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How to Conduct a Continence Assessment for Customised Care

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How to Conduct a Continence Assessment for Customised Care

A truly great care home should always be prepared to meet the various needs and expectations of its residents - regardless of whether those needs present themselves in the form of standard patient support, or highly tailored continence care.

Although incontinence can be a difficult subject to breach with care home residents, it's important for carers and nurses to ensure that they discuss the various needs an individual may have with them, so that the right help can be offered at all times. After all, it's crucial to ensure that you have the appropriate support and equipment in place, from disposable pads and hygienic spill kits to specialist bedding and seat covers.   

Providing the right level of continence support for your residents begins with understanding their situation and the specific type of incontinence that they have, as well as the causes and any other symptoms they may have. In the following post, we'll discuss the different types of incontinence individuals may experience, and how to conduct an assessment for customised care.

The 4 types of incontinence to consider


Urinary continence - an issue wherein your body accidentally leaks urine - is a problem that affects millions of people every year of both genders and across all ages. However, it's worth noting that there are different types, and different ways to potentially manage each problem.

1.    Stress Incontinence


The first type of incontinence to consider is stress incontinence. This issue allows urine to leak from the body due to weakened pelvic tissues and muscles. Many individuals with this particular form of incontinence find that they can suffer most when pressure on the bladder is increased, such as during exercise or movement, laughter, sneezing, or coughing.

Childbirth and pregnancy is known to lead to weakened pelvic floor muscles in women, and other causes can include obesity, taking specific medications, or for men, having prostate surgery. Since stress incontinence can lead to problems so suddenly, incontinence bedding is often essential. 

2.    Urge Incontinence


Also known as overactive bladder syndrome, urge incontinence could leave your residents feeling an urgent need to go to the bathroom, and not always managing to get there in time. Causes of overactive bladder may include damage to nerves in the bladder, or surrounding muscles. However, this condition is sometimes caused by other chronic conditions such as Parkinson's, multiple sclerosis, and diabetes.

The nature of urge incontinence may mean that incontinence skincare is necessary to prevent residents’ skin becoming sore, alongside everyday support from products such as disposable incontinence pants and washable absorbent briefs.

3.    Overflow Incontinence


If your residents struggle to fully empty their bladders, this could be a sign that they suffer from overflow incontinence, which causes urine to dribble even after they've been to the bathroom. Causes of this issue can include nerve damage, constipation, weak bladder muscles, certain medications and an enlarged prostate. This is a type of incontinence that must be treated by a doctor.

4.    Functional Incontinence


Finally, mental or physical problems such as arthritis or living with dementia might prevent a resident from getting to the bathroom in time. People who are living with dementia can easily forget to go to the bathroom when they need to, whereas those who struggle with low mobility need quick assistance from carers in order to make the transition from a seat or bed, to the bathroom.

For people with these conditions, it's a good idea to invest in washable seat protection, just in case an accident can't be avoided.

Evaluating the continence care that your residents need


Of course, in some cases, a resident may not be able to give nurses and carers a full picture of the support they need in managing issues of incontinence. This is often why everyone with incontinence problems should be assessed by a nurse or doctor.

Carers can be present during this assessment, but it's essential that they allow the people that they care for to tell their own story regarding their problems in their own words. During these circumstances however, a carer can be asked to fill out charts on the behalf of the resident.

Once the assessment has been carried out, care home nurses or carers should have a better understanding of the type of incontinence problems that residents are facing. This is absolutely essential when it comes to creating a tailor-made and person-centric approach to continence care - from stocking up on the correct disposable incontinence pads to investing in washable bedsheets and seat pad protection. 

Questions commonly asked during a continence assessment


In order to get a comprehensive view of the problems residents face with incontinence, most nurses and doctors will ask some of the following questions:

  • How often do you go to the toilet?
  • How much urine do you pass?
  • What do your bowel movements look like?
  • How much leakage occurs, and how often?
  • What is your fluid and diet intake?
  • What are your current medications?
  • Do you have any other health problems currently?

Questions your residents may ask carers


It can be useful for carers to be prepared with useful answers to the most common questions that residents may have regarding incontinence. This can help to ease the embarrassment of incontinence and foster a positive and comforting culture within the care home.

One issue that many carers have is that residents often notice their pad is wet, and hasn't yet been changed. However, it's important for residents to be aware that their utilities are equipped with a colour-changing strip that informs carers of when they need to be changed. This knowledge can help residents to know that they aren't being ignored, and carers to avoid uncomfortable interactions.

Other questions might include:

  • "Do I need to wear a pad?" - If a pad has been recommended by a doctor during an assessment, this issue can be reiterated with the resident.
  • "Can you see the pad through my clothing?" - Most smaller pads are invisible to the naked eye, though larger ones can be seen. It may be important to reassure a resident that their continence pads are discreet.

Why customised continence care is important


Incontinence can be a deeply embarrassing issue for people living in a social care home environment, and it can even make them feel the need to isolate themselves from group activities and interaction. The best way for care home staff to manage this common and debilitating issue is to provide individuals with the specific and customised care that they need to feel confident in themselves, and their bodies.

Each pad often comes with a specific use, including pads specifically for urinary incontinence and faecal incontinence. What's more, different products come with different levels of absorption relating to the severity of the incontinence. Having incorrect pads could lead to leaks and accidents, which might lead to skin problems, embarrassment and discomfort.

Though some one-size-fits-all solutions can be used, incontinence generally requires a careful consideration of each individual resident's personal needs and preferences. After all, too much, or too little assistance can leave care home residents feeling awkward and uncomfortable.  

We hope that you have found our guide to conducting a continence assessment for customised care useful, but we would love to hear any additional tips or advice that you have to share. Leave us a comment below or join the conversation over at @CareShopBunzl

A truly great care home should always be prepared to meet the various needs and expectations of its residents - regardless of whether those needs present themselves in the form of standard patient support , or highly tailored continence care . Although incontinence can be a...

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