Continence aids and professional support

Find out about the range of continence aids and professional support available to carers of people living with dementia.

Professional support

It can be hard to seek professional help for incontinence. Many people do so only as a last resort, as the person with dementia may feel like they are losing their dignity. However, for many people with dementia, with the right advice and support, accidents and incontinence can be managed or sometimes even cured.

GP support

The GP should be the first point of contact. They should review the symptoms and any underlying medical conditions (such as urinary tract infection or constipation), diet or medications that might be causing the problems. The doctor may do an internal examination of the bowel.

Continence adviser

If the GP’s assessment is unable to resolve the problem, ask for the person to be referred to a continence adviser. NHS continence services vary across the country, and you may have to be persistent to see someone who understands incontinence in people with dementia. You may have to wait for these services.

The continence adviser will assess the person’s problems and how they are affecting their quality of life, as well as yours. It’s common to be asked to keep a chart of toilet habits.

After the assessment, the continence adviser will write up a continence care plan for the person with dementia. This should include things that the person and you can do to help. It should also include the support that professionals should provide, as well as follow-ups and next steps.

The aim should be to cure toilet problems or incontinence wherever possible. This should be agreed with the person with dementia and with you. In many cases, practical steps such as changing medications or making simple changes to lifestyle (such as diet, drinks and exercise) can help to achieve this.

Further support from other health professionals

In a few cases, the person may need to be referred to a further specialist (for example a geriatrician, urologist or gynaecologist). For some people, advice will focus not on curing but on managing the incontinence as comfortably as possible using aids (see ‘Continence aids’ below).

Other health professionals can offer support:

  • A community nurse can help with access to NHS-funded continence products and give advice on managing the problem, hygiene and how to protect the skin.
  • An occupational therapist can give advice on adaptations and equipment.
  • A physiotherapist can give advice if the person has difficulties with co-ordination or movement.
  • A community psychiatric (mental health) nurse, Admiral Nurse or the community mental health team for older people can help if behavioural changes are affecting how someone uses the toilet.

Speak to the GP about getting a referral to any of these professionals.

Continence aids

Sometimes, you might try everything you can but the toilet problems or incontinence remain. If this happens, using continence aids can help to keep the person comfortable and protect clothing, furniture and bedding.

Continence aids include the following:

  • Incontinence pads and pull-up pants – these can be worn day and night, or during the night only, to soak up pee. It’s important to find the right type and absorbency for the person. They should be comfortable without chafing the skin or leaking. They should be changed as often as necessary.
  • Male continence sheath – this is a condom that drains into a bag attached to the leg. It may be especially helpful when worn at night.
  • Absorbent bed pad – this is an under-sheet that provides a dry surface on a bed or a chair. These are available as washable or disposable products.
  • Waterproof mattress protector – this is often used in combination with an absorbent bed pad. The protector should not come into contact with the skin, as it may cause chafing and soreness. You can also buy special protective duvet covers and pillowcases.

Speak to the continence adviser or community nurse for advice, or to find out how to get NHS-funded supplies. The NHS should supply enough continence products to meet a person’s needs. However, this varies across the country, and many people top up supplies or buy different versions of products themselves, with their own money.

You can get further advice and buy products from independent living shops or large branches of high-street chemists. For national organisations that can help, see Other resources.

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