Continence is one of the topics I’m most asked about, yet is often an incredibly sensitive subject to broach or prepare for. It’s an important topic. Continence confidence can boost health, self esteem and make life easier all round. Read on for how to broach this topic, free support and more practically, how to prepare a bathroom for all eventualities…
It’s taken me a while to take a run up at this. I want to be as sensitive as the subject requires yet not shy away from being of real practical help. So I’ll aim for minimal faff.
First, consult a GP about incontinence. Lifestyle changes, Kegel exercises and ‘bladder training’ may well help. Incontinence is not something we should resign ourselves too.
Broaching the subject of continence
Broaching older adult continence with even a close relative or friend is tricky. But please do try, sensitively of course. Any concerns you may express are likely to be brushed away. Can’t say I’d blame anyone for this. Yet you may have legitimate concerns about personal hygiene, health and confidence, furniture protection and the sustainability (or capability) of constant laundry. Here are my tips:
First buy some time
Buy one or two ‘kylies’ (I know, poor woman). These are small washable and waterproof pads that you can slip on a sofa or on a bed to save laundry and protect the furnishings. I put a fleece throw over the sofa and slip the kylie underneath that, not to draw attention to it. Waterproof bed covers also do the same thing of course and they save washing all bed linen every time. I’ve noticed disposable versions in some big chemists now, useful for emergencies.
Then buy some continence pads or pants and just leave them handy in the bedroom or bathroom.
Get help with the conversation
Switching from our beloved M&S knickers to disposable pants is a big freaking deal. Like handing over the keys to your car for the last time, it’s not a happy milestone. Seek the help of a health professional to have the conversation for you. It’s often easier to agree a solution. Alternatively you or a domiciliary care worker can usually get away with a ‘let’s just try these today’ approach.
Practical steps for everyone’s convenience
Kit out the loo with everything you might need, so nothing will faze you.
In addition to the all-important hand soap and towel, this is how we kit out our bathroom, in the order we use it (if needed):
- Disposable gloves and aprons, just in case.
- ‘Nappy bags‘ to put used pants, pads or wipes into. I haven’t found any on sale in supermarkets for adults, but they surely must exist.
- Loo roll is still the most environmentally sound way of cleaning our butts. (Hope you’re not using the pipe-blocking quilted ‘luxury’ stuff? The un-dyed regular loo roll is best for plumbing).
- Andrex wipes (or similar) for the last couple of wipes if needed. Never flush any wipes, even so-called flushable wipes. Unless you love talking to plumbers.
- Flannels are a more environmentally friendly alternative to shop-bought wipes. We colour code: cream for ‘top’, ie face and pink for ‘tail’. It’s easier and cheaper to launder a load of flannels than a load of towels that might only have been used once.
- Talc used occasionally, but not essential.
- Sudocrem seems best for protecting and treating delicate skin, you may prefer an alternative.
- Anti-bac spray and loo bleach for cleaning down afterwards.
Find the right pants in the right size
If you can afford it, buy a sample of all the continence pad / pant options. Involving your loved one in the choice is only polite and also more empowering. We tried a range of pants for fit, comfort and functionality and settled on Tena in the end. The sizing is very important for comfort and effectiveness too, so do experiment.
Find the cheapest way of getting hold of pants
Before I discovered our local authority’s (LA) continence service (see next para), I bought pants from Boots online. Some brands like Tena are always on a ‘buy 6 packs for the price of 5’ type offer and they’re delivered free if you spend over £45.
Nowadays we save £85 a month by accessing the local (and free) continence service. An enquiry at our GP surgery led to an assessment by the local adult community healthcare team. Now I ring the LA service provider (NRS in our case) every three months to say we still need pants. About a week later, three months’ supply of pants are delivered free of charge. That’s a lot of pants (270 to be exact), so you need some storage space.
People living with dementia qualify for the continence service, but other conditions may qualify too. In some LAs you can choose the continence brand you prefer (thanks Bucks :-). In other LAs, they’re the NHS ‘standard issue’. I’ve not seen them but have heard they’re not so comfortable. A shame and another example of the current ‘postcode lottery of Care’.
This service was not offered, we had to ask for it, so do raise with your elder’s GP. For other support available from your GP, click here.
Good luck and always wash (everyone’s) hands.
PS If anyone knows of more environmentally sound versions of what I’ve described above, please do let me know and I’ll post about them. All tips welcome.