Continence Resources

Falls in the elderly come at a high cost, both to the NHS and to the health and confidence of the person who has fallen. Hospital-based trials in 2021 started to explore potential links between caffeine and falls associated with going to the toilet, given caffeine’s diuretic effect. In 2023, following positive trial outcomes, the project spread to social care, where a 35% reduction in falls associated with going to the toilet was seen when decaffeinated products were introduced as standard in eight care homes for the elderly. This article explores the Decaf Project and potential benefits of decaffeination in wider community settings, including for elderly people living in their own homes. It examines ways in which community nurses can support those in their care to understand potential benefits of decaffeination.

When most people, professionals or media discuss the NHS, it is more often NHS England that they think about. However, due to devolution, each country has its own form of NHS system. While the goal of any NHS system is to provide an excellent service for health
provision to their population, how it is delivered can vary greatly. This article examines how the initial NHS was set up, how devolution in Wales has changed how services in Wales are commissioned, and how this has impacted on continence/bladder/bowel care in Wales.

The fourth and final part of the JCN continence clinical skills series identifies how continence problems, which may not have responded to conservative treatment/interventions, can be managed by the appropriate use of equipment/devices and products. The range available is vast and variable and some are more suitable to specific conditions than others. Healthcare professionals need to understand how they work to offer the best solution for individuals and their lifestyle. Products include, for example, commodes, urinals, sheaths, catheters, anal irrigation and pad products. This article specifically looks at equipment/devices and products for urinary retention, e.g. catheters; urinary incontinence, e.g. sheaths, pubic pressure devices; and faecal incontinence, e.g. anal plugs, transanal irrigation (TAI) and pad products. 

Urinary and faecal incontinence are common in the older population, yet incontinence is not a normal part of ageing. Dementia can impact upon a person’s ability to remain continent, yet incontinence is unlikely to be a symptom of dementia until the latter stages of disease progression. There is a misconception that nothing can be done if a person with dementia experiences episodes of incontinence. However, many people with dementia often experience functional incontinence caused by immobility, communication difficulties, disorientation, or the inability to find the toilet, which can all be alleviated if the right support and advice is available. Improving the identification, assessment and management of continence issues can not only enable people with dementia to maintain their dignity and improve their health, but also their sense of wellbeing and quality of life. There is also the possibility to improve relationships, reduce carer burden, and reduce the risk of a premature transition into a residential care setting. This fourth paper in the series explores some of the issues relating to dementia and continence and the impact as experienced by our two case studies, Dhriti Singh and Gregory Brewin.

Here, Davina Richardson, children’s specialist nurse, Bladder & Bowel UK, looks at the guidance available for school leaders, proprietors, governors, staff and practitioners to help them better support children and young people with bladder and bowel issues as they return to school.

World Continence Week (WCW), taking place from 21–27 June, is an annual health campaign run by the World Federation for Incontinence and Pelvic Problems (WFIPP). The campaign highlights the impact that urinary incontinence can have on people’s lives and encourages sufferers to seek help to improve their quality of life.

This JCN clinical skills series looks at different aspects of continence care in the community, with useful tips on patient care and improving practice.

The second part of the JCN continence clinical skills series looks at the requirements to undertake a basic continence assessment for bladder and/or bowel dysfunction. Assessment is the first step in identifying the type of continence issue an individual may suffer from. It should identify, for example, key elements of underlying medical history, presenting symptoms and duration of problem, medications, allergies, mobility and cognitive ability. This assessment should be supported by investigations, e.g. bladder and/or bowel diary, fluid/dietary intake, urinalysis, assessment of any post-void residual urine and pelvic floor/rectal examinations (if competent in skill).

This JCN clinical skills series looks at dif ferent aspects of continence care in the community, with useful tips on patient care and improving practice.

Continence is not a life-threatening condition, but does affect patient quality of life. The first part in this new continence clinical skills series explores continence issues and how to improve patient care. It looks at the prevalence of the condition, different types of continence issues, how they can affect quality of life and the complications that can occur when poorly managed.