Continence aids and professional support
Find out about the range of continence aids and professional support available to carers of people living with dementia.
It can be hard to seek professional help for incontinence. Many people do so only at a point of crisis, as it may feel to the person with dementia like they are losing their dignity. Some may see incontinence as inevitable, but for many people with dementia, given the right advice and patience, accidents and incontinence can be managed or sometimes even cured.
The GP should be the first point of contact. They should review the symptoms and any underlying medical conditions (eg urinary tract infection or constipation), diet or medications that might be causing the problems. The doctor may do an internal examination of the bowel.
If this assessment is unable to resolve the problem, ask for the person to be referred to a continence adviser. NHS continence services across the country are quite variable 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.
Reducing and dealing with accidents
Read our advice for dealing with toilet problems and reducing accidents.
The continence adviser will assess the person’s problems and how they are affecting their quality of life, as well as yours. It is common to be asked to keep a chart of toilet habits.
After a thorough assessment the continence adviser will write up a continence care plan tailored to the individual. This should include things that the person with dementia and any carer can do to help. It should also describe the support that professionals should provide, as well as follow-up 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 their carer. In many cases, identifying and addressing practical issues, changing medications or making simple changes to lifestyle (such as diet, drinks and exercise) can help to achieve this.
In a few cases, the person may need to be referred to a further specialist (eg geriatrician, urologist or gynaecologist). For some people, advice will focus not on curing but rather on containing the incontinence as comfortably as possible using aids.
Other health professionals that can help
- A community nurse can help with access to NHS-funded continence products and give advice on management of the problems, 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 problems with coordination or movement.
- A community psychiatric nurse, Admiral Nurse or the community mental health team 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.
Sometimes, you might try everything you can but the toilet problems or incontinence don’t go away. In this case, using continence aids can help to keep the person comfortable and protect clothing, furniture and bedding. The main aids are listed below.
- Incontinence pads and pull-up pants. These can be worn day and night, or during the night only, to draw fluids away from the skin. It is important to find the right type and absorbency for the individual. They should be comfortable without chafing the skin or leaking. They should be changed as often as necessary.
- Male continence sheath. This is a silicone condom which 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 which 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. You should talk 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 independently with their own money.
You can get advice and buy products from independent living shops or large branches of high-street chemists. For national organisations that can help, see ‘Other resources’.