Urinary Incontinence in Seniors (Singapore) : Why It Happens and Strategies for Better Comfort and Confidence
- PhysioMatters
- 3 days ago
- 4 min read
As a physiotherapist in Singapore, I frequently work with older adults navigating urinary incontinence (UI), a deeply personal issue that can erode self-confidence and restrict daily activities. While it’s common, many seniors suffer in silence, mistakenly believing it's an unavoidable part of aging.
Let me reassure you: urinary incontinence is manageable, and physiotherapy plays a vital, evidence-based role in restoring comfort, control, and dignity.
Understanding Urinary Incontinence in Seniors
How Common Is Urinary Incontinence in Singapore?
A local study of Singaporean seniors aged 65+ found a UI prevalence of 4.6% in the community, with over 80% experiencing long-term symptoms exceeding one year (National University of Singapore, 1991). Among outpatient female patients, UI prevalence soared to 41.7%, with many reporting significant lifestyle disruptions, but only 41% sought help, mainly due to embarrassment (Springer, 2017).
Clearly, the problem is more widespread than it appears and treatment available.
What Are The Causes of Urinary Incontinence in Seniors?
Seniors may develop UI due to:
Weakened pelvic floor muscles
Reduced bladder elasticity or detrusor overactivity
Post-menopausal hormone changes
Prostate issues in men
Neurological or musculoskeletal conditions (e.g. stroke, Parkinson’s, arthritis)
Medication side effects – of the a big cause for many clients.
What Are The Common Types of Urinary Incontinence Experienced By Seniors?
Stress Incontinence: Leakage during coughing, sneezing, or physical exertion.
Urge Incontinence: Sudden, strong urge to urinate with minimal warning.
Overflow Incontinence: Incomplete bladder emptying causing frequent dribbling.
Functional Incontinence: Physical or cognitive limitations impair access to the toilet.
Mixed Incontinence: A combination of the above types.
How Physiotherapists Assess Urinary Incontinence In Seniors?
As a Physiotherapist, I conduct a comprehensive continence assessment that includes:
1. Subjective History
We begin with a respectful and private discussion to understand:
Bladder habits and frequency
Leakage patterns (what triggers it, when it happens)
Fluid intake and dietary habits
Use of pads or incontinence products
Impact on quality of life and emotional wellbeing
2. Bladder Diary Analysis
Clients are often asked to keep a bladder diary over 3–7 days, recording fluid intake, voiding times, leakage episodes, and urgency. This helps identify patterns and triggers.
3. Pelvic Floor Muscle Assessment
Using external or internal examination techniques (as appropriate and with consent), we assess:
Muscle tone and strength
Coordination (ability to contract and relax)
Endurance and timing (how long the contraction can be held)
4. Posture and Functional Mobility Review
Since many seniors experience functional incontinence due to poor mobility or balance, we assess:
Gait speed and walking ability
Transfers to and from the toilet
Environmental safety (falls risks, clutter, lighting)
What Are The Physiotherapy Treatment for Urinary Incontinence in Seniors?
We use a combination of evidence-based interventions tailored to individual’s needs.
1. Pelvic Floor Muscle Training (PFMT)
Also known as Kegel exercises, this is the gold standard for stress and mixed incontinence.
Seniors are taught to identify, activate, and strengthen pelvic floor muscles.
We use biofeedback or electrical stimulation (where appropriate) to enhance awareness and muscle control.
Research supports significant improvement in continence rates when PFMT is supervised by a trained physiotherapist (Cochrane Review, 2018).
2. Bladder Retraining
Ideal for urge incontinence, we coach clients to:
Delay voiding gradually to extend bladder capacity.
Learn to respond to urges with distraction and breathing techniques.
Re-establish a toileting schedule to prevent urgency and accidents.
3. Functional Training & Mobility
To reduce accidents due to poor mobility, we work on:
Balance training
Timed toilet transfers
Home-based exercises to maintain strength and agility
Advise on bathroom modifications and adaptive equipment, such as grab bars or raised toilet seats.
4. Education and Behavioural Advice
Education is a powerful tool. Seniors and caregivers receive practical advice on:
Optimal fluid intake (not too little!)
Avoiding bladder irritants (e.g., caffeine, carbonated drinks)
Regular toileting routines
Pelvic-friendly habits like avoiding straining or rushing
What Are Our Tips for Seniors & Caregivers?
For Seniors:
Use absorbent products as needed, but combine with active treatment.
Don’t reduce fluids excessively, it may worsen symptoms.
Practice pelvic floor exercises daily, it’s never too late to start!
For Caregivers:
Be patient, respectful, and discreet.
Monitor for signs of skin breakdown or UTIs.
Encourage independence and participation in therapy.
Conclusion
"Urinary incontinence in seniors is common AND TREATABLE."
At PhysioMatters our team offers safe, effective, and empowering solutions to help older adults regain control, improve physical function, and restore confidence.
Don’t let embarrassment hold you back. If you’re in Singapore and struggling with urinary incontinence, reach out to us for an assessment and a personalised treatment plan.
Cheers
Contact Information
Email: hello@physiomatters.com.sg
Phone: +65 9352 9067
Address: 360 Orchard Road #10-07 International Building, 238869
References:
Goh, L. B., et al. (1991). “Prevalence of urinary incontinence in Singapore elderly.” Annals of the Academy of Medicine Singapore. PubMed
Low, L.L. et al. (2017). “Urinary incontinence among women in Singapore: prevalence and risk factors.” Int Urogynecol J, Springer
Society for Continence Singapore (SFCS): www.sfcs.org.sg
Singapore General Hospital: sgh.com.sg
KK Women's and Children's Hospital: kkh.com.sg