Incontinence Management For Carers

• Be sure the person is drinking adequate fluids; preferably water (6 to 8 glasses daily – jelly, ice-cream or custard may be substituted). Many people with dementia forget to drink or no longer recognise the sensation of thirst.
• Consider reducing the person’s caffeine intake by using decaffeinated coffee and tea, especially if they suffer from an overactive bladder
• Observe the person’s toileting patterns and suggest they use the toilet at regular times that follow their pattern
• Try toileting before and after meals, and before bed
•  Try to establish a regular routine for the person to have something to drink with and between meals

There are many aids and appliances available to assist in incontinence management:

The BD PureWick™ Urine Collection System is designed to better manage your urinary incontinence. It works with the BD PureWick™ Female External Catheter to wick urine away from the body into a designated collection canister. The BD PureWick™ Female External Catheter is changed every 8 –12 hours and the collection canister containing urine is emptied into the toilet. The BD PureWick™ Urine Collection System is now available for home use. The benefits may include keeping the skin dry by wicking urine away, reducing the need to get out of bed at night to use.

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Environment

Try to make the situation as simple as possible. Some things to consider include:

• Is the distance to the bathroom too far? A commode may help
• The bed may be too high for the person to feel safe getting in and out
• The floor and toilet seat may be the same colour. Try using contrasting colours
• The person may have difficulty undressing
• The lack of privacy may inhibit the person
• Poor lighting may make the toilet difficult to find
• Is the toilet clearly marked? Put a sign on the door, use a night-light or leave the door open
• Can the door be opened if they fall?
• Can they lock themselves in?
• If the person is urinating in inappropriate places, try to remove any objects that may be mistaken for the toilet
• When using a public toilet, the person will usually need help. Toilets for people with disabilities are usually for both sexes and there is plenty of room for two people

Communication 

When discussing toileting, it may help to:

• Use short, simple words to give step-by-step instructions. For example, ‘sit down’
• Watch for non-verbal clues, such as pulling at clothes, agitation or a flushed face
• Use words that are familiar to the person, such as ‘pee’ or ‘tinkle’
• Do not rush the person. Proper incontinence management make take time.
• Reassure them

Clothing

Try to make getting clothes on and off as easy as possible.

• Use Velcro tape instead of buttons or zippers
• Try elastic waistbands for trousers or wraparound skirts
• Try not to let the person become accustomed to wet clothes
• Select clothing that is washable and does not need ironing
• Protective garments and disposable pads may be useful

In the toilet

• If the person is having trouble urinating, try giving them a drink of water or running the tap
• If the person is restless or hyperactive and will not sit on the toilet, allow them to get up and down a few times. Music may have a calming effect. Try giving something to distract them while they are on the toilet.

Bathroom aids

• A raised toilet seat and wall grab-bars may help the person get on and off the toilet
• Make sure the seat is fastened securely to the toilet to reduce the risk of slipping
• Avoid floor mats to prevent tripping

Remember – respect privacy

It is important to respect privacy and dignity. Losing control can be humiliating and embarrassing, and caregivers need to be sensitive to these feelings. There are bound to be accidents, so try not to worry too much. Get help in managing the problem and make sure that you take adequate breaks.

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This article is sponsored by Independence Australia, a social enterprise that provides choices for people living with a disability or other personal need, enabling them to regain and retain their independence within a supportive community.

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