Beyond the Diagnosis: The Emotional Reality of Incontinence and Caregiving

The following transcript was generated electronically. Please let us know if you see any transcribing errors and we’ll get them corrected immediately. 

Bruce Kassover: Welcome to Life Without Leaks, a podcast by the National Association for Continence. NAFC is America’s leading advocate for people with bladder and bowel conditions, with resources, connections to doctors, and a welcoming community of patients, physicians, and caregivers. All available at nafc.org. 

Welcome back to another episode of Life Without Leaks. I’m your host, Bruce Kassover, and joining us as always is Sarah Jenkins, the executive director for the National Association for Continence. Welcome Sarah. 

Sarah Jenkins: Thanks, Bruce. It’s nice to be here.

Bruce Kassover: Yeah. I’m really looking forward to this because it’s going to be an interesting conversation. Today our guest is Ruth Naismith. She’s been a registered nurse now for 35 years and has also worked as an assistant director at a long-term care facility, and now she’s serving as a nurse consultant for Attends, and she’s going to be talking with us about the emotional side of dealing with incontinence.

But she’s coming at it from a really interesting perspective because she has a personal story that’s as compelling as her professional one, and I think it’s going to really be very informative for a lot of our listeners. So welcome, Ruth. Thank you for joining us today. 

Ruth Naismith: Thank you very much, Bruce, and I’m honored to be here. 

Bruce Kassover: Now, I understand that you are not simply coming to us as a nurse, but you have a personal journey that really gives you an interesting perspective on incontinence care and, caregiving in general. Maybe you want to share that with us today. 

Ruth Naismith: I’d love to. Yes, thank you. I started my nursing career as a nurse manager in a lovely long-term care home, and that was after the birth of our first child. Several of the residents in that home were family friends and just part of my extended community. So it really was a lovely place to work.

But I resigned from that position after the birth of our second son. He has Down syndrome. He does very well, and he’s a thriving 32-year-old now. So for a number of reasons, I chose to stay home when the children were young. It was a busy home and we had extra things to do with Steven, our second child.

Now, once our children reached school age, I returned to that same long-term care home in a casual position. And then I transitioned into the role of assistant director of care. After being there for some time, I was approached by an incontinence manufacturer and asked if I would work for them.

I decided to, and I worked for them in a sales and clinical support position. Since then, I’ve worked for different incontinence companies and also worked for one that was based in Europe, so that further expanded my education into the world of incontinence. And then just before the pandemic, I took some time off to develop a comfortable one piece garment called ZipperOn.

So now I wear a few different hats and it’s an honor to meet and support many in my various roles, and especially as a nurse consultant for Attends healthcare. I did work for them several years ago and I’m thrilled to be back. 

Bruce Kassover: That’s really interesting. Now I wanted to ask you about being a mother and also a caregiver of somebody with Down Syndrome. That’s a perspective we don’t always hear about or don’t often hear about here on our podcast. When we’re talking about Down Syndrome, there’s a broad spectrum of people’s abilities, and I’m wondering do you find there that incontinence happens to be an issue among that community? Or is it just the same as for people without Downs? 

Ruth Naismith: That is an interesting question, Bruce. I would say that most with Down syndrome may be on a slightly delayed schedule for, say, just the regular toilet training. But again, the regular population varies so much as well. We’ve been fortunate in that Steven was, able to use the bathroom quite early on and he’s done, he’s perfectly continent like any other adult. But there are those for whom there are health challenges that go along with maybe Down syndrome or any diagnosis.

But by virtue of having a son that does have delays, that’s put us in touch with Special Olympics and just various other community programs. And with that, I’m also tied in with different levels of disabilities. I’ve seen many that can have dual diagnoses.

Maybe they have Down Syndrome and autism. They could have, just so many different scenarios for which there may be challenges related to incontinence, and not that being autistic means you’re incontinent, no. But there’s just so many different variables at the world at large, and this extra piece of our life has really opened up that world to me, too. And I guess it’s allowed me to meet so many and to be able to relate at a different level and therefore provide some words of encouragement and maybe suggestions regarding products or strategies. 

Bruce Kassover: That makes a lot of sense. And I suppose that the one common thing that you’re talking about for people in your position, regardless of the person you’re caring for, is that you are a caregiver. Of course with your son, you’re principally a mother, but for those who are dealing with people who aren’t directly related, they’re principally caregivers. And, caring for somebody who has incontinence needs is its own challenge. I know that we’re going to talk about, the emotional aspect of living with the condition.

