Urinary incontinence means leaking urine by accident. It is common in older adults, but federal health agencies say it is not a routine part of getting older, and it can often be stopped or controlled. The first step is to tell a doctor, because the cause is often treatable.
Is leaking urine a normal part of getting older?
No. It is common, but it is not normal. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) says bladder control problems are common, that about half of women have some urine leakage, and that as many as 1 in 3 men over 65 may lose urine by accident. It also says leaking is not a routine part of getting older.
Age does raise the odds. Urinary tract muscles weaken, and conditions such as diabetes, stroke, arthritis and prostate problems become more common. Those are causes a doctor can look for, so “it’s just age” is the wrong answer.
What are the types of urinary incontinence?
Types are named by what happens when the leak occurs, and many older adults have more than one. The definitions below follow NIDDK’s bladder control problems pages.
| Type | What happens | Examples given by NIDDK |
|---|---|---|
| Stress | Movement puts pressure on the bladder and urine leaks | Coughing, sneezing, laughing, physical activity |
| Urgency (overactive bladder) | A strong urge to urinate, and urine leaks before reaching a toilet | Nerves and bladder muscles do not work together; more likely with diabetes, Alzheimer’s, Parkinson’s, multiple sclerosis or stroke (NIA) |
| Mixed | Stress and urgency incontinence at the same time | Leaks with a cough and also with sudden urges |
| Overflow | The bladder does not empty fully, becomes too full and leaks | An enlarged prostate blocking the urethra, diabetes, spinal cord injury (NIA) |
| Functional | Normal bladder control, but a physical or thinking problem prevents getting to the toilet in time | A wheelchair, arthritis that makes buttons hard, Alzheimer’s disease |
| Temporary | Lasts a short time because of a passing situation | A urinary tract infection, a bad cough, a medicine |
What causes urinary incontinence in older adults, and what triggers leaks?
Several causes can overlap. NIDDK, the National Institute on Aging (NIA) and MedlinePlus list these:
- Medicines. MedlinePlus says some medicines can cause short-term leaking, including water pills (diuretics), antidepressants, tranquilizers, some cough and cold remedies and antihistamines. Do not stop or change any medicine because of leaking. Bring the full list to the prescriber and ask.
- Infections. A bladder infection can cause temporary leaking. NIDDK’s symptoms include burning when urinating, frequent or intense urges, lower belly pain, and cloudy, bloody or strong-smelling urine.
- Constipation. MedlinePlus says hard stool packed in the bowel can press on the bladder.
- Prostate problems. In men, an enlarged prostate can block urine flow, and treatment for prostate problems can also affect bladder control.
- Trouble getting to the toilet. Arthritis, weakness or slow walking can turn a normal urge into an accident.
- Dementia and nerve conditions. NIA says people with Alzheimer’s disease may not realize they need to go, forget to go, or not find the toilet. Diabetes, stroke, Parkinson’s disease and multiple sclerosis can also affect bladder nerves.
- Drinks. NIDDK lists caffeine, alcohol and carbonated drinks as lifestyle factors that can contribute.
NIDDK adds that some urges are set off by triggers such as running water or reaching into a freezer.
What does the doctor do to find the cause?
There is no single test. The doctor combines a history, an exam and a few simple checks.
- Medical history and medicine list. The doctor asks about symptoms, conditions and every medicine and supplement being taken.
- Physical exam. It looks for conditions that can lead to leaking. NIDDK says a person may be asked to cough with a full bladder to see whether urine leaks.
- Bladder diary. NIDDK suggests 2 to 3 days before the visit. Write down what and when the person drinks, when and how much they urinate, each leak, whether a strong urge came first, and what they were doing.
- Tests, as needed. Options include a urine test for infection, blood tests, an ultrasound to see whether the bladder empties fully, urodynamic testing, a look inside the bladder with a thin scope, and imaging.
- Referral, if needed. A primary care doctor may send the person to a urologist, a specialist in urinary tract problems. NIDDK says gynecologists and geriatricians also treat bladder control problems.
What treatments are there?
NIA says the simplest and safest treatments are tried first, and a combination often works best. These are general descriptions of what NIDDK and NIA list, not a plan for any one person.
