It is estimated that a whopping 140,000 out 400,000 older people living at home with incontinence do not receive adequate support. Incontinence care for the elderly is an issue that is being constantly revisited.
Evidence gathered over the years has shown that continence in older people can be managed successfully and restored in many cases. Incontinent seniors are at risk of having depression, pressure ulcers and catheter-related urinary infections. The way incontinence is managed is incredibly important in improving quality of life. Incontinence researcher Booth asserts “continence is arguably the biggest threat to individual dignity. The ability to maintain bladder and bowel continence is an elemental part of who we are”.
The main issue that stands in the way of many seniors being treated is their reluctance to find care. Putting a stop to the ideology that incontinence is a normal part of ageing is a vital first step to encourage seniors to find care. A study by Susan Vogel found that seniors go to great lengths to deny and hide urinary incontinence, which affects their enjoyment of life. Promoting continence is everybody’s business and shouldn’t be hidden. It is vital for people to view incontinence as a condition that requires treatment and action. As incontinence expert Steven Reinberg states, “incontinence should not be considered a normal or inevitable part of ageing”. When practitioners consider incontinence as a normal part of ageing, older patients are then reluctant to seek help.
Related: Read our blog to find out how you can help erase the taboo of incontinence
Having empathy and viewing seniors as individuals is a second prominent factor in delivering high-quality care. This can also help seniors maintain dignity and feel respected. Dignity has been analysed from the older person’s perspective in several studies and has been defined as a concept that embraces human rights, autonomy and behaviour. Senior health researcher Jenny Billings asserts, “dignity is compromised when older people are treated as objects, patronised and excluded from decision making”. Many studies and questionnaires have highlighted the need to avoid seeing seniors and objects and instead be empathetic and understanding of their situation. This could both improve treatment and help seniors feel valued by carers. Courses now aim to improve medical students’ attitudes toward caring for the incontinent seniors. For example, medical schools have introduced ideas such as an “ageing game” to enhance medical students’ attitudes toward caring for elderly patients. This game provides experiential learning about factors including loss of functional status, semi-independent living, and living in a care facility. There was a significant improvement in 6 of the 8 attitudes toward caring for elderly and a statistically significant increase in empathy towards elderly patients following the ageing game. This ultimately helps students and workers understand the impact that incontinence has on someone’s life.
Additionally, failing to provide individualised care is a common mistake that can worsen seniors’ quality of life. Association of Urology guidelines on incontinence advocate that treatment should be individualised for elderly individuals. To ensure seniors are understood and helped in the best way possible, carers and healthcare providers should consider the physical, psychological and social health of each senior. Quality of life, rather than simply managing incontinence is another vital factor. It is important to steer away from the “one size fits all” ideology for taking care of residents. Person-centred incontinence care requires a complete understanding of an individual and the specific causes of their incontinence. This type of care allows seniors to have their own input and opinion on the treatment methods they feel comfortable with. Person-centred incontinence care also ensures people with communication difficulties are provided with the support they need. One to one support and advice should be provided to ensure all seniors are educated. It is also vital that seniors are viewed as individuals with their own preference for communication. Every senior likes to communicate in a different way and has their own preferred terminology surrounding incontinence. Some seniors may prefer using the words “briefs”, “throw away underwear” or “disposable pants” instead of “nappies”. Getting to know seniors’ personalities and sense of humour can be invaluable when talking to them about incontinence. If you speak about incontinence lightly and openly, you can maintain your parent’s dignity and seniors will be more comfortable.
Finally, looking after incontinent seniors should not only consist of ensuring they are protected throughout the day. As well as this support, carers and staff should pay attention to other elements of incontinence care such as skin care. The process of looking after someone with incontinence should not be something that is cut short or rushed. It is estimated that Urine and faeces can damage the skin, causing redness, irritation and soreness. This can affect their self-esteem and self-image. Keeping the skin moisturized with a barrier ointment or a cleansing milk is essential for keeping the skin soft and healthy. The skin needs to be moisturised and cared for to ensure it maintains a physical barrier against the environment. Using cleansing products specially designed for incontinence skin care are recommended over soap and water methods. Using cleansing wipes regularly deodorises skin and fights bacteria, whilst products such as bed bath wipes are useful for seniors with delicate skin. You can find out more about skin care and how to prevent Incontinence Associated Dermatitis here.
Key Steps to Improving Elderly Incontinence Care:
- Spread the message that incontinence is not a normal part of ageing
- View seniors as individuals
- Maintaining dignity is key
- Don't forget about skin care