Maybe you want to share with us a little bit about the emotional impact that you experienced as somebody who is providing the care. 

Ruth Naismith: The emotional impact for those providing care is huge. And the thing is, it is a life altering change for many. And I can just think to my immediate world, I have been a caregiver and a close friend, and her spouse had dementia, had Alzheimer’s.

The struggles that she found were sometimes he didn’t even want to wear protective underwear. Huge impacts, even just for keeping clean and where he was going to void. There’s also the fact if someone is afflicted or has a challenge with incontinence related to a health concern, the challenge there is because of incontinence that may be a result of medications, treatment, chemotherapy, immunotherapy, there’s so many of these harsh chemicals. One of the first side effects is what? Nausea, vomiting, and diarrhea. And if that is what’s happening, the loved one who, I guess, almost becomes a caregiver or support in so many ways, they may find that their world suddenly shrinks and gets smaller. The person with the challenges, whether it’s a urinary challenge or bowels, their world can get pretty small.

They don’t even feel comfortable leaving the home. So for that reason, there can be a huge stress depending on the mobility and the ability of the person that’s unwell to get to the bathroom. Whether it’s a physical tool of helping to change someone, even just helping to encourage, support. And also it can be life limiting in that they cannot be a part of the communities they once were because the one they’re caring for is not as able to get out and about or isn’t secure with their challenges to feel comfortable being out and about with people.

Bruce Kassover: I can imagine that as a caregiver, regardless of the nature of the care you’re providing, whether it is for somebody who’s dealing with incontinence or some sort of other medical condition, you talk about the stress, you talk about, there’s certainly anxiety and other issues. What do you suggest somebody do to handle those feelings when they start to happen? When you’re responsible for caring for somebody, but you’re finding it really difficult? What do you do? How do you manage that? 

Ruth Naismith: I’d say the first and most important piece to manage those feelings is to acknowledge that this is a challenge, and I have seen caregivers who are absolutely exhausted and with lack of sleep because if we’re talking about somebody, say, with a dementia like Alzheimer’s, they can be up at night with a loved one, they may refuse to wear incontinence products. Then, because someone is so overtired, they can be angry.

And there’s just so much surrounding this. It’s quite complex. And I think Number One is to reach out for support for help. And when it comes to products, there’s, I’ll probably speak to this later, but it is learning what products to use, even how to approach somebody just to encourage them to use a product.

And that’s not always easy either. But I think for the caregiver to understand even what is out there in the market, I think of Attends Healthcare with such a vast line of products for whether it’s hospital or home care, that there really is phenomenal products and there has never been a better time to find a product that will suit the need for which a caregiver is struggling with the person that he or she is looking after.

Bruce Kassover: Okay, that makes sense. And you used the word “struggle” and I think that, that’s a good word because it can sometimes be a struggle physically, of course, we know that, but, and we’re talking about emotionally as well. Maybe you want to talk a little bit about that struggle that patients are facing. What are some of the biggest challenges that you see when it comes to dealing with patients living with incontinence? 

Ruth Naismith: We talk about the biggest challenges with incontinence, I guess I think of two areas, and this is just speaking from my experience and from where I’ve come from… the first area I would speak to are care settings, congregate settings, whether it’s long-term care, the hospital, also developmental disability sites. There could be a group-type homes.

And then the second area involves those living at home with struggles. And this is probably my newer concern, and I’m not sure if it’s because as I am getting older and I have friends with challenges and their acquaintances, my newer concern is individuals with sudden health challenges that involve some level of incontinence.

So, if I were to speak first about, say, long-term care or acute care, the developmental disabilities users, I’d say that when it comes to the challenge, the main one is people can think that a larger product is a better product. It will hold more. And this is simply not true. I compare it to little children wearing diapers and I don’t think any young parent out there is going to put their toddler size diaper on their newborn because they think it’s going to hold more because it’s larger.

And the same is true with adults. You’ll have a huge mess if the product is too large. Now, on the other side, I want to mention one thing, too. And I’ve often heard adult briefs, which are referred to as diapers. And we like in the US and, say, Canada, to call diapers briefs. Now in Europe, they often refer to them as “slips,” and it’s all about dignity.

I’ve heard several comment to me over the years that, “Oh, Ruth,” they’ll say, “I know, once an adult and twice a child,” and we really want to steer away from that harsh and sad stigma. There’s so many that are really struggling. They do need a brief, and they’re beautiful. They’re designed to conform to the body beautifully.

