Maintaining continence plays a crucial role in the dignity, independence, and overall health of older adults. For those living in aged care facilities or receiving care at home, incontinence can be a sensitive issue, yet it’s far more common than many realise. By supporting continence through proactive care, education, and allied health collaboration, we can reduce its impact and improve quality of life.
Prevalence and Impact of Incontinence in Older Adults
Incontinence affects a significant portion of the ageing population. Research indicates that up to 65% of residents in aged care facilities and around 15–20% of older adults living in the community experience some form of urinary or faecal incontinence. The likelihood increases with age, frailty, and the presence of neurological conditions such as stroke, Parkinson’s disease, or dementia.
The impact of incontinence goes beyond the physical. It can cause skin breakdown, urinary tract infections, dehydration, and sleep disturbances. Psychologically, it can lead to embarrassment, anxiety, depression, and social withdrawal. Unfortunately, many older adults see incontinence as a normal part of ageing and hesitate to seek help. This makes education, early identification, and supportive management essential parts of aged care and community health programs.
How Nurses Identify Underlying Contributing Factors
Nurses and continence specialists play a pivotal role in identifying the underlying causes of incontinence. Rather than accepting it as inevitable, they conduct thorough assessments to determine if the incontinence is functional, urge-based, stress-related, or a mix of multiple types.
The assessment process often involves:
- Bladder and bowel diaries to track frequency, volume, and triggers
- Medical history reviews to identify medications or conditions affecting continence
- Mobility and cognition checks to assess functional ability and responsiveness
- Environmental assessments, especially in community settings, to see if bathroom access or layout contributes to accidents
Importantly, nurses look for reversible causes such as urinary tract infections, constipation, or poorly managed diabetes. By identifying and addressing these factors, they can often significantly reduce episodes of incontinence without the need for invasive measures.
Training Carers and Staff in Continence Best Practice
Supporting continence effectively requires a team approach. Carers, whether in aged care or in-home environments, need proper training and resources to manage continence with respect, skill, and consistency.
Best practice training includes:
- Understanding the types and causes of incontinence
- Using continence aids appropriately, ensuring they are well-fitted, discreet, and regularly changed
- Prompted voiding and scheduled toileting, which are particularly effective in those with cognitive impairment
- Hygiene management, including proper cleaning to prevent skin damage and infections
- Maintaining dignity and privacy, so clients don’t feel ashamed or embarrassed
Regular refresher training and support from registered nurses or continence advisors ensures that staff remain up to date and confident in their approach. When carers understand that continence can often be improved—or even restored—the focus shifts from passive management to active support.
Linking Clients with Physiotherapy and Allied Health Support
Incontinence is not just a nursing issue—it’s a multidisciplinary concern. Physiotherapists, occupational therapists, and dietitians all have vital roles to play in promoting continence and independence.
Physiotherapists, especially those specialising in pelvic health, can provide exercises to strengthen the pelvic floor muscles. They also address mobility and balance issues, which are common contributors to functional incontinence—where the person knows they need the toilet but can’t get there in time.
Occupational therapists can assess home environments and recommend modifications like raised toilet seats, grab rails, or night lights. They may also introduce strategies and routines to support toileting independence, especially for clients with cognitive impairment.
Dietitians ensure the client’s nutrition supports good bowel health. Adequate fibre and fluid intake are essential in preventing constipation, a key factor in faecal incontinence.
At My Rehab Team, trained healthcare professionals work together to ensure that every client receives a tailored continence support plan, integrating allied health where appropriate. We believe in a proactive, person-centred approach that looks beyond symptoms to create sustainable solutions.
Preventing Incontinence-Related Complications
While incontinence itself is challenging, the complications it can cause are often more serious if not managed properly. Older adults are at increased risk of developing pressure injuries, urinary tract infections (UTIs), and social isolation, which can spiral into a decline in overall health.
Preventative strategies are key and include:
- Skin integrity management, using barrier creams and prompt changing of wet garments
- Regular toileting schedules, especially for those with memory impairment
- Monitoring for signs of infection or irritation, such as changes in urine colour, odour, or increased confusion
- Encouraging hydration, even when clients are worried it will worsen their incontinence
Preventing falls is another priority. Many toileting accidents happen during the night or when a client is rushing to the bathroom. Simple changes like improved lighting, mobility aids, and non-slip flooring can make a big difference.
By adopting a proactive mindset and working closely with families, carers, and allied health professionals, we can help prevent complications and maintain the client’s dignity and wellbeing.
Conclusion
Incontinence doesn’t need to be accepted as an inevitable part of ageing. With the right assessment, care, and support, many older adults can see improvements in their continence and quality of life. At My Rehab Team, we’re committed to helping clients live with comfort, dignity, and confidence whether that’s through linking them to physiotherapy, educating carers, or tailoring continence strategies to their individual needs.
If you or a loved one needs support with continence management in a community or aged care setting, we’re here to help. Contact My Rehab Team today to learn more about our services and how we can support your goals for independent, dignified living.
Source
Australian Institute of Health and Welfare
https://www.aihw.gov.au/getmedia/b57c8119-4050-4757-98ef-957d8664251b/ah16-3-16-incontinence.pdf
Faecal incontinence in older people in Australia and New Zealand: a narrative review
https://www.researchgate.net/publication/322653248_Faecal_incontinence_in_older_people_in_Australia_and_New_Zealand_a_narrative_review
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