Caring for someone with incontinence

‍Incontinence is a problem that affects a large number of New Zealanders. It can be either a bowel or bladder problem, or both at the same time. It is recognised as one of the leading reasons why people place their loved ones in care facilities. This fact sheet is designed to help carers look after someone with a continence problem, and what they can do to help resolve or manage it better.

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

Who is at risk?
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‍Incontinence is a common issue that affects nearly 1.1 million adult New Zealanders from all walks of life, regardless of their age or cultural background. It is not just a problem for older people or people with disability, though people from these two groups are at greater risk of becoming incontinent. People with poor mobility (ability to get around), memory problems and chronic health problems such as Parkinson's disease, stroke, dementia and multiple sclerosis are more likely to have continence problems.

The most important thing to remember when caring for someone with 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 as early as possible.

Symptoms of continence problems‍

Urgency to go to the toilet – with or without leaking urine or bowel motion.

Toileting frequently (around six times through the day and once at night is the average range of toileting.

Leaking urine or bowel motion without being aware.

Burning/stinging when passing urine.

Passing small volumes of urine (adults should be able to pass around 400–600ml).

Dribbling urine after voiding.

Feeling that the bladder or bowel is not empty after toileting.

Difficulty or straining when passing bowel motions.

Urine flow is slow to start and flows slowly.

‍‍Continence assessment
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‍The first step required to effectively manage a person's incontinence is a continence assessment. A continence assessment helps identify the type and causes of the problems being experienced by the person and assists the health professional to devise an appropriate treatment or management strategy based on the individual's needs. There are a number of different types of incontinence, and management of each of these different types varies.

A continence assessment will collect information about the person's bladder and bowel function, including:

How often do they go to the toilet, and how much urine is passed

What do their bowel movements look like

How often and how much do they leak

What their fluid and diet intake is, including types, volumes, and times

What current medications are they taking, including any supplements or over-the-counter medications