They’re very discreet and we really want to do our best to minimize stigma. So anyways, that’s about the name of diapers versus briefs. But back to the misconception that I see out there, which is a huge challenge, is that a larger brief will hold more. And I tell staff and caregivers that, the crotch area is very similar person-to-person.

And I know this sounds rather forthright, but I just say it the way it is. And really what is different between individuals is our size, our shape, and we need different sizes to fit the actual body type. And it’s the correct size, when that is selected, that will make all the difference for a good result for containment of either urine or feces.

We want tabs on a brief, for example, to fit well. If it’s too large a product, it will gape and then we will have leakage. Proper sizing is the main step and challenge that I have to speak to when I am doing any education. I should add that often it’s easier to put a larger product on someone, even if it isn’t thinking that bigger is better.

There still is the point that if I have someone who is struggling with pain, perhaps they’ve had a stroke, they’re immobile, they can’t move. It is just physically easier as a caregiver to put a larger product on someone. There’s longer side panels to put under the body and then to spread it around the person. So it’s just physically easier. But I also say that, short-term gain, getting a product on quickly, can result and will result in being an overnight pain. And I don’t want to see caregivers disrupted from a good sleep because they have to be changed due to leakage which could have been avoided with a better size.

Now, the Attends products, they’re beautiful in that they wick away the moisture from that top level of the brief, and that leaves it dry, a dry surface for optimal skin health. And that is the goal. And if a brief is too large, it means that the urine can just trickle down, and it’s not being wicked away because the product is not up close and personal to the groin.

So for many reasons, we do want to have a proper sized product for skin health and just for proper containment. And I do remind staff that we just want a finger’s width around the inner leg or groin area. I remind them that the brief should fit like underwear that just nicely hugs the inner thigh and leg area.

And then the second challenge, which is I said is my newer concern, and it’s really been on my mind… I think I’m a caregiver for so many in my own private life that this has really come to the forefront, and that is finding the correct product to wear when there’s been a sudden health change. And now I think especially of maybe my brother-in-law, a busy school principal, and once he received a diagnosis of colorectal cancer, everything changed. For five years, he wore protective underwear “just in case.” Now I could say he only had two or three emergencies, but that word “only” is just, I think it’s almost demeaning and limiting because it just takes one accident to change someone’s whole mind and outlook on going out, even though he soon learned after his treatments, his body rhythms and patterns. He stayed close to home those few days after treatments when he felt the worst. He was very tired for a good number of days. His bowels acted differently. He knew it. He could anticipate. It was predictable. Then the predictable suddenly became the unpredictable. Those known patterns just suddenly changed without warning.

And I can remember we were out at dinner as a family. All the other siblings were all having a nice dinner, and then suddenly he hurried to the bathroom, and he spent most of the meal in there. Fortunately, he always planned ahead. He was an organized principal, and he had his “little kit,” he called it, with extra clothes. He had the wipes, he had extra product just in case, and that is how he lived. He wouldn’t go anywhere without knowing exactly where the washroom or the restroom was, and he would hopefully sit close, just in case. Didn’t happen often, but when it did, he wanted to be prepared.

And I can think of another close relative who has multiple myeloma, takes three different medications as part of the ongoing treatment, and all three have that same frustrating potential for side effects, which include diarrhea.

Now I know for some this isn’t an issue, but for so many it is, and it happens without warning. And I know that it just is, it’s so traumatic and it is frightening for the person struggling with a health challenge. 

Sarah Jenkins: Thanks, Ruth. That’s such great information. And I want to touch on just a couple of things that you pointed out, first of all the size. I think that is such an important point for people to remember. Not just caregivers… individuals choosing a product for themselves. So many times we hear from people that they think a larger product is going to hold more, and that’s just not the case because of the reasons that you said, the sizing, things leak out, it’s just not going to serve someone well. So I think that’s really important for people to know.

And also the mental impact of just having to always be on guard is really understated and not talked about very much. NAFC did a mental health survey last year where we talked to patients about how incontinence affected their everyday life. And we heard exactly what you’re saying. So many of them plan every single day, every portion of their day, where they’re going, where the restrooms are going to be, making sure that they have supplies. That’s just a huge emotional burden that they have to live with every day. And I think it’s really important for healthcare professionals and for themselves to address that and find ways to deal with that emotionally.

