Frequently asked questions about incontinence

Coping with incontinence can be difficult for older people and their carers. However, there are many ways to manage bladder and bowel problems that can make everyone's life easier.

The Continence Foundation of Australia answer your questions about common bladder problems. 

In this article;

• What factors contribute to incontinence in older people?
• What is the cause of frequent urinary tract infections? Can they be prevented?
• What factors should I consider before buying incontinence pads? 
• Can older people benefit from pelvic floor exercises? Who can teach pelvic floor exercises? 
• What is a continence nurse advisor? 
• What is the Continence Aids Assistance scheme?  

What factors contribute to incontinence in older people?

There are many causes of incontinence, both bladder and bowel. They can be quite complex conditions, with many factors interacting. The association with other health problems is a significant factor too. That’s why it’s so important to have a thorough continence assessment.

Treatments will depend on the type(s) of incontinence, for example, factors such as fluid intake, bowel function, medications, plus people’s individual medical histories and life situations. 

What is the cause of frequent urinary tract infections? Can they be prevented?

There are many reasons for UTI’s.  Some ways of preventing them are drinking enough fluid (find out more about this important aspect), avoiding known “bladder irritants” such as caffeine-containing drinks such as cola, tea, coffee or chocolate drinks.

Post-menopause, some women may be more prone to UTIs. Even intercourse can be a factor. Sometimes if they are recurring, a specialist referred by your doctor might need to investigate further.  

What factors should I consider before buying incontinence pads? 

You should ideally be considering the volume of urine the pad has to hold, how comfortable it is for the wearer, and whether the person (or carer) is able to easily change the product. Waist size (for men) and hip size (for women) and when the incontinence is occurring (day or night or both) are important too.

There are other factors such as the cost of the product – check if you are eligible for product funding assistance under a government scheme. With bowel leakage (faecal incontinence), pull-up style pants are firm around the legs and contain any “accidents”.  Sometimes a pad inside the pull-up helps also.

Again, going to a continence clinician (a continence nurse advisor or talking to your GP) and finding out more about your condition will mean you have a better idea of the most suitable product for you.

Some people find keeping a bladder diary helpful because they may see the patterns – there may be times during the day when a pad is not needed, or perhaps a smaller capacity will do. And it may show up when certain foods or fluid types may be irritating the bladder, making it unstable. 

Can older people benefit from pelvic floor exercises? Who can teach pelvic floor exercises? 

Yes! Age is no barrier to the benefit of effective pelvic floor muscle exercises. The key word here is “effective”. It’s no use – and could be actually harmful – if you are doing the exercises incorrectly.

If poor muscle tone underlies the incontinence, the best way to go is to attend a continence (pelvic floor rehabilitation) physiotherapist. The physio will test your strength at the beginning (so that your improvement is measurable), check that you are doing the exercises properly, and guide your program. The cure rate with this approach is researched to be about 80% - and for women of any age.

Some continence nurses also teach pelvic floor muscle exercises. The National Continence Helpline (1800 33 00 66) has a database of continence physiotherapists and nurses, so you can get the details of the closest clinic to you.   

What is a continence nurse advisor? What kind of information should I gather before I contact a continence nurse advisor?  

A continence nurse advisor (CNA) is a nurse who has done extra training in the field of incontinence. Before you go, it could be helpful to have read some information leaflets about bladder and bowel control. 

You could feel more comfortable being able to use terminology, and feel more confident talking about the subject, if you go “armed” with some basic information.

Medical history, including operations, number of pregnancies and births, and medical treatments will be relevant.  But really, the important thing is to actually go – the continence nurse advisor will guide you.

If you think it might help with your awareness – and help you answer questions – keeping a bladder diary for a few days could help too, but it’s certainly not necessary. (Bladder diary sheets and guidance on how to use this, are available from the Helpline and from the Continence Foundation’s website www.continence.org.au).   

What is the Continence Aids Assistance scheme? 

Under this scheme, an amount of money is received each year for the purchase of continence products. Prior to 1 July 2007, the Continence Aids Assistance Scheme (CAAS) covered people aged between 16 and 65 years. The Australian Government has now changed the eligibility, extending the cover to include those aged 5 years and over with permanent and severe incontinence.

Eligible health conditions include spina bifida, cerebral palsy, intellectual disability (including Down syndrome) and autism, plus a range of acquired and degenerative neurological conditions.

For some of these conditions, the parent or guardian needs to have a Pension Concession Card. Every financial year, CAAS clients will receive a subsidy of up to $470 for continence products.  

Continence products, especially for those with moderate to severe incontinence, can be very expensive. Getting the right advice about your eligibility for funding assistance, plus good information to help you choose the best products – or mix of products – can make a big difference to the household budget.

Article by:

Anne Ramus, Continence Foundation of Australia
Steve Marburg,  National Continence Helpline
19/03/08

www.continence.org.au

The National Continence Helpline 1800 33 00 66