Getting help for incontinence
Incontinence can affect both the bowel and the bladder in either men or women. There are lots of different causes, including serious conditions such as cancer, so it should never be dismissed as simply “old age”.
Despite this, and largely due to embarrassment, many people delay seeking help. This can lead to unnecessary distress for all involved.
Continence problems are more common in later life
NHS England reports that continence problems are common in older adults. 1 in 3 women and 1 in 7 men over the age of 65 experience urinary incontinence. Faecal incontinence affects around 15% of those aged 85 years or more who are living at home.
Continence problems are more common in residential care homes, where at least one in three residents is affected.
Early treatment for bowel and bladder incontinence is important
Left untreated, bowel and bladder incontinence in older adults can lead to emotional and physical health problems. It can contribute to social isolation and depression, skin breakdown, falls, and urine infections.
Bowel and bladder incontinence often make independent living difficult and are recognised as a significant reason for care home admissions.
NHS services for incontinence
NHS experts can provide all the necessary assessments and treatments for incontinence.
Each area across the country has an “adult continence service”. These services are often staffed by expert nurses who can arrange all the necessary tests, treatment, and support. They will refer to doctors and other experts as necessary.
Community nurses can help assess and treat housebound patients, liaising with specialist services and practitioners as required.
This link outlines the continence services in Coventry and Warwickshire. Similar services are provided in every area across the UK.
Free incontinence pads are available through the NHS, according to certain criteria.
There are many different ways to manage incontinence, and free treatment is available through the NHS. Wherever possible, NHS practitioners will aim to treat the problem rather than simply “contain” it with incontinence pads or other devices like sheaths or catheters.
Incontinence pads will only be supplied following a formal assessment by a suitable practitioner. You will need to buy products in the period leading up to that assessment
If appropriate, they will supply incontinence pads free of charge, but current guidance indicates that daily supplies are limited to 4 pads in 24 hours. There are also guidelines about the provision of free containment products for hospital inpatients.
Faecal incontinence and constipation
Treating faecal incontinence and constipation
Faecal incontinence and constipation can be very distressing conditions, but this NHS video from Sandwell and West Birmingham Hospitals NHS Trust shows that NHS continence services understand the problem and can help. Similar services exist around the country.
Overflow diarrhoea and faecal incontinence
This is a recognised problem affecting older people. Sometimes constipation problems can become so severe that the rectum becomes completely plugged up (impacted) with hard faeces. One main symptom of faecal impaction is overflow diarrhoea i.e. the bowel leaks out watery stools around the hard pooh plug. This leakage of faeces is often involuntary and can appear like diarrhoea.
This problem needs expert treatment from a health care specialist, such as a community nurse or continence adviser. A GP can arrange this treatment. The practitioner will ensure that the impacted rectum is unblocked so that normal bowel function can resume.
Faecal impaction and constipation can be caused by:
- Medicine side effects
- Prolonged inactivity
- Low fibre diet
- Poor fluid intake
- Depression and anxiety
- Underlying diseases
About containment products and devices
Treating the cause is always the preferred method of care, but incontinence pads and other devices like sheaths, catheters, or anal plugs are commonly used. Bed and chair sheets, and waterproof mattress covers can also be helpful to contain leaks.
About incontinence pads
Incontinence pads can come in different levels of absorbency depending on the level of incontinence. Both washable and disposable incontinence pads exist. Washable products use multiple layers to promote dryness and deal with odour. Disposable incontinence pads have a one way liner to protect the skin, lock urine away, and deal with odour. They might also have an indicator strip to show when they need changing.
Pull up absorbable pants are also available for men and women and can be easier to use than those that insert into underwear.
A full bladder can hold around 1 pint/ half a litre of urine, and even the most absorbent incontinence pads will leak if this amount of fluid is leaked all at once. It is therefore important to empty the bladder regularly (every 3 hours or so) to reduce the amount of urine leaked at any one time.
Incontinence pads cannot absorb faeces so soiled pads must be changed as soon as possible and the skin cleaned.
This NHS leaflet gives information about different product brands and prices (which might be out of date).
This NHS leaflet goes into more detail, and although some of the advice relates to Torbay, there is still some useful information regardless of where you live.
Bowel and bladder incontinence and dementia
We have a separate resource on this specific topic.
Incontinence and mobility problems
Sometimes, older adults can experience bladder or bowel problems simply because they can’t get to the toilet on time. This can make them reluctant to leave home and contribute to social isolation and low mood. Our guide to finding toilets might be helpful, along withe information about stairlifts.
Consider getting a “just can’t wait” toilet card
These cards are available in either digital or plastic form and can be accessed for free online from charities including the bladder and bowel community and the Crohn’s and Colitis charity. They are for use in shops, restaurants, entertainment centers, and other businesses. By showing the card you can get access to toilets that are not usually available to the public. They also mean you don’t have to give a long explanation about the problem, thus saving time and avoiding any potential embarrassment.
Further information
The continence product adviser website is designed to give users, carers and healthcare professionals detailed, essential information about products for bladder, bowel, and toileting problems.
The bowel and bladder community provides UK-wide support for those suffering from bladder and bowel conditions.