Ruth Naismith: Absolutely. And I find that individuals who have never even had to learn the word “incontinence” are suddenly faced with it. And it is scary. They’re terrified, and it’s just, it’s almost debilitating. And all it takes, as I mentioned, is just one accident. And I can think of the person that I know and love with the multiple myeloma. She had a major accident on the elevator in a shopping mall and didn’t even think of this as a possibility. And suddenly that has changed an entire outlook.

It affects, even say, going to church. It affects, wanting to go shopping and just knowing where the bathroom is and then getting there in time. What if you go into the bathroom and every stall is filled? There’s just so many complexities. And I think even with that though, is knowing. Even more importantly or as important, what products can I use for my specific type of challenge? I think we need a strategy and just to help someone along so they don’t end up being cocooned in their house.

Especially when someone is going through a health challenge, we need community. We need to get out and about, but when it’s so traumatic to think about going out and even anxiety itself can cause diarrhea, so it just seems to be this ongoing cycle, which is frightening, and it also limits the ability of caregivers, of loved ones – maybe it’s a spouse or a child or a parent – it even limits their world because if the person they’re caring for or live with isn’t wanting to go out, then suddenly the family birthday parties or other outings are limited and so much is being missed out in life… the very things that we really want to encourage to feel fulfilled and to be loved and to love those for whom we interact with.

Sarah Jenkins: Yeah, you’re right. It affects the whole family.

Bruce Kassover: Emotionally many patients learn how to live with their condition. And certainly, hopefully they learn how to live it as they’re on a treatment path and find that their symptoms are improving, but they develop strategies to help manage leaks and, physical issues. And they also, develop ways to deal with things on a mental health level as well. But, there’s a group of patients that I’m really interested in hearing your thoughts on, and that’s those who are experiencing incontinence for the very first time.

People who are just recognizing the fact that, “Hey, I’m having leaks, I’m having a problem.” Can you talk about their emotional response and how you might address that from somebody who’s really experienced at helping these patients sort of work through those issues? 

Ruth Naismith: That’s, yeah, very interesting and relevant as well. I have a dear friend, and she suddenly found herself in the emergency with what turned out to be a bowel obstruction requiring emergency surgery. She had great, great bladder function prior to surgery, but because she ended up having a catheter for several days after and maybe as a result, she now finds that she has urge incontinence.

And I only realized it when speaking on the phone. She goes, “Ruth, sorry to bother you. I have to go. I got to go.” And she didn’t even realize that maybe I could put a product in place at that point. It was more just living with the, “I gotta go,” and then hanging the phone up and running. Fortunately she has a bathroom right close to the phone, so it worked out well.

But I think there’s that initial shock, there’s that response of, “I don’t even know what to do. What can I do. It’s just me now.” But when you have something like that suddenly spring upon you because of, maybe it’s a surgical procedure, taking that step, you know what? Go and get even a substantial liner just to wear so that you never find yourself in a place where “I have to go, but I can’t get to the restroom in time.” The other challenge that comes to mind is speaking with, several that I know that have had prostate cancer or other prostate challenges as a result of perhaps its radiation, suddenly they have to go, or at night they have frequency. And again, this is men who have never even had to consider the idea of wearing any type of protection.

So again, it’s just making do or just trying to be close to the washroom. And when, really, there are, I keep mentioning there is the male guards, there’s protective underwear, there are, shape pads depending on the level of the severity of the challenge. So yes, there’s that initial shock, but we don’t want to be confined living there and adapting our life such that we don’t do as much because of this problem, but realize, you know what, there are solutions. I can live a life without leaks or worrying about leaks if I get the proper product for my own individual situation. 

Bruce Kassover: So Ruth, what do you recommend to try and find the right item for the right situation?

Ruth Naismith: Good question, Bruce. Thank you. Now there’s what we call a decision tree or how to choose products. And for example, just to make it really simple, if you were to go to the Attends.com website, they do have a product finder on there and it asks a few simple questions, and that is actually a very good starting point.

Beyond that though, I think it is very helpful to understand what kind of incontinence or what types, plural, of incontinence am I or the person you’re caring for struggling with. So for example, if I have stress incontinence, which is generally that laugh, the cough, the sneeze, I have allergies, ah, or a bad cold or a chest cold, and I just have a leak when I cough, maybe it’s exercise. For some, it’s standing and sitting, and that even causes a little leak. For those, I just simply suggest a small liner is often adequate, or for men there is a male guard, which is a more of a triangular shape product, which sits nicely and especially sits well in brief-style underwear. I generally suggest the brief-style for men because it does hold products in place better.

