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If the person you are caring for has problems with incontinence, the first thing to check is whether they are able to get to the toilet without any problems. They may want to use the toilet but be unable to use it, or even to find it.

• Make sure that the person knows where the toilet is. A sign on the door may help. A visual reminder, such as a picture, may be more effective than words.
• Make sure that there are no obstacles, such as awkwardly placed furniture, in the person’s way, or doors that are hard to open, obstructing the way to the toilet.
• Leave the toilet door open when not in use so that the person does not think that somebody is in there.
• Make sure the toilet is easy to use. If you think the person could benefit from aids such as handrails, ask the GP to put you in contact with an occupational therapist, who can offer advice free of charge.
• Make sure the person’s clothes can be quickly removed and unfastened. Some people find Velcro fastenings easier to use than zips or buttons.
• If it becomes too difficult for the person to get to the toilet, an aid such as a commode may be useful. Ask your community nurse for advice.

Other ways to help

Use the following tips to help reduce the number of accidents:

• Remind the person to go to the toilet, or take them there, at regular intervals. You may be able to manage faecal incontinence by taking the person to the toilet at a set time, if their habits are regular.
• Be aware of signs that the person wants to go to the toilet. These may include fidgeting, getting up and down, or pulling at their clothes.
• If the person is incontinent at night, encourage them to avoid drinks for two or three hours before going to bed. However, make sure that they drink plenty of fluids during the day.

Incontinence aids

If you’ve tried everything you can and the person is still having problems with incontinence, there are plenty of ways to help them feel more comfortable while also protecting items such as clothes and bedding. Various products are available from your local continence adviser or community nurse. You can find others at the chemist.

• Waterproof bedding You can protect the mattress with a waterproof cover. However, make sure the sheet doesn’t come into contact with the person’s skin as it can make the skin chafed and sore. You can also buy special protective duvet covers and pillowcases.
• Absorbent under sheets Reusable under sheets are available for beds and chair beds. They enable the person to lie or sit on a dry surface.
• Incontinence pads and pants These can be worn day and night, or during the night only, to keep the area next to the person’s skin dry. Make sure they are the right absorbency, that they do not chafe, and that they are changed as often as necessary.

For more advice on these and other aids, talk to your community nurse or continence adviser.

Ensuring good personal hygiene

Incontinence can lead to skin irritation and may make the person feel generally uncomfortable. It’s important to act quickly after someone has had an accident to make sure they feel comfortable and to ensure good hygiene.

• If they have become wet or soiled, help them to wash afterwards with mild soap and warm water, and dry them carefully before putting on fresh pads and clothes.
• Moist toilet tissues can be useful for minor accidents.
• Wash soiled clothes or bedding immediately, or soak them in an airtight container until they are washed.
• Put used pads in an appropriate container.

Where to get help

Your GP should be your first port of call. Whatever you think the cause is, if someone becomes incontinent, pay a visit to the GP. Even if there is no immediate treatment, they may be able to put you in contact with your local community nurse, continence adviser or occupational therapist.

The community nurse, continence adviser or occupational therapist can make a home visit to assess the situation and suggest ways that will make it easier for you both to cope.

The Continence Foundation is a charity that works to provide information, expertise and advise about all aspects of incontinence. They can put you in touch with an adviser in your area and they also run a telephone helpline, open Monday to Friday from 9.30am to 4.30pm.

InContact is a charity for people affected by bladder and bowel problems. It provides support and information, and represents the interests of people with continence problems.

The Continence Foundation
307 Hatton Square
16 Baldwins Gardens
London EC1N 7RJ
Helpline 020 7831 9831,
Website www.continence-foundation.org.uk

InContact
United House
North Road
London N7 9DP
Telephone 0870 770 3246
Email info@incontact.org
Website www.incontact.org

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Reviewed: 02/2006