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Posted on 22/01/2021

Coping with incontinence

One of the most common symptoms we support our clients with is urinary incontinence, which is where a person unintentionally passes urine. Despite the fact that millions of people experience some form of urinary incontinence in their lifetime, it is a condition that remains shrouded in stigma and embarrassment for many individuals, and often leads to family carer breakdown when relatives struggle to support a loved one who has developed incontinence.

Our live-in carers are trained to provide dignified continence care. Having the same live-in carer for up to 12-weeks at a time means that a supportive and compassionate bond is often formed that helps to remove any discomfort or embarrassment that the person may be feeling. In addition, our care plans are personally tailored to each client, and take full account of the differing needs that the person may have as a result of living with dementia, Parkinson’s, cerebral palsy, a spinal injury or any other condition alongside their urinary incontinence.

Types and causes of urinary incontinence

The most common types of urinary incontinence are:

• Stress incontinence, where urine leaks when a person coughs, sneezes, laughs or makes another physical movement.
• Urge incontinence, where a person has a sudden need to urinate and cannot get to the toilet in time.
• Overflow incontinence, where a person doesn’t fully empty their bladder and leaks urine as a result.
• Total incontinence, where a person’s bladder cannot store urine and it is constantly passed or leaked.

Urinary incontinence can be caused by many different factors, including:

• Weakened muscles in the person’s pelvic floor (for example in a woman who has given birth).
• Prostrate problems in men.
• Overactivity of the detrusor muscles that control the bladder.
• Side-effects of medication.
• Urinary Tract Infections (UTI’s).

The link between urinary incontinence and urinary tract infections (UTI’s)

UTI’s are a particular problem not only because they can cause or increase incontinence through sudden urges to urinate, they are also often accompanied by pain or burning on urination and symptoms like fever and generally feeling unwell. For a person with dementia, a UTI can lead to acute confusion and make their dementia appear to have suddenly worsened.

UTI’s need to be rapidly diagnosed so that the person can receive appropriate treatment (usually antibiotics) and remain in their home, rather than their infection escalating and them needing hospital treatment. For people who are prone to frequent UTI’s, it is often helpful to have dipsticks at home to test the person’s urine quickly to ensure treatment is started without delay.

Supporting a person with dementia

Many people who have dementia experience some form of incontinence as their dementia advances. While the person is still continent, it can be helpful to make environmental modifications like those we discussed in our article ‘Creating a dementia-friendly home’ to support the person to orientate themselves and remain as independent as possible with their use of the toilet.

It can also help to observe the person for signs that they need the toilet (for example fidgeting, holding their groin or becoming more agitated) and gently prompting them to use the toilet. You may need to use pictures to prompt the person if they are struggling to understand what you are saying, or accompany them to ‘stretch their legs’, looking into the bathroom to see the toilet on the way.

How ENA live-in care can help

We know that incontinence can be a distressing condition both for the person and their family. By getting to know the person we aim to first and foremost preserve any level of continence that the person has or can achieve by, for example, following an exercise regime in the case of weakened pelvic floor muscles, or wearing more easily removable clothes to enable the person to use the toilet in time, with or without the support of their live-in carer depending on the person’s level of need.

Where a person is incontinent, we aim to help them to find the products and style of support that works best for them. For some people this may mean wearing pads and our carers changing those pads regularly, as well as ensuring their bed/chair and other furniture is protected, or it may mean using specialist underwear that the person can pull up and down themselves and our carers can wash as needed.

Please visit the NHS website for additional information about urinary incontinence: https://www.nhs.uk/conditions/urinary-incontinence/ and urinary tract infections (UTI’s): https://www.nhs.uk/conditions/urinary-tract-infections-utis/.

Find out more about how ENA Care Group could support you or your family by calling 08004 334 413 or emailing care@ena.co.uk.