People with incontinence should not have to suffer in silence

Incontinence affects people of all ages, and while there are many common challenges, some are specifically related to the elderly. Paul van Houten, Head of the Medical Department of Zonnehuisgroep Amstelland in The Netherlands, shares his thoughts on the challenges connected to continence care and what can be done to improve the quality.

Van Houten has over 30 years of experience in elderly care and works mainly with frail, elderly persons living in nursing facilities. As a nursing home physician, he noticed a big share of his patients suffering from incontinence, and realized that there was little known how to care for them.

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For some people experiencing incontinence, symptoms occur at a much earlier stage in their life. The main challenge for this group is to acknowledge the problem, talk about it with their spouses or family, and seek help.

– Many people think that incontinence is an inevitable result of ageing, but there are things you can do. You should not have to suffer in silence. Even though there are many types of incontinence that cannot be cured, there are many things you can do to make it easier to live with the condition.

Once incontinence has been diagnosed and it has been confirmed that it cannot be cured, the care should consist of a combination of containment products and toileting strategies.

– Having the right protection is important, but it is always better to have access to a toilet when needed. Relying only on containment products may lead to constipation, infections, or skin irritation, says van Houten.

For the elderly with limited mobility, having access to a toilet at the right time is often a challenge, especially for those who live in a nursing home. In professional elderly care, resource constraints are a real challenge. According to van Houten, three times more nurse aides would be required to ensure that all patients have access to the toilet at any given time. There are ways, however, to meet the needs of patients in a more effective way.

Improving continence care in nursing homes:

  • Ensure that toilets are easy to find and use.
  • Learn the signs patients show when they need to visit the toilet.
  • Understand at what time of the day patients usually need to visit the toilet and adopt the schedule to their rhythm.

– First, you need to make sure that the toilets are easy to find and use. In some nursing homes, the toilets are almost hidden. Second, you need to learn the signs of patients who need to use the toilet. Third, you need to assess each patient and get a better understanding of when they usually need to use the toilet. That way, healthcare workers can adapt their schedules to suit the patients’ needs. This is better for the patients and does not necessarily require more staff.

Another key factor is to take a more holistic approach to incontinence care, especially for frail, elderly people who might be suffering from a number of other conditions, like dementia or Parkinson’s disease.

– You need to take several conditions into account. Incontinence may have other underlying causes. Incontinence can, for instance, be a consequence of medication taken to treat something else, but there is no awareness about this. This is why we need to have a more holistic approach; you cannot look at incontinence separately. A better understanding of each patient’s needs is crucial to giving the best care possible.