A Caregiver’s Guide to Understanding, Compassion, and Action

Caring for someone you love can be one of the most rewarding and most challenging journeys you can take in life. And sometimes, it means noticing changes that are private, confusing, or uncomfortable to talk about.

Maybe you begin to see more laundry. Or your loved one begins to shy away from family dinners. Perhaps you notice they avoid social outings. That unease, the whispered fear: what if they are experiencing issues with their bowel control?

If you’ve asked yourself these questions, you’re in the right place. Whether you’re helping an aging parent, partner, or friend, this guide is for you. It’s meant to help you understand what accidental bowel leakage (ABL) is, why it’s often overlooked, how you can start a conversation, and what steps to take so your loved one can stay home with dignity, comfort, and hope.

What Is Accidental Bowel Leakage (ABL)?

“Accidental bowel leakage” or ABL, also known as fecal incontinence (FI), means stool leaks unexpectedly, without the person’s control. That might mean small leaks here and there, or larger accidents. This is different from having the occasional upset stomach or diarrhea. ABL is about a loss of control over bowel movements. It affects 18 million adults in the United States1 and 1 in 12 adults worldwide2.

ABL can happen for many reasons, some of which include:

  • Weakness or damage to the muscles or nerves that help control the rectum and anus, sometimes after childbirth, surgery, or illness
  • Age-related changes that weaken control over bowel function
  • Chronic constipation, diarrhea, or bowel diseases that make stool control harder
  • Pelvic floor disorders or previous injuries

Because there are many causes, and because the condition varies widely from person to person, ABL is often misunderstood or ignored. But that doesn’t make it unimportant. If anything, it’s even more important because untreated ABL becomes a burden not only on the person affected but their caregivers, too.

Health care professionals and family caregivers agree: ABL should be addressed, not hidden. With care, many people with ABL can continue living at home and enjoying life.

Why ABL Is So Often Missed or Ignored

It’s not uncommon for ABL to go unrecognized, even when it’s significantly impacting a person’s life, so don’t feel bad if you haven’t heard of it. There are a few big reasons for this:

Shame, Embarrassment, and Silence

Bowel control is deeply personal. Many people feel embarrassed, ashamed, or like they’ve “lost control” of their body. That makes it hard to open up. Some may even try to manage it secretly by hiding accidents, over‑laundering clothes, and avoiding social situations. But that’s no way to live.

As a caregiver, you may notice signs long before your loved one says anything. Perhaps more laundry. Maybe sudden avoidance of activities. Maybe subtle changes in mood or withdrawing socially.

Lack of Awareness, Even by Doctors

Studies show that ABL often goes undiagnosed: many people who experience bowel leakage either never mention it to their doctor or are never asked. In fact, one study found that only 2.7% of women who reported ABL symptoms to their doctor received a formal diagnosis.3

Worst of all, because it’s not talked about, people assume it’s just “part of aging,” or something they can’t do anything about. But medical and lifestyle-based treatments are available.

Speaking up matters. Over 90% of patients report never being asked about bowel control by their doctor.4

Practical and Emotional Burden on Caregivers

If you try to address ABL alone, it can feel overwhelming. Cleaning, extra laundry, and nighttime accidents all take their toll on you. It’s emotionally and physically draining. You may question whether home care is still a real option. Many caregivers say that incontinence is the “tipping point” for considering moving a loved one to an assisted living facility or nursing home.

But here’s the reassuring truth: ABL doesn’t have to mean loss of independence or dignity. With awareness, compassion, and the right support, it’s possible to stay at home and have a good quality of life.

How to Start a Gentle Conversation: Bringing Up ABL with Compassion

As you can imagine, and are probably stressing about currently, talking about bowel issues can feel awkward. But how you open the conversation can make all the difference. Here are some caregiver-tested tips:

  • Choose a calm, private moment. A quiet afternoon, not right after a leak, when you’re both relaxed.
  • Use gentle, caring language. You might say something like: “I’ve noticed there have been a few mishaps lately. I just want to make sure you’re comfortable and that we take care of this together.”
  • Focus on care, not blame. Avoid judgmental words. Don’t say “you’ve been careless.” Use neutral observations: “I’ve noticed…” or “I wonder if…”
  • Listen. Then listen again. Let them share their feelings. Shame and fear are common, so give space for those emotions.
  • If they don’t respond, that’s okay. Sometimes, denial or shame may prevail. Respect their feelings. Offer reassurance: “If you ever want to talk, I’m here.”

Caregiver guides emphasize that empathy, patience, and dignity go a long way, sometimes more than quick fixes.

Signs You Might Be Caring for Someone With ABL

If you’re not sure whether ABL is happening, here are some common red flags to look for, especially for someone trying to hide it:

  • Frequent soiled clothing or underwear, or more laundry than usual
  • Changes in behavior: avoiding outings, skipping meals away from home, declining social activities
  • Sudden anxiety around leaving the house out of a fear of not finding a restroom in time
  • Bathroom-related patterns: rushing to the toilet, going more often, or avoiding toilet visits altogether
  • Skin issues: irritation, rashes, or discomfort (a sign of repeated leakage and moisture exposure)
  • Mood shifts: withdrawal, depression, or heightened irritability after accidents

If you notice several of these signs, gently consider whether it’s time to talk or get professional advice. Early awareness gives you more time, options, and dignity.

