Incontinence Resources

Many healthcare professionals recommend absorbent pads for men with urinary incontinence. These can be seen as easy to use and convenient (Chartier-Kastler et al, 2011), but potential odour and skin irritation are a significant concern (Williams and Moran, 2006; Gray, 2007). They can also impact dignity and quality of life (Williams and Moran, 2006). To provide a high level of holistic care, patients should be made aware of all suitable management options appropriate for them to be empowered to manage their bladder accordingly.

Childhood continence problems are common. One in 12 children are affected by a bowel or bladder problem: that’s around three children in every primary school class. In an average
secondary school, around 30–40 of young people struggle with a wetting or soiling issue (Joinson et al, 2018).

Urinary and faecal incontinence are common in the older population, yet incontinence is not a normal part of ageing. Dementia can impact upon a person’s ability to remain continent, yet incontinence is unlikely to be a symptom of dementia until the latter stages of disease progression. There is a misconception that nothing can be done if a person with dementia experiences episodes of incontinence. However, many people with dementia often experience functional incontinence caused by immobility, communication difficulties, disorientation, or the inability to find the toilet, which can all be alleviated if the right support and advice is available. Improving the identification, assessment and management of continence issues can not only enable people with dementia to maintain their dignity and improve their health, but also their sense of wellbeing and quality of life. There is also the possibility to improve relationships, reduce carer burden, and reduce the risk of a premature transition into a residential care setting. This fourth paper in the series explores some of the issues relating to dementia and continence and the impact as experienced by our two case studies, Dhriti Singh and Gregory Brewin.

The definition of incontinence is acknowledged as any involuntary loss of urine or the inability to control the bowels (International Continence Society [ICS], 2013). It is not a life-threatening condition, but has a significant and distressing effect on the physical, psychological and social quality of life of those affected (Lukacz et al, 2011). Isolation, anxiety, depression and embarrassment are commonly reported by people who have a bladder or bowel issue (Wan and Wang, 2014). Urinary incontinence is more common than breast cancer, heart disease or diabetes among older women (Sexton et al, 2011; Tannenbaum et al, 2013). Incontinence is not gender or age specific, it can affect people of all cultures at any point from childhood to old age and can have devastating implications for the individual and their family. Many people may fail to seek help with incontinence for years due to embarrassment and stigma.

Here, Sharon Holroyd, lead CNS, Calderdale Bladder and Bowel Service; chairperson, Yorkshire ACA, defines stress urinary incontinence and the treatment options available, and reviews the evidence to support pelvic floor exercises as an effective rehabilitation for patients with symptoms of stress urinary incontinence.

If you are one of the estimated 12 million people with some form of bladder or bowel problem in the UK, you will know that needing the toilet frequently can be an urgent requirement and you will often need to go at just a moment’s notice.

Claire Smith describes a small pilot study which questioned the attitudes of health workers towards incontinence.

Linda Smith & Paul Smith review continence training approaches used in the treatment of people with learning disabilities.

Gwenda Lewis describes the use of psychological assessment to ensure the well-being of incontinent patients.