The short answer
- Skin damage is usually preventableSore or broken skin from incontinence is common but not inevitable. A barrier product and a proper cleaning routine stop most of it before it starts.
- Build it into the visit, not a separate jobChecking skin and offering the toilet fits naturally around arrival, meals and leaving. It does not need a routine of its own.
- The right product matters as much as changing itA pad that does not suit your client's mobility or level of leakage fails no matter how often you change it.
- A sudden change is usually treatableInfections, constipation and some medications are common causes of incontinence getting suddenly worse, and all three respond to treatment.
Checked against NICE, NHS and Parliament's own figures on continence care, September 2026.
Why it matters
What unmanaged incontinence costs a client
Incontinence is far more common than most people realise, and it is worth taking seriously well before it becomes a crisis, because what looks like a small, private problem reaches into most parts of a client's life if it is left unmanaged.
An estimate given to Parliament in 2023 put the number of people in the UK with some degree of urinary incontinence at 14 million, with at least 6.5 million more affected by bowel control difficulties. Left unmanaged, the effects go well beyond the bathroom. Clients often stop joining in social occasions rather than risk an accident away from home. Skin left in contact with urine or stool can become sore, broken or infected within days. Bedding, chairs and carpets get damaged. Pads and other products cost money that adds up over a year, particularly if the level of need is climbing.
None of this reflects badly on your client, and it is rarely something a carer is expected to diagnose or treat alone. Working out which of the four main types of incontinence your client has, and how to raise the subject without adding to the embarrassment, is covered in full in managing a client's continence. This page picks up from there: the skin care, the products and the daily routine that keep incontinence a manageable part of caring for someone rather than a source of harm. If your client's family are working through the practical side from their end, managing incontinence covers the same ground for them.
Through the visit
Folding continence care into the shape of a visit
Continence care works best as part of what you are already doing, rather than a separate task bolted on top. The same four points come up in most visits, whatever else is on the plan for the day.
On arrival
- Check
- Look at the skin around the groin and lower back as you help them change or wash, and ask if anything feels sore.
- Do
- Offer the toilet before starting anything else, and change a wet or soiled pad rather than leaving it until later in the visit.
After meals and drinks
- Check
- Whether there has been an accident since your last check, and how full the current pad is.
- Do
- A toilet offer shortly after eating or drinking often catches the urge before it becomes a leak, since a full stomach tends to trigger the bladder or bowel.
Before you leave
- Check
- The skin once more, and that the pad is fresh rather than the one from earlier in the visit.
- Do
- Leave them in a dry pad, the route to the toilet clear, and a short note for the next carer or the family of anything that happened.
Overnight, if you are there
- Check
- Whether they wake wanting the toilet, or you find them wet on a check.
- Do
- A nightlight nearby means getting up does not mean a fall in the dark, and a prompt change is kinder than leaving it until morning.
None of this needs a special routine of its own. Checking skin as you help someone dress, and offering the toilet before you start on something else, take moments once they are habits. If your client has limited mobility, taking your client to the toilet and moving and handling for private clients cover how to help them get there and back safely.
Skin care
Protecting skin from soreness and breakdown
Skin that stays in contact with urine or stool for any length of time can develop what's known clinically as incontinence-associated dermatitis, inflamed, broken skin that is painful and can become infected. It is one of the more serious consequences of incontinence, and one of the most preventable.
What protects skin
- Change a wet or soiled pad as soon as you find it, rather than waiting until a scheduled point in the visit
- Clean the skin gently with water or a pH-balanced cleanser, then pat it dry rather than rubbing
- Apply a barrier cream or film to skin that is frequently wet, as NICE recommends for anyone at risk of a moisture lesion
- Look at the skin properly each time you change a pad, not just when there is a specific complaint
- Tell the GP or district nurse as soon as you notice redness, soreness or broken skin
What tends to damage it
- Use ordinary soap on skin that is already sore; it strips natural oils and makes irritation worse
- Rub the skin dry with a towel, which can break skin that is already fragile
- Leave a pad in place because the visit is nearly over, "to save time"
- Assume redness will settle on its own without a barrier product or a change in routine
- Wait for your client to mention discomfort; broken skin is not always painful until it is advanced
NICE's guidance on preventing pressure ulcers recommends considering a barrier preparation for anyone at high risk of a moisture lesion or incontinence-associated dermatitis, which includes anyone with incontinence, dry or already inflamed skin. A GP or district nurse can prescribe the right strength of barrier cream for your client's skin, so it is worth raising skin soreness with them directly rather than treating it yourself with whatever is in the bathroom cabinet.
