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Caring For Someone With Incontinence

Continence Care

Helping to make their life easier and better

Incontinence is not just a problem for older people or people with disability. Despite this, people from these two groups are at greater risk of developing bladder or bowel control problems. This is because of poor mobility (ability to get around), memory problems and chronic health problems such as Parkinson’s disease, stroke, dementia and multiple sclerosis.

The most important thing to remember when caring for someone with incontinence is that it is not ‘normal’ or ‘inevitable’. Options for preventing, treating, managing and curing incontinence are available, so it is very important to seek professional help sooner rather than later.

Where to seek help

If the person you are caring for is incontinent, the most important you should do is seek professional help.

In the UK, there are over 360 NHS continence clinics, with specialist teams providing support and medical advice for people with bowel or bladder incontinence.

Continence clinics are usually based in a hospitals, however they can also be found in your local community and are often attached to health centres. You don’t need to be referred by your GP and you can phone them directly to make an appointment. On your first visit, a continence adviser, usually a nurse who specialises in bowel and bladder problems, will assess you and explain your incontinence treatment options.

Continence assessment 

The first step required to effectively manage someone else’s incontinence is a professional continence assessment. A continence assessment helps identify the type and causes of the problems being experienced by the person and assists the continence advisor to tailor an individual management strategy. There are a number of different types of incontinence. Management of each of these will differ and also take into account the living environment and lifestyle of you, the caregiver and the person you’re caring for.

You can help the doctor make an accurate assessment and diagnosis by providing as much information as possible during the appointment. For a week prior to seeing the health professional, make note of the following:

  1. Keep a urine bladder diary for the person in your care during the seven days prior to the doctor’s visit. Document the signs and patterns of voids including:
    • Time of day incontinence usually occurs.
    • Behaviours or activities proceeding incontinence
    • Location where loss of bladder control happens most often – for example: toilet, hallway, bedroom, stairway, away from home, etc
    • Amount of liquid consumed per day
  2. Any special diets or changes in diet
  3. Any prescription and over-the-counter medications
  4. Any behaviours that you suspect may be a side effect of medications
  5. Are incontinent episodes becoming progressively worse?

What you can do

There is a range of management options available for people with incontinence, which largely depends on the type of incontinence they have and outcomes they hope to achieve. An incontinence management plan will usually consist of several of the following options:

  • Adequate fluid intake (1500-2000ml each day)
  • Adequate diet (a fibre rich diet to prevent constipation)
  • A pelvic floor muscle exercise program
  • A bladder retraining program
  • A toileting program
  • Medication, and continence aids (pads, condom drainage or catheters)

Practical tips while waiting for assistance

Bladder problems:

  • Find a pad that will keep clothing or bedding dry for about three to six hours
  • If the problem comes on suddenly, see your doctor to make sure it is not an infection
  • If the person you’re caring for suddenly cannot pass urine, see your doctor as this may be a medical emergency
  • Make sure they drink lots of fluid – between 1.5L and 2L spread evenly throughout the day
  • If they’re constipated, see your doctor about different treatment options, as constipation can impact bladder control
  • Seek professional help on the cause and treatment of the incontinence

Bowel problems:

  • Use a continence pad to give the person you’re caring for comfort and security
  • Use a barrier cream to protect their skin (bowel leakage can make skin red and sore very quickly)
  • See your doctor if diarrhoea persists for more than 24 hours (the cause of the diarrhoea could be food poisoning, or certain kinds of medicine such as antibiotics)
  • Wear disposable gloves (available from supermarkets or chemists) to protect yourself
  • Wash your hands carefully (even if you wear gloves) after you have had any contact with bodily fluids such as urine or faeces

If the person you’re looking after is constipated, see your doctor about different treatment options

Get the support and help you need

Many people find caring for someone with incontinence to be one of the most difficult aspects of caring. Incontinence can be unpredictable, add dramatically to your workload and be very costly. Many carers report feeling angry, frustrated, lonely, and not coping as they try to manage alone. It is not always easy to care for a person with incontinence, but the right advice and support from a health professional may make it more manageable for you.

Who to contact for advice and support 

To find details of your local NHS continence clinic:

  • Call the Bladder and Bowel Foundation (B&BF) confidential helpline on 0845 345 0165.
  • or Call your local hospital for details of your nearest clinic. For advice on products call KC consumer service: 0800-11 32 32