- Bladder training. Urinating on a schedule (timed voiding) and gradually lengthening the time between trips.
- Pelvic floor exercises. Often called Kegel exercises. NIDDK says men and women can benefit, and that a physical therapist trained in pelvic floor therapy can help get them right. A correct technique matters, so ask for a demonstration.
- Everyday changes. Urge control techniques such as slow breathing, preventing constipation, cutting back on caffeine and alcohol, keeping a healthy weight and quitting smoking.
- Medicines, devices and procedures. These are decisions for the clinician. NIA notes that some medicines used for overactive bladder have been linked to a higher risk of cognitive decline in adults over 65, so ask the doctor to weigh the pros and cons.
When should you call the doctor soon, and when is it an emergency?
Most leaking is not an emergency, but the signs in the first five rows need quick attention, so do not wait for a routine appointment. The last row is a reason to book a visit soon.
| What you notice | What the official sources say |
|---|---|
| Cannot pass urine or empty the bladder | NIDDK lists this under “seek care right away” |
| Blood in the urine | NIDDK: seek care right away; it can signal a serious problem |
| Pain or burning when urinating | NIDDK: seek care right away |
| Fever and chills, nausea or vomiting, pain in the back, side or groin | NIDDK: possible kidney infection signs; quick treatment is important |
| Sudden loss of bladder control with trouble speaking or walking, weakness or numbness in an arm or leg, vision loss, confusion or loss of consciousness | MedlinePlus: call 911 or go to an emergency room |
| A new leak that began suddenly, or urinating 8 or more times a day | NIDDK and MedlinePlus: tell a provider. Sudden leaking is often temporary and caused by something treatable, like infection or constipation |
How do you protect the skin and keep dignity?
Skin that stays damp can become sore. NIDDK lists kinds of protective products: washable absorbent or waterproof underwear, disposable briefs and pads, large pads for chairs and beds, and skin cleaners and creams that can help block urine from the skin. Ask the nurse or doctor what suits the person.
Change wet clothing promptly and give privacy. Tell the doctor or nurse about redness that does not fade, open skin or pain. Our guide to preventing bed sores explains skin checks, and our incontinence supplies guide covers who pays for products in New York.
How do you make night trips to the bathroom safer?
Rushing to the toilet is a fall risk. NIA’s guide to falls and fractures says conditions that cause rushed trips, such as incontinence, may raise the chance of falling.
- Keep a light on in the bathroom and a clear path from bed to toilet. NIA suggests clear hallways, a clutter-free bathroom and a light on at all times for people with Alzheimer’s.
- Check footwear and rugs. NIA lists backless shoes and tripping on rugs among common causes of falls.
- Ask the doctor about evening fluids. NIDDK says stopping drinks a few hours before bed may help, but only if the health care professional suggests it, and not to the point of dehydration.
- Consider a commode chair near the bed if the bathroom is far.
See our guides on fall prevention in NYC apartments and the home safety checklist. If nights are the main danger, overnight care is one option families consider.
What practical steps at home help?
- Clothes that are easy to manage. NIA suggests underwear that is easy to get on and off, and NIDDK notes that arthritis can make buttons hard.
- Regular bathroom breaks. For people with memory loss, NIA suggests offering breaks on a schedule.
- Easy access. Grab bars or a bedside commode can shorten the trip. Our guides on medical equipment in New York and grab bars and home modifications explain how to get them.
What does Medicare cover for incontinence care?
Original Medicare covers doctor visits and some therapy, but not diapers. Medicare Advantage plans can differ, so check with the plan.
| Service | Original Medicare |
|---|---|
| Doctor visits to find the cause | Part B covers medically necessary doctor services, usually 20% of the approved amount after the deductible |
| Physical therapy, including training in pelvic floor exercises | Part B covers medically necessary outpatient physical therapy certified by a doctor or other provider, with 20% after the deductible. Medicare.gov does not name pelvic floor therapy, so ask the therapist’s office |
| Biofeedback for stress or urge incontinence | Covered under a national coverage rule for cognitively intact patients who did not improve after a documented 4-week trial of pelvic muscle exercises |
| Commode chair | Part B covers commode chairs prescribed for home use when medically necessary, with 20% after the deductible, from enrolled suppliers |
| Adult diapers and incontinence supplies | Not covered. Medicare.gov says you pay 100% |
Our guides explain Medicare physical therapy coverage in New York and how New York Medicaid can help with supplies.
