Tips for Carers: Discussing Incontinence

It’s possible that you may notice continence issues before the person your caring for does. Losing bladder or bowel control can be upsetting, so excusing it as a ‘one-off’, even when it becomes increasingly regular, is not uncommon. Some well-meaning carers go along with the pretence, but recognising and actively managing frequent urination or continence issues, rather than dealing with ‘accidents’, is more dignified for everyone.

Having the conversation about incontinence
Wait for a time when it’s just the two of you, and you’re both feeling relaxed. Gently raise the topic by saying you’ve noticed some changes and then ask some questions to better understand what’s happening.

For example:
Are you finding you’re having difficulty getting to the toilet in time?

• This is a good way to start the conversation and it may be as easy as providing some physical assistance getting to the toilet, ensuring pathways are clear, the door is open and the toilet lid is up.

Are you having trouble getting your clothing off when you get there?

• Conditions like arthritis can make the task of getting clothes off very difficult, especially if there are buttons, zippers and other fasteners to contend with. Elastic-waisted trousers or shorts might make things easier.

Can you tell when you need to go? Do you get enough warning?

• This could be a sign of an infection, such as a UTI (Urinary Tract Infection), a side effect of medication or a neurological issue hindering the messages between the brain and bladder.

Are you having trouble ‘holding on’ when you feel the urge to go?

• A weakened pelvic floor muscle is likely to be causing this and depending on ability, a series of pelvic floor exercises can improve – and in some case resolve – control issues.

Professional review
If the solution isn’t as simple as improving access to the toilet, then you should consult your doctor. The onset of incontinence may be a sign that the condition of the person you’re caring for has progressed – neurologically and/or physically - and that alone warrants a conversation with the doctor.

At the appointment, ask the doctor to check for an infection. This can be treated and once that’s gone, the incontinence should be too. Also ask the doctor to check medications, as some can contribute to incontinence and be adjusted to alleviate the problem.

In the meantime…

If there’s a delay in getting to the doctor, you may want to suggest using purpose-made incontinence pads and products to absorb leakage and prevent urine odours from developing. These products are extremely comfortable, as the technology allows them to be super absorbent, to keep skin dry and be discreet under clothing.

You can order up to 3 free samples here on the TENA website. Finding the incontinence product that best suits can make a world of difference.

Depending on mobility and cognitive capability, you may have to assist in changing continence aids. In the beginning, respectfully offer assistance – try not to ‘take over’. Within a short amount of time, you’ll both work out how much help is or isn’t required and management should hopefully become just another part of your daily routine.

If the issue is a weakened pelvic floor and the person you care for can follow instructions and undertake gentle exercises, ask for a referral to a continence physiotherapist or continence nurse for education and an individualised plan.

The conclusion could also be that it will be ongoing in which case, a referral to a continence nurse to assist with the development of a management plan, including advice on product funding options, might be the best approach.