Jun 23, 2021

Incontinence: Are we doing our best to ensure the elderly are dignified?

Incontinence is a term that describes any accidental or involuntary loss of urine, faeces or wind.

Though it can happen at any age, older people are particularly susceptible to experiencing incontinence.

People who suffer from incontinence often suffer from shame, fear and anxiety over having an accident.

There are two main kinds of incontinence;

  • Urinary incontinence – which is the involuntary passing of urine, and
  • Bowel incontinence – which can either be a bowel motion, faeces or passing of wind.

There are a number of things that can be done to improve – and in some cases even cure – incontinence, including changes in diet and lifestyle, incorporating regular exercise and practices, and good toilet habits.

In aged care, there are many residents who suffer with incontinence. It is believed that around 77% of residents in Australia are affected by some form of incontinence.

In fact, bowel incontinence is one of the three major causes (along with decreased mobility and dementia) for admittance to a residential aged care facility.

With so many elderly people struggling with cognitive and physical impairments, residents often need the support of a carer or nurse to prevent any accidents or incontinence.

While it is important to make sure the residents are kept hygienically clean and dry, it’s also vitally important to ensure that the older person’s dignity is maintained where possible.

Incontinence and dignity

When an elderly person is in aged care, they should not feel ashamed when they have an accident or leak.

Though staff are aware of incontinence, it still remains a highly stigmatised and mostly untreated condition.

Some aged care residents find that the way staff manage their incontinence issues is simply by ‘padding them up’ – which can leave them feeling uncomfortable and undignified.

Continence is strongly connected with a person’s quality of life – and working with an older person to prevent them from becoming incontinent can make a huge difference to a person’s physical and mental wellbeing.

So, what steps can an aged care worker take to ensure a resident maintains their dignity when dealing with incontinence issues?

  1. Learn to better recognise when a person may need to go to the toilet. This means making sure they get there on time or helping them find it.
  2. Help the resident get to the toilet independently or with assistance – some residents may not be comfortable with being assisted.
  3. Help the elderly person use the toilet once they get there, because in some cases simply getting them to the bathroom is not enough.
  4. Assist the person after they have used the toilet – this may mean adjusting their clothing and washing their hands after use.
  5. Once they are finished with the bathroom, assisting the person back to where they want to go, whether it’s their room or a communal area.

Factors that may influence whether incontinence is well managed within an organisation may depend on design and layout of the facility, the environment, access to professional support or aids, and staff attitudes.

Incontinence is a real issue in aged care that goes beyond ‘having an accident’, and staff need to remember the person behind the condition and their dignity.

What do you think? Write a comment below, or share and like this article.

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  1. One of the biggest problems I found was getting the nurses to wash my husbands hands after he had used the toilet. Their attitude was O he did not wipe himself so he does not need to have his hands washed. I made several complaints to management but nothing was done to rectify the situation. It is hard to believe that adults do not think one should wash their hands after using the toilet. People who suffer from dementia forget all about their personal hygiene they require assistance. Once again it gets back to very poor training of staff. It should be the first Golden Rule nurses are taught all residents must have their hands washed after using the toilet it is BASIC PERSONAL HYGIENE

    1. Basic personal hygiene is often not a priority in the caring space for people in residential aged care who do not have the capacity to self advocate. Residential aged care staff who get all their tasks done and are waiting around to go home have possibly not attended adequately to residents personal care, oral care and perianal care, I agree with Katie’s comment (06.12.2017) hand washing prior to meals and after toileting remains an area of personal care that is skipped/not prioritised by some aged care staff

    2. I found this with mum too. Many PCWs made mum wipe herself after using the toilet and she would often get her hands soiled but they never got her to wash her hands afterwards. We would often find faeces smeared over the handles of her “wheelywalker “
      Mum wasn’t incontinent when she went into the nursing home, but I found that to save work and time, they would tell her to use the pads rather than take her to the toilet. She now has both urinary and bowel incontinence.
      She gets very distressed when she soils the pads and wets them, it’s so very sad to see. She is now 97 and bedridden.


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