Figures from the Continence Foundation of Australia suggest that almost 4.8 million Australians are affected by incontinence. In fact even this figure may be understating the actual prevalence of the condition, as many patients feel embarrassed talking about their incontinence, despite it being a common problem especially associated with aging or following childbirth (1).

Available support for continence patients

There a numerous health professionals who specialise in the field of incontinence, which is why patients may get confused when looking for professional help. Continence nurse advisors are registered nurses who have extensive training and understanding in caring for continence patients. They can see patients either at home or in a clinic (2).

Physiotherapists are responsible for assessing the pelvic floor function and in prescribing a personalised exercise program to help strengthen the pelvic floor to bring back some level of bladder control. Pharmacists also play a key role when working with incontinence patients, as they can offer advice on medicines which can aggravate conditions and information about various continence products available on the market (2).

Medical professionals such as general practitioners (GPs), urologists, and gynaecologists are usually only responsible for diagnosing an incontinence condition and treating underlying causes of the problem. Patients should involve GPs in their on-going care, as GPs will have an understanding of the patient’s health history and any relevant medical conditions which can impact patient care (2).

Facts and figures around incontinence

There are two forms of incontinence; urinary and faecal incontinence, although the former is more prevalent. Incontinence affects everyone regardless of their gender, age or cultural background, however statistics show that women are more likely to have incontinence issues. This is mainly due to the fact that women undergo major bodily changes during pregnancy, childbirth, and later in menopause. Statistics show that age is also a major contributing factor in incontinence; almost 71% of seniors in residential aged care homes are incontinent.

The cost of incontinence can be thought of as a hidden financial burden, as costs include;

• Expenditure on the health care system (use of GPs and hospitals)
• Lost earnings due to a lower than average employment rate in patients of incontinence
• Costs of formal and informal patient care – informal care providers are usually missing on paid work opportunities and may have to source paid help for housework
• Personal patient expenses for continence pads, adult diapers, and laundry

Nursing care

Managing patients of continence can be a difficult and stressful job, especially with multiple patients in hospitals or in aged care facilities. Patients need to be handled effectively and discreetly so that each patient’s self-respect and dignity is preserved. The following practical toileting and hygiene suggestions can help simplify patient care (3);

• Use and change continence pads frequently.
• Utilise Velcro and elasticated fastened clothing as they are easier to manage.
• If the patient is unsteady on their feet, a wall mounted bar can help stabilise them.
• Patients should not be rushed when using the toilet, and toileting patterns should be noted so that the patient can be encouraged to visit the toilet at appropriate times.
• A patient’s need for privacy should be respected along with a relaxed demeanour to dispel any feelings of embarrassment or upset.
• Carers should wear disposable gloves when helping patients clean up, and should wash hands thoroughly afterwards.
• The patient’s skin should be washed with warm and soapy water, dried, and a barrier cream applied appropriately to avoid irritation and rashes.

Sources:

1. Continence.org.au
2. Continence.org.au - Health Professionals
3. Better Health