How can a home health aide help?
An aide cannot diagnose or treat incontinence, but help with toileting is part of daily personal care. Our personal care services page lists toileting, bathing, dressing, walking and transfers. In practice that means going with the person to the toilet, helping with clothing and following the schedule in the care plan.
Aides see the person every day and can pass changes they notice to the agency nurse and the family. Our dementia care guide describes routines that suit people with memory loss.
How do you talk about leaking urine without shame?
NIDDK says many people feel too embarrassed to talk about bladder problems, yet urges talking to a health care professional anyway. A few things make it easier:
- Pick a private, unhurried moment and treat it as a health problem with causes and fixes.
- Speak about the problem, not the person. “Many people have this and doctors treat it” lands better than “you keep having accidents.”
- Offer to make the appointment, keep the bladder diary or go along if the person would like that.
NIA lists two nonprofit groups for more information: the National Association for Continence (800-252-3337) and the Simon Foundation for Continence (800-237-4666).
What our nurse director tells families about everyday toileting care
Anna Klyauzova, RN, MSN, MPA, Director of Patient Services at ProLife Home Care, on what she sees in practice:
A registered nurse from the agency usually does the first assessment. She checks whether the person can stand, walk, dress, bathe and use the toilet alone. We look closely at what the person can really do, not just what they say they can do.
Families rarely hear this: don’t argue with the person and don’t keep correcting mistakes. A calm voice, a familiar room and a routine they can predict usually work better than long explanations. You can’t do all of it by yourself. Even a few hours of professional home care a week gives relatives time to rest.
We are a licensed home care agency in Brooklyn and Queens, licence #2572L001, New York State Department of Health. If the nights or the toilet trips are wearing your family down, call (718) 232-2777 or use our contact page, and we will talk through the help that may fit. We do not diagnose or treat incontinence. That belongs with the person’s doctor.
Medicare rules and benefits change. Everything above was checked on 16 October 2026 against niddk.nih.gov, nia.nih.gov, medlineplus.gov, medicare.gov and cms.gov. This page is general information, not medical advice. Ask the person’s doctor, nurse or prescriber about their own symptoms and medicines, and call 911 for an emergency.
Frequently asked questions
Is urinary incontinence a normal part of aging?
No. It is common, but NIDDK says it is not a routine part of getting older. Aging can weaken bladder muscles, but causes such as infection, constipation, medicines, prostate problems or nerve conditions can often be found and treated.
What causes sudden urinary incontinence in an older adult?
MedlinePlus lists temporary causes such as a urinary tract infection, severe constipation, certain medicines, mental confusion, prostate infection and bed rest. Tell the doctor soon, and call 911 if sudden loss of control comes with trouble speaking or walking, weakness, vision loss or confusion.
What kind of doctor treats urinary incontinence?
Start with the primary care doctor, who can examine the person and may refer them to a urologist. NIDDK says gynecologists, urologists and geriatricians often talk with people about bladder control problems.
Can urinary incontinence be cured?
Sometimes. NIA says incontinence can often be stopped or controlled, and surgery can cure some cases caused by a change in bladder position or a blockage. Some people still leak occasionally after treatment, and protective products can help.
Why does a person with dementia start wetting themselves?
NIA says people with Alzheimer’s disease may not realize they need to go, forget to go or be unable to find the toilet. Clear hallways, a light on, regular bathroom breaks and clothes that are easy to remove can help. Mention it to the doctor, too, to rule out infection or a medicine effect.
Does Medicare pay for adult diapers?
No. Medicare.gov says Original Medicare does not cover incontinence supplies or adult diapers, and you pay all costs. Some Medicare Advantage plans offer extra benefits, and New York Medicaid may cover supplies with an order.
Does Medicare cover pelvic floor therapy?
Medicare Part B covers medically necessary outpatient physical therapy when a doctor or other provider certifies it, with 20% coinsurance after the deductible. Medicare.gov does not list pelvic floor therapy by name, so ask the therapist’s office how it is billed.
