Best Practices in Caring for Patients with Incontinence

Incontinence is the lack of voluntary control of urination or defecation. Some 25 million adult Americans report some form of incontinence. Women experience it more often than men, but among age groups it is more common among the elderly. Because the older population is expected to grow to about 72 million by the year 2030, caregivers should expect that, in the future, they will be helping more patients with incontinence.

There are many types of urinary incontinence. Some patients leak urine when they laugh or sneeze. Some do not reach the toilet on time and pass urine when they feel the urge. Some women experience it when they are well-advanced in their pregnancies, too. There are cases when a person is unaware of the urge to urinate and urine simply flows out. In fewer cases, the bladder overflows and the person leaks urine.

Fecal incontinence, on the other hand, is the inability to control bowel movements. It could be as simple as leaking a small amount of stool while passing gas to a complete loss of bowel control.

Whatever the case, caregivers must have the upper hand while caring for incontinent patients. Take a look at these very helpful tips:

1. Be empathic and use a matter-of-fact approach.

Remember, it’s not just a physical problem but also an emotional challenge. People consider bathroom “accidents” embarrassing, shameful, and frustrating. The loss of a bodily function or control is a source of stress for patients, and caregivers must be careful to preserve the patient's dignity at all times.

Focus on helping the patient clean themselves and never pinpoint the problem. Instead of saying, "You had an accident again but that's ok," say, "Let me help you to the toilet," or "Let me help you clean up and change."

2. Next, focus on the physical aspects.

Some food and drink make incontinence worse. For those with poor bowel control, avoid spicy and fatty foods and limit gas-producing fruits and vegetables, such as prunes and sweet potatoes.

Decrease or cut out caffeinated drinks such as coffee and tea for patients who leak urine. It also helps to limit their fluid intake at night.

3. Help them prevent future “accidents.”

A strategy for urinary incontinence is to assist them in relieving themselves every two hours or so and before going to bed, to prevent having a full bladder for a long period of time.

4. Prevent complications from incontinence.

The main principle to follow here is to keep the patient clean and dry at all times. If the patient independently washes themselves, remind them of the importance of thoroughly cleaning and drying the genital areas to prevent skin irritation.

For those needing assistance in changing or those using incontinent pads, wash and rinse the genital areas thoroughly with lukewarm water and mild soap and pat dry before putting on new pads. For bedridden patients, airdrying for a few minutes before a pad change will help prevent bed sores.

5. Make your patient's life (and yours!) easier.

Place an incontinence sheet on the buttocks area of the bed to catch accidental leakage and save yourself time and energy changing bed sheets frequently. Also, allow your patient to wear clothes that are easy to take off, such as drawstring pants or those with Velcro fasteners. Patients who are in a hurry to go will need to remove their pants easily and quickly.

For patients with dementia, it also helps to position the bed so that they have a direct view of the bathroom.

6. Use quality incontinence products and undergarments.

There are many types of incontinence products and underwear available in the market today. Choose ones that are reliable and do not cause skin irritation in your patient.