Incontinence Care

10 Tips For Caregivers on Incontinence Care

Caring for someone with incontinence? Here are the top 10 tips for caregivers managing incontinence care, including ulcer prevention, stain removal and getting professional help.

by Pragalath Kumar

Incontinence here refers to both urinary and bowel incontinence. Urinary continence refers to the loss of bladder control that causes accidental urine leak. Bowel incontinence or also known as faecal incontinence is the inability to control bowel movements, leading to faeces leaking from the rectum. It involves:

Anal Incontinence – involuntary loss of faeces, flatus and/or mucous.

Faecal Incontinence – involuntary loss of faeces.

Flatus Incontinence – involuntary loss of intestinal gas (or flatus).  

Mucous Incontinence – involuntary loss of mucous from the rectum.

Both urinary and bowel incontinence have a variety of symptoms and causes.

Urinary Incontinence: Types, Symptoms and Common causes 

There are a total of six types of urinary incontinence. The first and most common type is stress incontinence. Women are most likely to have the first three types of urinary incontinence.

Incontinence type

Bowel Incontinence Types

Each of the 4 types of bowel incontinence described earlier has 3 subtypes.

Incontinence subtypes

Symptoms

Symptoms for bowel incontinence would depend on the type of incontinence one has. When one passes stool without realising it, that is called passive incontinence. When one has the urge but no control over the passing of the incontinence it is called urge faecal incontinence. Those with bowel incontinence will also have other problems such as diarrhoea, constipation and bloating stomach due to gas.

The stools from diarrhoea would be loose and watery. It would fill the rectum quickly to the point that it will be difficult to hold in compared to solid stools. It is the most common risk factor for faecal incontinence especially for those not warded in hospitals and other similar institutions. It may be caused by digestive tract problems such as inflammatory bowel disease, irritable bowel syndrome or proctitis.

Constipation leads to large, hard stools that are difficult to pass. The hard stools stretch and, over time, weaken the muscles in your rectum. The weakened muscles let watery stools that build up behind the hard stool leak out.

Causes

The following are causes for bowel incontinence:

  • Neurological diseases such as spinal cord injury, cauda equina syndrome, multiple sclerosis, spina bifida, dementia, stroke. 
  • Lifestyle and environmental issues – inadequate toilet facilities, poor diet, dependence on carers for mobility; communication difficulties. 
  • Age – The older one is the higher the chances to have incontinence
  • Physical disability 
  • Severe cognitive impairment, confusion and memory loss 
  • Learning disability 
  • Injuries post-childbirth such as anal sphincter injury 
  • Pelvic organ prolapse, rectal prolapse, third-degree haemorrhoids 
  • Faecal loading 
  • Post radiotherapy treatment

Discussions on incontinence and with those having incontinence

Incontinence is an sensitive matter that is akin to an elephant in the room. No one would like to speak about it but discussions on this medical issue are vital. Various studies conducted worldwide have found that individuals with this issue are facing isolation. This is due to their inability to maintain a hygienic lifestyle.

Being sanitised is a right. It is not limited to Covid-19 and it is a vital aspect in this discussed condition. Raising awareness regarding this in the public sphere via education, public discussion and media would assist in tackling stigma and reducing social barriers. 

Discussions on incontinence also must be done with the loved ones who are troubled by the condition they have. 

Having a health professional who is not part of the family and someone close to the loved family member would calm them and set the tone for a decent talk. One needs to understand the final goal of getting them to apply the solutions such as using diapers. If the condition is due to medical reasons, one can obtain the right medication and advice on using the diapers.

Set up the discussion to happen during a pleasant period for the loved one. Rehearse what needs to be said in a well-mannered tone so that one doesn’t appear to be abrasive.

Be gentle and empathetic as it will make them more comfortable and less embarrassed. Speak honestly about your concerns with detailed observations.

If they are comfortable and not embarrassed with the issue at hand, they would be receptive. If not they would deny. Be sympathetic and speak on the symptoms. Ensure they are comfortable because one’s goal is to normalise incontinence.

Engaging the Right Care Professional For Your Loved One

When it comes to caregiving, it is important to get a care professional with the right experience and expertise. Homage provides holistic, professional care for persons with with. You can explore our range of home care services.

Book a Free Care Consultation with Homage Today >

Caring For Those with Incontinence

Caring for those with incontinence normally would involve caregivers who are either family members or private nurses from homes that provide such services. The following are tips for caregivers.

  1. Talk to the doctors

Incontinence is not a normal progression in ageing. So when one sees signs of continence, get them to the doctor to check for possible infections such as urinary tract infections or other medical issues.

  1. Watch out for bladder trigger food and drinks

Consuming too much fluid would raise the frequency to urinate. Drinking too much too quickly would raise the urgency to urinate. It is best to drink fluids during the day instead of the night. Keep away from alcohol and caffeinated beverages. Food such as soup also contributes to increasing fluid. Too little fluid would lead one to have highly concentrated urine that is dark yellow in colour with a strong smell. Stay away from bladder irritants such as spicy foods, tomato-based products, carbonated drinks and chocolate.

  1. Bladder training

Train the bladder to urinate at a specific period after identifying its pattern and stick to its schedule

  1. Waterproof the furniture used

It is vital to waterproof the furniture used most. Take similar measures for the bed and pillow. Use fabric protector along with waterproof sofa covers, seat protectors and large absorbent bed pads.

  1. Use humour to reduce anxiety and avoid embarrassment

Treat incontinence as a normal aspect of life as that would ease tension. Reassure them and clean up. Use humour and show them the silly side of life so that they laugh it through.

  1. Incontinence care kit

This would comprise cleaning up essentials, incontinence briefs, personal cleansing wipes and a change of clothes all packed in a bag. This comes in handy when your loved one would need to travel.

  1. Easy to change clothes

Get easy-to-change and wash clothing. One example would be pants with elastic waistbands. Get specialised adaptive clothing and avoid clothes with multiple fastenings. 

  1. Beat the lingering odours

To do this, obtain scented disinfectants, air sanitisers and odour reducers.

  1. Diaper change

This is one of the most vital aspects of caring for loved ones. It is also going to a large budget. Diaper changes occur on average 5 to 8 times daily which means one with incontinence would require 150 diapers monthly. Caregivers also need to frequently check and change soiled diapers.

  1. Pressure ulcers

It is a result of limited mobility which begins with pressure exalted over a long period of time. To care for and prevent ulcers use the following tips:

  • Use barrier cream after every diaper change
  • Turn them every 2 hours
  • Provide nutrition with a balanced diet and good hydration
  • Get them to move frequently since frequent movement prevents ulcers.
  • Maintain clean dry skin for your loved one.
  • Raise their prominent bony parts with cushioning
  • Use bedsheets to move them instead of dragging them.
  • Managing pressure ulcer forms
  • Redness: Apply more barrier cream and elevate cushioning
  • Wound: Contact home nurse and get loved one to the clinic
  • Cradle Nursing: This involves removing all diapers and pants. Use a sarong instead for increased ventilation on the skin

Getting professional care

Managing someone with incontinence care can be demanding. Depending on the severity and type of incontinence, your loved ones could benefit from home personal care which can help with activities of daily living (ADLs) such as eating, bathing, toileting and transferring.

A trained caregiver can be an immense help for you and your family and knowing that these are taken care of allows you to have greater control of your daily routine.








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About the Writer
Pragalath Kumar
K Pragalath is an independent writer. He was a former journalist with a number of Malaysian news sites. He watches elections like how people watch football but dozes off over the matches.
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