An Introduction to Managing Continence Needs at Home

Supporting Others

This article is a great place to start if you're managing your own or someone else’s continence needs at home.  It explains the basics including causes, treatments, continence assessments, tips for managing bowel and bladder issues at home and where to go for help.

Incontinence is a loss of bladder or bowel control that may result in involuntary leakage of urine or faeces. Urgency (needing to get the toilet in a hurry) and frequency (wanting to go to the toilet often) are also common bladder control problems, though they are not necessarily associated with leakage.

Who is at risk?

Incontinence is a common issue that affects nearly 600,000 adult New Zealanders from all walks of life, regardless of their age or cultural background.

Incontinence is not just a problem for older people or those who have disabilities. Despite this, people from these two groups are at greater risk of developing bladder or bowel control problems due to limited mobility, or memory or chronic health problems due to conditions such as Parkinson's disease, stroke, dementia and multiple sclerosis. The most important thing to remember is that incontinence is not normal or inevitable. Options for preventing, treating, managing, and curing incontinence are available, so seek professional help as early as possible!

Treatments

Managing incontinence may involve:

  • Having enough fluids (1500 - 2000mls each day)
  • Adequate diet (for example, a fibre rich diet to prevent constipation)
  • A pelvic floor muscle exercise programme
  • A bladder retraining programme
  • A toileting programme
  • Medication
  • Incontinence aids (for example, pads, condom drainage sheaths, or catheters)

Continence assessment

The first step to effectively manage bowel or bladder concerns is to identify the type and causes of incontinence. A continence advisor can recommend how to best manage or treat incontinence. There are a number of different types of incontinence and these are managed in various ways. A continence assessment will collect information so the advisor can recommend how to treat bowel or bladder incontinence. Following is information that will help an advisor.

  • Frequency of visits to the toilet
  • How much urine is passed
  • What bowel actions look like
  • Leakage frequency and volume
  • Details about fluid intake and diet
  • What medications are being taken
  • Other health problems
  • Ability to perform self-care tasks such as toileting, dressing, getting to and from the toilet
  • A rectal or vaginal examination may also be required as part of the assessment

Practical tips

Bladder problems

  • Find a pad that will keep clothing or bedding dry for 3 to 6 hours.
  • Urinary infections can cause or worsen incontinence. If urinary incontinence is a new problem, or if it hurts to pass urine, see your doctor.
  • If you or someone you support suddenly CANNOT pass urine, see your doctor, as this may be a medical emergency.
  • Consume adequate fluids (1500 to 2000mls spread evenly throughout the day).
  • If constipation is a problem, see your doctor about different treatment options, as constipation can affect bladder control.
  • Seek professional help.

Bowel problems

  • Use a pad for protection.
  • Use a barrier cream to protect skin (bowel leakage can make skin red and sore very quickly).
  • See your doctor if diarrhoea persists for more than 24 hours (causes could include food poisoning or certain kinds of medicine, such as antibiotics).
  • Wear disposable gloves.
  • Wash your hands carefully (even if you wear gloves) after you have had any contact with bodily fluids such as urine or faeces.
  • If the person is constipated, see your doctor about treatment options.

Getting help

Contact the National Continence Helpline, 0800 650 659. It's a free, confidential service available to anyone living in New Zealand. The Helpline can provide information and advice, and refer you or someone you support to your nearest continence clinic. Find out more by visiting the New Zealand Continence Association website.