Choosing products
Matching the product to what your client needs
There is a wide range of continence products on the market, and the right one depends on how much your client leaks, how independent they are, and whether they can manage a change themselves. Getting this wrong causes more leaks and more laundry than the product itself should.
| Best suited to | Changing it | |
|---|---|---|
| Liners and light pads | Occasional light leaks in someone who is mobile and continent most of the day | Worn inside normal underwear, changed like a sanitary pad |
| Pull-up pants | Moderate leaks in someone who still uses the toilet, with or without help | Go on and come off like normal underwear, which keeps some independence and dignity |
| All-in-one pads (tabbed briefs) | Heavier or more frequent leaks, or limited mobility | Fastened at the sides, usually easier for a carer to change with someone lying down |
| Night or maximum absorbency | Overnight, or long gaps between visits | Best paired with a waterproof bed protector regardless of the pad itself |
Liners and light pads
- Best suited to
- Occasional light leaks in someone who is mobile and continent most of the day
- Changing it
- Worn inside normal underwear, changed like a sanitary pad
Pull-up pants
- Best suited to
- Moderate leaks in someone who still uses the toilet, with or without help
- Changing it
- Go on and come off like normal underwear, which keeps some independence and dignity
All-in-one pads (tabbed briefs)
- Best suited to
- Heavier or more frequent leaks, or limited mobility
- Changing it
- Fastened at the sides, usually easier for a carer to change with someone lying down
Night or maximum absorbency
- Best suited to
- Overnight, or long gaps between visits
- Changing it
- Best paired with a waterproof bed protector regardless of the pad itself
Products bought outright add up over a year. After an assessment by a GP, district nurse or continence team, many areas supply pads and other products at no cost for an ongoing, moderate to heavy need, though what's on offer depends on the local integrated care board, so it's worth asking for a referral before your client buys in bulk.
Waterproof sheets, seat covers and mattress protectors are worth having alongside personal products rather than instead of them, since even a well-fitted pad can leak at the edges. If you are not sure which product suits your client, the GP or continence nurse who assessed them is the right person to ask, rather than guessing from what is available in the shop.
Beyond the pad
Protecting the home, and staying confident out and about
Managing incontinence well is not only about the product. Protecting the home from damage and helping your client stay confident when they leave the house both matter to how well the whole thing is managed.
Beyond changing the pad
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Protecting the home
Staying confident out and about
Both the card and the key solve different problems: the card lets your client ask for help before an accident happens, and the key gets them into a locked accessible toilet once they are there. Neither costs much, and both are worth having ready before your client needs one urgently rather than after a bad experience out.
When to get help
Signs to bring in the GP or continence team
Most of what a carer does with continence is day-to-day management rather than treatment, but there are signs worth acting on quickly rather than waiting to see if they settle.
- 1
A sudden change, rather than a gradual one
Mention itInfections, constipation and some medications are common, treatable causes of incontinence suddenly getting worse. A sudden change is more likely to have a cause that can be fixed than something that has crept up over months. - 2
Redness, soreness or broken skin
Do not waitOnce skin is visibly sore, a barrier cream alone may not be enough. Tell the GP or district nurse promptly rather than continuing with the same routine and hoping it settles. - 3
A referral to the continence team
Ask the GPA GP can refer your client for a fuller continence assessment and for treatments such as bladder training or medication if the current products and routine are not enough. - 4
Anything that raises a wider concern
SafeguardingAn unexplained injury, bruising, or anything about a client's continence care that feels wrong rather than simply difficult is not something to raise with the client alone. Tell their family, or contact the local council's adult safeguarding team if you believe they are at risk.
Questions
Questions carers ask about managing incontinence
There is no fixed number of hours that suits every client. Change a pad as soon as you find it wet or soiled, and always check at the start and end of a visit rather than assuming the last change is still holding. Leaving a pad in place because the visit is nearly over is one of the most common ways skin gets damaged.
Redness, soreness, a rash, or skin that looks shiny or broken around the groin and lower back. It can develop within days of skin staying in contact with urine or stool. NICE's guidance recommends a barrier product for anyone at risk, and the GP or district nurse should know as soon as you notice anything.
Often, yes, after an assessment. Many areas supply pads and other products at no cost for an ongoing, moderate to heavy need, though what's offered and how much depends on the local integrated care board. A GP or district nurse can start the referral.
A free card from the charity Bladder & Bowel Community that a client can show to ask discreetly for the nearest toilet while out, without having to explain their situation to a stranger. It is now also available as a digital card for a phone. Register for one on their website.
Yes, they solve different problems. A RADAR key, sold by the charity Disability Rights UK, opens locked accessible toilets found in shops, stations and other public places. The Just Can't Wait card is for asking staff for access to a toilet that is not locked. It is worth your client having both if they are out and about regularly.
Mention it to the GP rather than waiting to see if it settles. A sudden change is more likely to have a treatable cause, such as a urine infection or constipation, than a gradual one.
No. A barrier cream or film protects skin from urine and stool and can be used on intact or already broken skin, but only some also moisturise. A GP or district nurse can advise on the right strength and type for your client's skin rather than whatever is available generally.
Yes, supporting someone with personal care, including continence, is a normal part of caring for a client day to day. What is not part of the job is diagnosing the cause, prescribing treatment, or running a formal continence assessment; that sits with the GP, district nurse or continence team. PrimeCarers is an introductory service, not a care provider, so it does not issue clinical guidance or supervise visits; the standards on this page come from NHS and NICE guidance. Managing a client's continence covers the types of incontinence and how to raise the subject.