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.

Independence and dignity

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

Memory issues

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.

Bladder

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

Resources