Managing your Client’s Incontinence

Incontinence is a delicate subject for clients and their loved ones and should be approached with sensitivity and compassion. Although a common problem for men and women of all ages, incontinence can drastically reduce a person’s quality of life if not actively managed.

What is incontinence?

You will know this from your training, however, for completeness, incontinence refers to a person’s inability to control their own bodily functions. Involuntary urination and excretion are extremely common, affecting between 15-35% of the British adult population. Though incontinence is often a part of ageing, it can be very embarrassing for your client and their loved ones, and can lead to a number of undesirable consequences:

• Social: people suffering from incontinence are often unwilling to participate in prolonged social activities, which can lead to social isolation.
• Physical: if incontinence is not actively managed, rashes and sores can quickly develop in the affected areas.
• Environmental: left unmonitored, incontinence can also cause unpleasant smells and damage to furnishings.
• Financial: pads and other treatments can be expensive, especially if the client’s incontinence issues worsen.

Addressing incontinence

You may get mixed reactions when discussing incontinence. Though your client may be aware of their incontinence issues, they might not feel comfortable discussing the problem right away and may respond in a defensive or even aggressive manner. Incontinence issues often cause considerable embarrassment and shame, so don’t pressure clients to talk about their difficulties before they are ready. Instead, try leaving them with some leaflets which they can read through in their own time, and approach the issue again another day.

When you are able to engage them on the topic, it is important, not only to talk about measures to put in place but also how the family can support them. Your patient may not want this addressed with their family, so you may need to respect their wishes by being discreet about their issue.

Your client’s GP will also be able to refer them to their district nurse or local incontinence team, who can offer specialised guidance and support.

As an independent carer, it is your job to assist the client in accessing guidance and support from NHS professionals, such as their GP or an incontinence nurse. If required you may need to contact their GP or district nurse, to access support for them.

Incontinence is not always a chronic problem. With the right support, temporary incontinence can be effectively treated, allowing the client to regain their confidence and independence in every-day life.

For more information, visit: https://www.ageukincontinence.co.uk/

Types of incontinence

Though incontinence can have a big impact on a client’s life, it can be successfully managed with the right products. Incontinence can be experienced in a number of ways, so it’s important to determine the type of incontinence your client is suffering from. This will allow you to identify the most effective products and treatments.

The most common types of incontinence are stress incontinence and urge incontinence. Though these types may be experienced separately, sufferers often experience a combination of the two.

Stress Urinary Incontinence (SUI)

Stress Incontinence (SUI) refers to unexpected bladder leakages caused by physical exertion, such as coughing, sneezing, laughing, heavy lifting or exercising. SUI is a common cause of light bladder leakages, but may also result in larger releases of urine.

SUI is the most common type of incontinence experienced by women.

To help strengthen the bladder and urinary tract muscles, health experts recommend a number of exercises for both men and women. Pelvic floor and kegel exercises are especially effective and are as simple as drawing up the lower pelvic muscle towards the abdomen and holding for 5-10 seconds before releasing. These exercises can be done anytime, anywhere, and can help improve bladder control as well as reduce the risk of prolapse. These simple exercises are also known to improve sexual health.

Urge Urinary Incontinence (UUI)

Urge Urinary Incontinence (UUI) occurs when the bladder tries to empty itself, despite an individual’s best efforts to prevent leaking. UUI is caused by a lack of communication between the bladder impulses sent to the brain, and the actual action of the bladder. This can result in large losses of urine, and increased frequency of urination.

UUI is the most common type of incontinence experienced by men and is commonly linked to an enlarged prostate or prostate surgery. UUI is also common among women, particularly those who have suffered nerve damage.

Functional Incontinence

Functional Incontinence refers to a person’s inability to reach the toilet in time due to limited mobility or mental illness (such as Alzheimer’s or dementia). Some medical conditions, such as Alzheimer’s, Parkinson’s, stroke, diabetes, and multiple sclerosis, may also result in neurological bladder disorders, where the brain fails to recognise the body’s need to urinate. Neurological bladder disorders are often caused by nerve damage resulting from injury or illness.

For more on urinary incontinence, visit: https://www.nhs.uk/conditions/urinary-incontinence/

Bowel Incontinence

Bowel incontinence (known as faecal incontinence) is the inability to control bowel movements, causing stool (faeces) to leak unexpectedly from the rectum. Bowel incontinence can range from the occasional leakage of stool while passing gas, to a complete loss of bowel control.

Bowel incontinence can be caused by nerve damage, physical damage (such as through childbirth), spinal cord injuries, strokes, or constant straining during bowel movements. Some diseases, such as diabetes, Parkinson’s, and multiple sclerosis may also lead to faecal incontinence.

Bowel incontinence can be exacerbated by certain foods and drinks. If your client is suffering from faecal incontinence, recommend they limit their intake of the following substances:

• Alcoholic beverages
• Caffeinated drinks, and any food containing caffeine
• Dairy products (such as milk, cheese, and ice cream)
• Fatty and greasy foods
• Foods and drinks containing added fructose
• Spicy foods

For more information and guidance on bowel incontinence, visit:

• https://www.nhs.uk/conditions/bowel-incontinence
• https://www.bladderandbowel.org/bowel/bowel-problems/faecal-incontinence/

Incontinence products

There is now a wide range of specialised products on the market to help ensure the cleanliness and comfort of those suffering from incontinence issues.

When it comes to shopping for incontinence products, it is always worth searching for the best value for money. Remember that incontinence products can often be obtained for free through your client’s local social services.

As well as personal incontinence wear (such as pads and incontinence pants), there are a number of products designed to protect beds and chairs, such as waterproof sheets, seat covers, and mattress protectors.

Many online vendors offer free samples, allowing you to find the most suitable products for your client. For further details, visit:

• www.depend.co.uk/sample
• www.coloplast.co.uk
• www.tena.co.uk
• www.allaboutincontinence.co.uk/sample-packs

Out and about, and just can’t wait?

For clients who are still mobile, PrimeCarers recommends registering for a FREE ‘Just Can’t-Wait’ toilet card. These cards are issued by the Bladder and Bowel Community and assist individuals in accessing their nearest toilet. These cards are marked with universally recognised symbols, meaning they can be taken anywhere.

To register for your FREE card, visit: