Continence Support

Products and adaptive equipment are available to help a person with continence.

Some examples:

Incontinence products:

• Pads
• Adult briefs (disposable)
• Adult briefs with area for disposable pad inserts
• Under pads to protect beds, chairs, couches
• Waterproof mattress protector
• Pre-moistened washcloths or wipes
• Barrier creams that protect the skin

Adaptive equipment to use incontinence products:

• Reacher/grabber tools that help a person get supplies from a shelf or closet
• Wiping aids (handles or wands)

• Keep adult briefs with other underwear, and in the bathroom.
• Be prepared and have incontinence products available, even if a person does not use them all the time.
• Keep it dignified. Avoid the word “diaper”.
• Have compassion. Don’t make a person feel bad about their incontinence.
• Be calm and understanding.
• Have incontinence supplies in various places so they are there when you need them. This includes briefs, wipes, and gloves.

There are two ways to think about continence safety: Safety of the person needing continence support and safety of you, the caregiver.

To help ensure the safety of your loved one:

• Have grab bars to give a person more stability.
• Clear the area of clutter to reduce risks of a person stumbling or falling.
• Place supplies where a person can reach them. This includes placing supplies in a place where a person does not have to turn a lot or bend down and risk losing balance.

To help ensure your safety:

• Use disposable gloves.
• Protect your back when helping someone with incontinence products. Consider gait belts, lifts, transfer benches – whatever will help you try to avoid a back injury.
• When helping a person on or off the toilet, avoid pulling them by their hands – this could injure you or the person.
• Bend your knees when helping someone lower onto a seat or stand up.
• Try to avoid bending from the waist because this can hurt your back.
• When helping someone change incontinence products when they are in bed, make sure there are no obstacles around the bed that could cause you to trip or have to overreach.
• Be mindful of protecting yourself when helping a person to get on their back or turn on their side.

Asking your loved one what they want to do regarding continence sends the message that you are giving them control. Here are some basic questions to ask about their personal preferences so that you can provide the right support:

• What incontinence products do you like to use?
• When do you prefer to use incontinence products?
• When do you prefer to not use incontinence products?
• Do you want to use the toilet as well and how often?
• What other continence supplies do you like to use (particular wipes, lotions, etc.)?
• What parts of continence support would you rather do yourself?
• What parts of continence support would you like support with?
• Would you like reminders to change incontinence products? How often?

One way to figure out the type of support your loved one needs is to think about their strengths and weaknesses with continence support – what can they do and what do they need help with.

It is important to not just focus on what a person can’t do, but also think about what a person can do. Whether you write it down or you simply know it from your caregiving, it might look like this:

Strengths:

• Can use the toilet first thing in the morning and before bed.
• Can sometimes use the toilet during the day, especially when on a frequent restroom visit schedule.
• Can more easily put on or take off pads (as opposed to briefs).

Weaknesses:

• • Has difficulty getting to the restroom on time because the urge to go comes on very fast.
  • Has difficulty being able to “hold it” when the restroom is not close or available right away.
  • Needs some help putting on and taking off adult briefs.

When a person uses incontinence products there are particular health concerns you must consider:

Skin

Incontinence products can cause skin problems because the skin is in constant contact with the urine or bowel movements. Products must be changed often, so the skin can be dry and clean.

Pressure sores

Pressure sores are likely to happen if a person is in a wheelchair or bed, does not move around a lot, or does not have the strength/ability to change their position or move around on their own. Pressure sores are also more likely with people with fragile skin, or people who have blood flow or circulation problems. The risk of pressure sores gets much higher if a person sits or lies in urine or bowel movements for a long period of time.

Social Isolation

Having incontinence might make your loved one feel self-conscious, especially when out in public or around other people, in case they have an accident. They might be worried people can see or smell them.

Urinary Tract Infections

People who use incontinence products can be at higher risk of urinary tract infections, especially if they are not changed often enough, allowing bacteria to grow and lead to infection.