And if the stress incontinence is becoming more of a challenge, heavier leaks, then there are pads and products that are longer, larger and have increased absorbency. And I think it’s good to remember that there are different sizes and they are all discreet with the Attends products they are called the “Discreet” line and they are discreet. And that is the beauty, you can just choose accordingly. Now, if someone is moving or has urge incontinence, and this is true for men and women, that’s that need, that urge to go, and oftentimes the feeling of that urge and the feeling of having to go doesn’t leave enough time to get to the restroom in time.

And there can be huge challenges as a result. So again, having a large, more absorbent liner is important. Even moving to a larger shaped pad, which are beautiful because they have these protective confidence cuffs on them, which help keep the fluid in place. Or there’s also for urge incontinence, the a good quality, high quality, premium protective underwear.

In this case I’m referring to and looking at the Attends Sleep Comfort Premium Overnight Underwear. And I don’t want to say “overnight” and limit it to that, it’s good for day or night, but oftentimes some folks can wear a liner during the day, but they do need more. Maybe it is protective underwear at night. And I must say it is very discreet. With my brother-in-law, he put underwear on and he walked around with his pants around the home, with his wife and his two late teenage sons and they assured him that, “No, dad, we cannot tell.” So that just was a huge stress relief for him and gave him the confidence to go out.

So really a quality protective underwear is so important. And then if there’s very heavy urge incontinence or maybe moving on to functional incontinence, which is either a physical or a cognitive reason that someone can’t get to the bathroom in time or at all, then briefs are often the best decision or the best choice to make.

And briefs, again, come in all sizes. There is, I’ll tell you a product that I love and I know my kids have called me the incontinence queen because I really get excited about incontinence products. But the Attends 5XL product is so amazingly absorbent, holds so much, and it goes to, it has 115 inches circumference, so it really does fit very well.

And choosing that correct product, that correct size and absorbency is key when it comes to, just containment and having the correct product. And if someone’s on a lot of diuretics or other medications, they may really appreciate having an extra absorbent product to contain.

There’s also, I should add in here, there’s overflow incontinence, and that generally affects more men than women because of maybe prostate challenges. And that is when the bladder isn’t fully emptying and there can be a lot of dribbling. And for that, a lot of the men do choose to wear a male guard.

It’s a kind of a nice gray color and it’s, as I mentioned earlier, it sticks nicely into brief-style underwear and it is absorbent and really solves any challenges in that regard. So yes, there is stress incontinence – laugh, cough, sneeze. There’s the urge, that sudden urge to go and it can be a huge volume. I have seen shoes full of urine and the floor around, so it can be very challenging. So the correct product is important.

Overflow. The inability of the bladder to empty completely. And then functional incontinence, a cognitive, it could be some type of a dementia, developmental delay, or it could be a physical reason.

Maybe it’s a broken limb, a broken hip. Could be a stroke or, severe Parkinson’s. So many reasons for which a brief may be the best option. And again, it can be a very dignified option to wear. 

Bruce Kassover: That’s very cool to hear and I love the variety. What we’ll do is we’re going to put a link to Attends.com and also a specific link to the Sleep Comfort product as well. I believe that they’re available on Amazon. We’ll make sure that’s linked in the show notes. Anybody who’s interested, just go take a peek there and you should be able to click right on through. 

But, you were talking about this great variety and it got me thinking, there are products that are bargain basement. There are products that are far more high end. Can you talk about what makes a premium product so that when people are shopping, they understand what they’re looking for? 

Ruth Naismith: Yes. Thanks Bruce. That is an excellent question. Just to start first, when it comes to nomenclature wording standards, you could have certain droplets, you can have pictures of measuring cups on bags, for example, and there really isn’t a clear standard within the market of incontinence and the world of incontinence to know that, company A’s four droplets may not equal company B’s four droplets.

So I can certainly speak to what makes the Sleep Comfort “premium.” And that is, it was designed for overnight protection and that’s, really, dryness, comfort from dusk till dawn. It’s rated for up to 12 hours of protection, and I know it’s called “overnight,” but I like to think, you know what, this is great for daytime as well, day or night.

Now, some people, depending on their challenges, they may just be fine wearing a liner during the day or a male guard; they can get to the bathroom fine, but at night, whether it’s getting there fast enough, sometimes when we’re sleeping, everything just relaxes and suddenly those kidneys and that bladder works over time and we have to go.

