Caring For Someone With Urinary Incontinence
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 control problems. This could be because of poor mobility (ability to get around), memory problems and chronic health problems such as diabetes, Parkinson’s disease, stroke, dementia and multiple sclerosis.
The most important thing to remember when caring for someone with urinary 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.
If the person you are caring for has urinary incontinence, the most important step for you to take is to seek professional help. Continence NZ Helpline 0800 650 659 is a free and confidential service available to anyone living New Zealand. The Continence Helpline can provide you with wide range of information.
The first step required to effectively manage a person’s incontinence is a professional continence assessment. A continence assessment helps identify the type and cause of the person’s urinary incontinence. Once your continence health practitioner has this knowledge they will be able to tailor an individualized management strategy for you to use. The best management strategies also consider the living environment and lifestyle choices of both, the person being cared-for and their caregiver.
You can help your doctor or continence nurse advisor in making an accurate assessment and diagnosis by providing as much information as possible. Prior to seeing the health professional, collect the following information:
- Keep a 3-day urine bladder diary, that specifies the toileting habits of the person in your care. You can download a bladder diary by clicking on the link, Treatments of Incontinence.
- In addition to the bladder diary, it is also important that you document the following information about the person’s urinary incontinence:
- Behaviours or activities that immediately preceeded any episodes of wetness.
- Location: where the person experiences problems with bladder control – for example: bedroom, stairway, away from home, etc
- Any bowel difficulties such as constipation or diarrhoea
- Any changes in diet or fluid intake
- A list of all prescribed and over-the-counter medications the person takes.
- It is also important to let the doctor or continence nurse advisor know if the person’s episodes of incontinence have recently become worse.
There are a range of management options available to people with urinary incontinence, which largely depend on the type of incontinence they have and outcomes the person hopes to achieve. Depending on the person’s needs a good continence management plan will consist of several key elements:
- An adequate daily fluid intake, usually between 1500-2000ml
- A well balanced, fibre rich diet that prevents constipation
- A program of pelvic floor muscle exercises
- A review of all the medications the person takes
The practitioner may then suggest:
- A bladder retraining program
- A toileting program
- The prescription of consumables that may include disposable or washable continence pads, external male (condom) catheters, an indwelling or intermittent catheterisation.
Practical tips while waiting for assistance from a continence nurse advisor, continence physiotherapist or your medical specialist.
- Find a disposable continence pad that will keep the person’s clothing or bedding dry for up to six hours
- If the person’s urinary incontinence is a new problem or their incontinence has recently become worse visit your GP to make sure it is not a urinary tract infection.
- If the person is unable to pass any urine, see your doctor immediately or attend your local accident and emergency department.
- If the person you are caring for has no medical condition that requires a restricted fluid intake, ensure the person is drinking 1500-2000ml of fluid spread evenly throughout the day
- If the person you care for experiences a change in their bowel habits, see your GP. Remember, constipation can alter a person’s bladder control
- Keep the person’s skin clean from any faecal leakage or soiling. If faeces are left on a person’s skin, even for a little time it will very quickly make their skin very red and sore. Use a good barrier cream to protect the person’s skin from bowel leakage. You can ask your local pharmacy to recommend a good protective barrier cream or spray.
- See your doctor if the person you are caring for has diarrhoea for more than 24 hours
- Wear disposable gloves (available from supermarkets or chemists) to protect yourself and others from the bacteria in faeces
- Even if you wear gloves, wash your hands carefully after you have had any contact with bodily fluids such as urine or faeces
Many carers find caring for a person who has urinary or faecal incontinence to be a very confronting aspect. Incontinence can be unpredictable, dramatically increase your workload and be very costly to manage. Trying to cope alone leaves many carers reporting feelings of frustration, loneliness, and anger. It is not easy to provide care for a person with incontinence, but in seeking and receiving good advice and support from a health professional will make the situation much more manageable.
- For information and advice about bladder and bowel problems contact the Continence NZ on 0800 650 659
- For advice and support relating to caring, contact Carers NZ. A national not-for-profit organisation providing information, advice, learning and support for older people, families with health and disability needs, individuals managing their own health conditions, and their supporters. Phone the National Carer Resource Centre on 0800 777 797 or email
- A useful website link is https://carers.net.nz/
