Microsoft word - 13 july incontinence.doc

This briefing is produced as part of the Building Community Capacity Project by AVDC’s
Lynne Maddocks. Contact on 01296 585364 or for
more information.

Incontinence = a persistent problem with controlling your bladder or bowel.
Urinary incontinence is a distressing condition which affects more than 2.5 million people over 60 in the UK.
Many don’t talk about these problems or seek any help, either out of embarrassment or the notion that
nothing can be done. But there are actions you can take to help you deal with some of the common
problems. Incontinence is not an inevitable part of getting older. In many cases, incontinence can be
improved, or even cured. There are also many ways of managing incontinence so that it does not interfere
with your everyday life.
The bladder is a balloon-shaped bag surrounded by muscle in the lower part of your body. Urine is made in
the kidneys and stored in the bladder until you are ready to pass water. When you go to the toilet the
bladder contracts, the bladder outlet (the urethra) relaxes, and urine empties out. Your brain
controls your bladder, automatically sending messages telling it when to hold on and when to empty.
There are many different types of urinary incontinence, but these are the most common.
Stress incontinence This is leakage when you cough, sneeze, laugh or exercise. Pelvic Floor Muscle
Exercises can help or even cure stress incontinence. It is wise to seek professional help from your local
continence service to ensure that you are undertaking these exercises correctly.
Urge incontinence This is indicated by a sudden, urgent need to pass urine, but not being able to reach
the toilet in time. To reduce these symptoms try reducing caffeinated drinks having decaffeinated drinks
instead. Pelvic floor muscle exercise will also help with urinary urgency symptoms but again you need to
seek professional help to ensure you are undertaking the exercises correctly.
Overflow incontinence This happens when the bladder does not empty completely. Symptoms or signs of
this condition would be dribbling incontinence, leaking urine while not being aware of it happening. Seek
professional help as you will require some simple investigations to diagnose or exclude this condition.
The need to pass urine more than twice during the night is called nocturia. Waking more than
once or twice in the night can be both annoying and tiring. Try restricting how much you drink in the few
hours before bedtime, but if it persists and is affecting your quality of sleep and daily life, speak to your GP
or Continence Service.
Practical difficulties walking difficulties might make it difficult to reach the toilet in time or stiff fingers might
make it tricky to get clothes out of the way.
With all types of incontinence aim to drink six to eight cups of liquid every day. Avoid having fizzy drinks
and alcohol. Try to avoid becoming constipated. Keep as active and mobile as you can. Try not to let
having a bladder problem stop you from going out

What can make urinary incontinence worse?
• A urine infection
• If you are constipated, this may irritate the bladder.
• Some medicines disturb the bladder. For example, water tablets (diuretics) make it fill more often.
• Not drinking enough makes urine very strong and concentrated. The bladder then becomes used to
holding very little.
• Fizzy drinks and alcoholic drinks may upset the bladder, and so might drinks containing caffeine, such as
tea, coffee, chocolate drinks and cola.
What to do?
Talking about it, especially with a health professional, is the best first step you can take to help yourself.
Your GP might be able to help or may want to refer you to another health professional. You can refer
yourself to the Continence Service. Just telephone 01296 31864. There will be an answer phone so just
leave your name and telephone number and someone will contact you.

What can I do to help myself?
There are some good general tips you can try that may improve your condition.
• Drink normally, as cutting down on liquids will make urinary incontinence worse, not better. Aim to drink at
least six to eight cups of liquid each day.
• If you notice that tea or coffee make your symptoms worse, then cut down on caffeine. • Avoid constipation by eating plenty of fibre-rich foods and making sure you’re drinking plenty of liquid • Keep as active and mobile as you can. Try not to let having a bladder control problem stop you going out. Planning ahead can help you to feel more confident. Take some spare pads and pants with you. A scented bag for soiled pants or pads could be useful if you’re worried about smell.
What will a professional need to know?
A healthcare professional may ask you some of the questions below. You may also be asked for a urine
sample, or your bladder may be tested.
• When did incontinence start?
• How often does leakage happen?
• How much is lost?
• How are you dealing with it?
• Can you feel when the bladder is full?
• How often do you use the toilet?

Making life easier
As well as exercises and medical help, there are some practical changes and special equipment that can
make things easier for you.
Improving the toilet Special rails may make it easier to get on and off the toilet. These grab rails can be
freestanding or mounted on the wall. Adding a raised seat to the toilet may make it easier. If you can’t
reach the toilet easily, a commode may be useful, many have a lid and look like an ordinary chair when not
in use. You can get hand-held urinals, for men and women, which can be used in bed or sitting in a chair.
Clothing Many women find that stockings are easier to manage than tights, and that full skirts are easier to
get out of the way than tight ones. The more layers of clothes you wear, the longer
it takes to remove them when you go to the toilet.
Men may find loose boxer shorts easier to manage than Y-fronts. An extra tab on a zip may make it easier
to open trousers in a hurry, or, if you can’t manage a zip, velcro can be used for flies.
Toilet queues The Bladder and Bowel Foundation offers a free Just Can’t Wait toilet card so that you don’t
have to queue if you’re out and need to use a toilet quickly. The card states clearly that the holder has a
medical condition that requires the urgent use of a toilet.
RADAR Operates a National Key Scheme that offers people with disabilities independent access to about
7,000 locked public toilets nationwide. Tel: 020 7250 3222 Email:
Incontinence products
Incontinence does not always respond completely to treatment, but good incontinence products will help
you deal with the problem and let you carry on with a normal life.
There are a variety of pads, pants and other products available. You can buy many of them in pharmacies
and supermarkets, but it’s important to seek professional advice before using them.
If you are assessed as having severe incontinence , your district nurse or continence service may be able
to arrange a supply, of incontinence pads, that will meet your clinical need free of charge on the NHS.
Support information
Continence clinics are run at the following locations;:
Brookside Clinic, Aylesbury Thame Community Hospital Buckingham Hospital The telephone number for the continence clinics are 01296 318102 and 01296 318108
Alzheimer’s Society factsheet - Coping with incontinence for people with dementia.
NICE (National Institute for Health and Clinical Excellence)
Provides guidance written for
patients and carers’. You can download:
• the management of urinary incontinence in women
• the management of lower urinary tract symptoms in men


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