So a much more premium product is important. Now, the beauty of the Sleep Comfort product is that it, as I mentioned earlier, it has this confidence cuff, and that just really helps with leaks around the legs. If a person changes position, it keeps everything in place and really does help to contain that void.

Further, it also has a dry lock containment core, and that means that because we want the product up close to the body, when someone voids, when the urine goes in the product, it is wicked away from the top level, leaving… the dry lock containment core locks away that liquid quickly, leaving it drier on top just to help with quick absorption, reabsorption, and also it’s much better for the skin.

Correct sizing also helps with that for sure. People don’t realize how it should fit. Again, going back to the misconception that a bigger one’s going to hold more, realizing, you know what, it must fit nice and neatly like underwear while being a product that has enough absorbency.

And if someone is trying to buy the cheapest for cost cutting, often that ends up costing more because they’re being changed more often or they’re having to put other ones in, which again, is not a healthy option. Not even, it’s not even healthy for skin health. 

Part of the premium feature is that there is odor control, the leak protection, and really it is soft. I’m playing with it right here on screen. I know many are just listening, but I have it in my hands and it really is a beautiful, soft product. And one of the words I’ll use, I know “premium” is great, “sleep comfort” is great, but there’s also, the word of ” discretion” is massive.

And I was just thinking too that the liners that I’ve referred to, that lineup of liners is actually called “Discreet.” So it’s very well named because that is so important for the population at large to get out there knowing there is huge discretion. People don’t have to know they’re wearing a product if they don’t want anyone to know. But again, there’s no shame in letting people know because we all know that any problems with incontinence can happen to anyone. No one expects these things. But I think to be forewarned is forearmed and that’s so important.

Bruce Kassover: I couldn’t agree with you more, and that ties directly into what we were talking about earlier about the emotional side of things. And the idea that knowing that you are being discreet and that people can’t tell, has got to add an enormous amount to people’s confidence. So that’s great to hear.

Now, this is Life Without Leaks, and one of the things we always like to do before we leave is give our guests one little, a hint, tip, strategy, a bit of advice on how they can live a life without leaks. So I’m wondering if you might have one that you could share with us today.

Ruth Naismith: I do. My one piece of advice would to please reach out, ask for support, ask for help. We want you living a life without leaks, but we want you living a life and to be able to get out there and to thrive. And I think that is so important.

And if I just step back, I don’t think I mentioned earlier, I love to knit. It’s my hobby. I take my knitting everywhere. And I can go into a yarn store and everything, all that yarn, those beautiful colors, I can envision a finished garment in any of the yarn that’s out there. I think of someone else who may have never done anything with yarn in their life and they just see a vast array of color and confusion. And I think that’s what happens with respect to incontinence. I have helped many a person in the incontinence aisle… there’s a sea of color and bags and no one knows, or a lot don’t know where to start, what to use. And that’s where I say, you know what? Don’t be afraid to reach out and ask for support if the person helping you at the retail store doesn’t know, because they could just be a part-time staff and not just, but they may be a part-time staff. Like I used to work in retail stores growing up, and they may not be experts in that area. I know I worked for one large retail chain that sold a vast array of incontinence product and they wanted all their staff, full-time and part-time, educated because they realized there was such a need now for not just long-term care homes or assisted living or this and that, but it’s everyone as we, age or if there’s a health complication or challenge that sets us back for a bit, we need to know about products, so they invested in that.

And in the same way, if you’re not getting the right answer in your retail outlet, do reach out to the manufacturer, go to Attends.com. There’s probably a phone number you can find. There are strategies and do get the help you need so you can live a life. And then a life without leaks will be the result as well.

And it’s just little steps. You may not want to go to a wedding for your first outing where you’re going to be out for hours, but maybe a 10 minute drive to a store and back and knowing where the McDonald’s are on the way in case you do need to make a quick stop or whatever it is, but just inch by inch to get back to the most fulfilled life that one can live despite having a challenging diagnosis, even if it is only for a short time.

Bruce Kassover: That is some great guidance and great insight and I really appreciate it. And I want to thank you for joining us today. It is really, really interesting to hear your perspective, your take on caregiving, on patient care, and on finding effective products. So thank you Ruth. I really appreciate you joining us.

Ruth Naismith: Thank you very much, Bruce. It’s been my pleasure. 

Bruce Kassover: Life Without Leaks has been brought to you by the National Association for Continence. Our music is Rainbows by Kevin McLeod. More information about NAFC is available online at nafc.org.