IT’s POSSIBLE TO STAY AT HOME WITH THE RIGHT SUPPORT

Don’t assume ABL means the end of independent living. Many people manage bowel leakage successfully at home, especially with help from an informed caregiver and supportive care plan. Here’s how you can make that possible:

  • See a doctor (together, if possible). A medical evaluation can help identify the cause of ABL and offer tailored treatments. Many people respond well to diet changes, lifestyle adjustments, pelvic floor exercises, or bowel‑training routines.
  • Adjust diet and hydration. Encourage fiber-rich foods (fruits, vegetables, whole grains), and plenty of water. This supports regular bowel movements and reduces risk of leakage.
  • Establish a toileting schedule. Help your loved one use the bathroom at regular intervals (after meals, before bed) to reduce accidents. Many caregivers find this preventive strategy effective.
  • Prioritize hygiene and skin care. After every accident, clean and dry the skin gently; use barrier creams to protect from irritation or breakdown. This reduces the risk of infection or discomfort.
  • Make the bathroom easier to use. Clear a path to the toilet, add night lights, remove rugs — simple changes can make a big difference if mobility is limited.
  • Ask for help when you need it. Incontinence care can be draining. Don’t hesitate to seek support, whether from family, friends, or professional aides.

With patience, planning, and support, ABL doesn’t have to mean losing home!

A New Kind of Option: Gentle, Discreet, Future‑Focused

For too long, the choices for managing ABL were limited: absorbent pads, uncomfortable briefs, or (in severe cases) invasive interventions. But today, new solutions offer an alternative that respects dignity, independence, and comfort.

If you’re exploring long‑term caregiving options, it may be worth discussing discreet, clinically designed aids with your loved one’s doctor. These tools can help prevent leaks without compromising your loved one’s quality of life or mobility.

Frequently ASKED Questions

Q: What if they refuse to talk about it or deny there’s a problem?

That’s very common. Loss of bowel control can feel shameful. Don’t force the conversation. Instead, offer understanding, patience, and safety: keep a gentle, non-judgmental tone; reintroduce the topic later if needed. You might say something like: “If you ever want to talk — I’m here, and I want to help.” Sometimes, showing care from a place of respect is the first step to acceptance.

Q: What if accidents keep happening even with care?

Then it’s time to speak with a healthcare professional. ABL can stem from many different causes, some treatable with diet or therapy, others requiring medical intervention. A doctor can help determine the next steps.

Q: Does incontinence always mean a move to assisted living or long‑term care?

Not necessarily. With consistent care, routine, and the right support tools, many people with ABL live comfortably at home for years. Your role as a caregiver, combined with proper support, can make all the difference in their lives.

You're Not Alone and This Doesn’t Have to Be the End of Home

If you’re reading this, chances are you care deeply about someone who’s struggling quietly. Observing, worrying, wanting to help. That awareness, that love, already shows how much you care.

Caring is about compassion, listening, and being willing to walk each step with dignity and respect, not about “perfect” solutions. With knowledge, empathy, and support, you can help your loved one stay where they belong: at home, with safety, comfort and hope.

Ready to Learn More?

If you want additional resources or are interested in discreet, dignity‑preserving solutions for accidental bowel leakage, visit StaySureToday.com for caregiver guides and support tools or talk to your loved one’s doctor to see if StaySure™ is the right fit.

References

  1. Meyer, I., & Richter, H. E. (2015). Impact of Fecal Incontinence and Its Treatment on Quality of Life in Women. Women’s Health, 11(2), 225–238. https://doi.org/10.2217/whe.14.66
  2. Mack, I., Hahn, H., Gödel, C., Enck, P., & Bharucha, A. E. (2023). Global Prevalence of Fecal Incontinence in Community-Dwelling Adults: A Systematic Review and Meta-analysis. Clinical Gastroenterology and Hepatology: The Official Clinical Practice Journal of the American Gastroenterological Association, 22(4), S1542-3565(23)007152. https://doi.org/10.1016/j.cgh.2023.09.004
  3. Dunivan, G. C., Heymen, S., Palsson, O. S., von Korff, M., Turner, M. J., Melville, J. L., & Whitehead, W. E. (2010). Fecal incontinence in primary care: prevalence, diagnosis, and health care utilization. American Journal of Obstetrics and Gynecology, 202(5), 493.e1–493.e6. https://doi.org/10.1016/j.ajog.2010.01.018
  4. Duncan, I., Stocking, A., Fitzner, K., Ahmed, T., & Huynh, N. (2024). The Prevalence of Incontinence and Its Association With Urinary Tract Infections, Dermatitis, Slips and Falls, and Behavioral Disturbances Among Older Adults in Medicare Fee-for-Service. Journal of Wound Ostomy & Continence Nursing, 51(2), 138. https://doi.org/10.1097/WON.0000000000001054