and forget how to urinate or move their bowels. Poor eyesight, speech or hearing may affect a person’s ability to seek help from a caregiver.

Incontinence is quite common in seniors, but it’s rarely an issue on its own – very likely there are multiple medical problems. So, for a caregiver, the first thing to understand is that it’s not their fault. Don’t get angry, and do try to get over the initial embarrassment you feel. And do help them get over any embarrassment they might feel.

You can help: put a big picture sign on the door; keep the route clear of obstacles; leave the washroom door open so the person knows it’s not occupied; consider handrails, use easy-off clothing (velcro vice buttons); consider a bed-side commode and waterproof bedding; avoid drinks in evening; always void before bed-time.
Most importantly though is to get medical advice – from your GP or from an Occupational Therapist. Only very rarely can nothing be done about incontinence, and getting treatment is the first step to being worry-free.
Article by Alex Handyside, CPCA,

I am Concerned About my Dad's Driving. What Can I do to Help?

Q. I followed my dad, 78, enroute to a family party, and was quite concerned by his driving – erratic speed, unsafe lane changes and dangerous hesitation at on-ramps. He’d be devastated to give up his license – what can I do?
A. Research confirms that older drivers are involved in more accidents – per kilometer driven – than their middle-aged counterparts. Of course you want your dad to be independent as long as possible – and drive safely and confidently.

  • Identify dad’s driving challenges – vision, reaction time, physical limitations
  • Schedule a family doctor visit - to check vision, hearing, cognition, medication dosages and /or combinations.
  • Get an evaluation - by a driver rehabilitation specialist who can make specific recommendations for improvement.
  • The doctor - may write to the provincial Ministry of Transport recommending that the licence be revoked. With luck, this step may convince your dad to surrender his licence and keys voluntarily.
  • Send a copy of the doctor’s letter to the Ministry and also to his auto insurer, who will cancel his policy.
    No one wants to treat a family member in this way, but you must keep in mind the liability and potential for harm to your parent and to others. It’s an unhappy role-reversal for you to do this to your father, so make sure you have the understanding and support of all family members, and give yourself credit for having the courage to love your dad so much.
    This information was provided by Pat M. Irwin, BA, AICB, CPCA, is founder and president of ElderCareCanada, a single-source consulting firm for adult children and their families, addressing all aspects of elder care -
Broccoli Orzo Salad

This salad has small pieces of broccoli that melt in your mouth with the orzo pasta. The fresh, tangy buttermilk dressing makes this salad extra delicious.
Preparation time: 20 minutes
Cook time: 8 minutes
Ingredients (Makes 4 to 6 servings)

  • 750 mL (3 cups) finely chopped broccoli
  • 175 mL (3/4 cup) whole wheat orzo


  • 75 mL (1/3 cup) buttermilk
  • 45 mL (3 tbsp) chopped fresh basil or 15 mL/1 tbsp dried basil
  • 30 mL (2 tbsp) chopped fresh parsley or 15 mL/1 tbsp dried parsley
  • 1 green onion, chopped
  • 1 small clove garlic, minced
  • 30 ml (2 tbsp) rice vinegar
  • 30 mL (2 tbsp) freshly grated Parmesan cheese


  • In saucepan of boiling water, cook orzo for 5 minutes. Add broccoli and cook for 3 minutes or until orzo is tender but firm. Drain well and place in bowl.
  • Meanwhile, in small food processor or blender, puree buttermilk with basil, parsley, green onion until smooth. Pulse in garlic and vinegar. Pour over orzo mixture; add cheese and toss to coat well.
    For a cold salad, simply rinse the orzo and broccoli under cold water after cooking and drain well. Add dressing as in recipe.
    To make 75 mL (1/3 cup) of your own buttermilk place 5 mL (1 tsp) lemon juice into glass measuring cup and add enough skim milk to make 75 mL (1/3 cup).
    Nutrition Information Per Serving (150 mL/2/3 cup) -
    Calories: 163, Protein: 9 g, Total fat: 2 g, Saturated fat: 1 g, Cholesterol: 4 mg, Carbohydrate: 31 g, Fibre: 5 g, Sugar: 3 g, Sodium: 104 mg, Potassium: 322 mg 

Recipe developed by Emily Richards, PH Ec. ©The Heart and Stroke Foundation 2011.

Powerful Thoughts

"What I focus on in life is what I get. And if I concentrate on how bad I am or how wrong I am or how inadequate I am, if I concentrate on what I can\'t do and how there\'s not enough time in which to do it, isn\'t that what I get every time? And when I think about how powerful I am, and when I think about what I have left to contribute, and when I think about the difference I can make on this planet, then that\'s what I get. You see, I recognize that it\'s not what happens to you; it\'s what you do about it."  W. Mitchell

Joke of the Month
A man was driving home one evening and realized that it was his daughter\'s birthday and he hadn\'t bought her a present. He drove to the mall and ran to the toy store and he asked the store manager "How much is that new Barbie in the window?"

The Manager replied, "Which one? We have, \'Barbie goes to the gym\'for $19.95 ...

\'Barbie goes to the Ball\' for $19.95 ...

\'Barbie goes shopping for $19.95 ...

\'Barbie goes to the beach\' for $19.95...

\'Barbie goes to the Nightclub\' for $19.95 ...

and \'Divorced Barbie\' for $375.00."

"Why is the Divorced Barbie $375.00, when all the others are $19.95?" Dad asked surprised.

"Divorced Barbie comes with Ken\'s car, Ken\'s House, Ken\'s boat, Ken\'s dog, Ken\'s cat and Ken\'s furniture."

  • There were approximately 25,000 hip fractures in Canada in 1996. Seventy percent of hip fractures are osteoporosis-related.
  • The one-in-six lifetime risk of getting a hip fracture is greater than the one-in-nine risk of developing breast cancer, and the death rate is higher. 

Source: Osteoporosis Society of Canada,


A doctor may prescribe medicine for malaria, altitude illness, or travellers\' diarrhea; seniors should make sure the doctor knows of any other medications they take, to watch out for possible drug interactions. Travellers\' diarrhea is common and may be more serious in seniors, so seniors should also be particularly careful about what they eat and drink.
In addition to medicine prescribed specifically for travel, seniors are likely to take other medicines regularly, such as medicines for high blood pressure, diabetes, or arthritis. They should plan to pack enough medicine for the duration of the trip, plus a few days\' extra in case of travel delays.

Prescription medicine should always be carried in its original container, along with a copy of the prescription, and all medicine should be packed in carry-on luggage, in case checked luggage gets lost.


Addressing Incontinence
I am Concerned About my Dad's Driving. What Can I do to Help?
Broccoli Orzo Salad
Powerful Thoughts