Some people cannot control when or where they pass urine or faeces. Many people in care homes have this problem. When residents wet themselves it is called “urinary incontinence” and if they open their bowels it’s called “faecal incontinence”.
Incontinence is not the resident’s fault. It is not a normal part of ageing. The resident is not bad or lazy and they often have a health or mobility problem you can help with.
Most people want to be able to use the toilet with as little help as possible and maintaining independence is good for the resident and care staff.
Encourage the resident to do as much as they are able for themselves.
Do they have access to walking aids to promote independence
Make sure that commodes are positioned to promote independent transfer
Looser fitting clothing or easy fastening clothes (elasticated waistbands) are easier to manage independently
Ensure raised toilet seats/frames are fitted if needed
Make sure there is no clutter/rugs on floors that could hamper access to the toilet.
Ensure that there is good lighting in and around the toilet
Place call bells easily to hand if the resident needs to summon assistance
Think about how any memory or awareness issues could affect continence.
Can they recognise the need to use the toilet and ask for help?
A regular toilet visiting plan may help.
Residents may exhibit certain behaviours when they need to go, such as fidgeting, fiddling with clothing/underwear, calling for help but not able to say why –
Can they recognise where the toilet is and what to do when they get there?
Pictures on the doors and or gentle prompts/supervision may help
Update care plans and communicate to colleagues to share your knowledge of resident’s behaviours and their personal needs. A chart can provide information on how many times they visit the toilet, a person’s toilet habits and episodes of incontinence. It can also help establish if more urine is passed out overnight than during the day.
In ladies, hormonal changes post menopause is one of the biggest causative factors for urinary urgency and incontinence. Sometimes a hormone cream may be prescribed to help treat an overactive bladder
Avoid known bladder irritants i.e. drinks containing caffeine and citric drinks/fruits
Ensure 8 x 250 ml drinks daily, concentrated urine can also irritate the bladder
For further help and support and advice for products refer to district nursing teams and/or continence services
Continence Referral form - CITY
Continence Referral Form - COUNTY
Care Home continence assessment form
How to weigh pads
Continence care sheet - Advice for pad users
Derbyshire Patient Requirement Form
Leaflet on Food and Drinks that irritate bladders
RCN guide to continence management
UTI Assessment form for care home residents over 65
Guidance for staff in Care Homes to support residents with UTIs -
PHE guidance for GPs on managing men & women over 65 years with suspected Urine Infection
Safe care in Care Homes - Continence