This fact sheet has been developed to assist carers looking after someone with a bladder or bowel control problem, also known as incontinence. Incontinence is a common problem and many carers find themselves having to cope with the added workload associated with it. This fact sheet provides you with general information about managing incontinence and where to seek further information and advice.
What is incontinence?

Incontinence is a loss of bladder or bowel control that may result in involuntary leakage of urine or faeces. Urgency (needing to get the toilet in a hurry) and frequency (wanting to go to the toilet often) are also common bladder control problems, although they are not necessarily associated with leakage.

Who is at risk?

Incontinence is a common issue that affects nearly 600 000 adult New Zealanders all walks of life, regardless of their age or cultural background. Incontinence is not just a problem for older people or people with disability. Despite this, people from these two groups are at greater risk of developing bladder or bowel control problems, because of poor mobility (ability to get around), memory problems and chronic health problems such as Parkinson's disease, stroke, dementia and multiple sclerosis.
The most important thing to remember when caring for someone with incontinence is that it is not 'normal' or 'inevitable'. Options for preventing, treating, managing and curing incontinence are available, so it is very important to seek professional help as early as possible.

Where to seek help

If the person you are caring for is incontinent the most important step for you to take is to seek professional help. The National Continence Helpline   0800 650 659 is a free and confidential service available to anyone living in New Zealand. The helpline can provide you with a wide range of information resources and details of a continence clinic located close to the person you are caring for.

Continence assessment

The first step required to affectively manage a person's incontinence is a continence assessment. A continence assessment helps identify the type and causes of the problems being experienced by the person and assists the continence advisor to devise an appropriate management strategy to treat these issues. There are a number of different types of incontinence and management of each of these different types varies.

A continence assessment will collect information about the person's bladder and bowel function including:

• How often they go to the toilet.
• How much urine is passed.
• What their bowel actions look like.
• How often and how much they leak.
• What their fluid and diet intake is.
• What current medications they are on.
• Other health problems they experience.
• Their ability to perform self care tasks such as toileting, dressing, getting to and from the toilet.
• A rectal or vaginal examination may also be required as part the assessment.

Management options

There are a range of management options available to people with incontinence, which largely depend on the type of incontinence they have and outcomes they hope to achieve. An incontinence management plan will usually consist of several of the following options:

• Adequate fluid intake (for example 1500 - 2000mls each day).
• Adequate diet (for example a fibre rich diet to prevent constipation).
• A pelvic floor muscle exercise program.
• A bladder retraining program.
• A toileting program.
• Medication.
• Incontinence aids (for example, pads, condom drainage or catheters).
Practical tips whilst waiting for assistance

Bladder problems:

Find a pad that will keep the person's clothing or bedding dry for about 3 to 6 hours.

Urinary infections can cause or worsen incontinence, if urinary incontinence is a new problem or if it hurts to pass urine see your doctor to make sure it is not an infection.
If the person suddenly CANNOT pass urine, see your doctor as this may be a medical emergency.
Make sure the person is drinking adequate amounts of fluid - 1500 to 2000mls spread evenly through out the day.
If the person is constipated, see your doctor about different treatment options, as constipation can impact bladder control.
Seek professional help on the cause and treatment of the incontinence.

Bowel problems:

Use a pad for protection.
Use a barrier cream to protect the person's skin (bowel leakage can make skin red and sore very quickly).
See your doctor if diarrhoea persists for more than 24 hours (the cause of the diarrhoea could be food poisoning, or certain kinds of medicine such as antibiotics).
Wear disposable gloves (available from supermarkets or chemists) to protect yourself.
Wash your hands carefully (even if you wear gloves) after you have had any contact with bodily fluids such as urine or faeces.
If the person is constipated, see your doctor about different treatment options.