Continence care
Our guidance offers tips and support if you are caring for someone who is affected by a continence issue. Although it can feel upsetting and disorienting at first, it can often be managed well with the right treatment and support.
What is continence?
Continence is the name given to the ability to control movements of the bowels and bladder. Someone may have urinary incontinence (the unintentional passing of urine) or bowel incontinence (where you are unable to pass faeces/ poo in an intended way) or both types – this may be referred to as double incontinence.
There are many myths linked to incontinence. One of the main ones is that problems with continence only affect older people. In reality, it can affect people of all ages, and it has nothing to do with hygiene.
How can it make you feel?
It is easy to feel self-conscious, frustrated or even a sense of rejection if you have incontinence that is not managed well. As a carer, you may feel helpless or exhausted or both, but it is important to know that there is specialist help and support available, and these issues are much more common than realised.
When you are caring for a loved one, these feelings can be complex. You might experience the sense of a role reversal if your parent is affected for example. Do seek emotional support to help you cope with these emotions if needed alongside medical advice and assistance.
If you are looking after someone with a continence issue
If you are worried that someone you care for has a continence issue, try to help them to feel comfortable enough to open up about it (if that’s right for them).
You might find the following tips helpful:
It is best to not ignore incontinence or hope that it will go away. Incontinence is usually a symptom of an underlying problem and if not treated, then symptoms can often get worse. It is always recommended that you seek medical advice.
Many consider continence issues to be part of getting older and something you cannot change. But in many cases, with the correct management and treatment plans in place, people can regain their continence or manage their symptoms so that their quality of life can be very much improved.
What you drink and eat is important and can go a long way to helping with any problems. Try to make sure the person you are caring for drinks plenty of water (this is discussed in more detail in the video below). Your kidneys need lots of water regularly to help them work well and to reduce the risk of getting infections such as Urinary Tract Infections (see next tab for more details).
The chart in this NHS document can give you a general idea about whether the person you care for needs to drink more fluids. The document also explains signs of infection and what to look out for. Speak to a health professional if you have spotted some of these symptoms.
What is a Urinary Tract Infection?
A Urinary Tract Infection (UTI) is an infection that affects the bladder, kidneys, uretha or tubes that connect to them. It is much more common than people realise, especially affecting people aged 75 and over, but people of all ages can be affected.
How can they be prevented?
Here are some suggestions of ways to help prevent a UTI:
- Drink plenty of fluids (tea, coffee and non-sugary options as well as water count). The recommended amount is 6-8 cups or glasses a day according to the NHS Eatwell Guide.
- Some people are put off from drinking too many fluids because of the thought of having to go to the toilet. If someone you care for isn’t able to access a toilet very easily, explore what adjustments could be made to help them go at regular intervals. A continence professional can offer support with a continence assessment.
- Keeping on top of regular personal hygiene such as showering/batheing daily (where possible) is important, but avoid cleaning around the genital area with any scented or perfumed sprays.
- If continence pads are used, ensure they are changed regularly and that they are wiping from front to back if you’re helping with personal care.
If someone you’re looking after is having UTIs on a regular basis, it is important to speak to a healthcare professional to look for ways to prevent this from happening.
If a person is suffering from a severe UTI, it is vital to seek urgent healthcare assistance and advice.
Contact a healthcare professional to find out more if you think someone you care for may have a UTI or a continence issue.
This could be the local GP, a senior nurse, the community pharmacist, walk-in centre or NHS 111 service. Be aware that you may need to seek urgent help from healthcare services if someone you care for becomes unwell either before or after a diagnosis as this may indicate a worsening infection affecting their whole body.
On an ongoing basis, your GP may choose to refer you to a specialist such as a dietician or continence nurse. Our ‘Conditions hub’ also offers resources and support from a range of condition specific charities from helplines to forums where you can ask questions and share experiences with others going through similar circumstances.
What should you do if you suspect you or someone you care for has a UTI?
If you think you might have a UTI, ensure you are drinking enough water to avoid becoming dehydrated, and seek further health professional guidance.
Who to contact if you or someone you care for has a UTI
Contact a healthcare professional if you think you might have a UTI. This could be your GP, a nurse, the community pharmacist, a walk-in centre or the NHS 111 service.
What else can you do?
Here is a summary of some of the best ways you can support someone with a continence issue:
- Don’t treat it as a taboo subject. The person you're looking after will welcome your discretion, good humour, common sense and attempts to keep in mind their dignity.
- Don’t hesitate to seek medical advice if someone you care for is in pain or has discomfort, even if they have already been given a treatment option such as a catheter. If the treatment or product is not working, there are alternatives that should be explored.
- For specialist support and guidance, you could contact your local NHS Bladder & Bowel Service.
- Speak to others in a similar situation. Charities like Bladder and Bowel UK also offer free helplines and specialist information.
- Our Share and Learn video on ‘Continence care and hygiene’ offers further detailed guidance (see below).
- Look after yourself too. It's crucial you are getting the rest and support you need as well. Do seek professional support with your doctor and by undertaking a carer's assessment if your quality of life is being affected.
Watch our continence care and hygiene video
The information in this Share and Learn video is provided by Ashley Clydesdale and Sarah Murray from TENA who specialise in the field of continence care management and hygiene. Their session outlines many of the myths around continence issues, how you might be affected as a carer and what you can do to get further support. (Recorded June 2023)