How to broach this sensitive topic, access FREE continence pants (if eligible in your LA) and prepare the bathroom for all eventualities…
Continence is one of the topics I’m most asked about and is often an incredibly sensitive subject to broach or prepare for. It’s an important topic, that I’ve had to take a run up at here. Continence confidence can boost health, self-esteem and make life easier all round. 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 to.
Broaching the subject of continence
Broaching older adult continence with a close relative or friend is tricky. But please do try, sensitively of course. Be warned that 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, social situations 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 but these smaller protectors save washing all bed linen every time. I’ve noticed disposable versions in some big chemists now, useful for emergencies but not so sustainable.
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 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 or care professional to have the conversation for you. It’s often easier to agree on 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 when an accident happens.
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 for sale in supermarkets for adults, but I guess they 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 regular loo roll is best for the plumbing.
- Andrex wipes (or similar) for the last couple of wipes if needed. Never flush wipes down the loo, even the so-called flushable wipes. Unless you like talking to plumbers about fatbergs.
- Flannels are a more environmentally friendly alternative to shop-bought wipes. We colour code them: 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.
- Medi Derma-S (on prescription) came recommended by our home care company, it’s a high performing thin barrier cream
- Sudocrem seems best for treating broken skin, though it can also be used as a barrier cream
- 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 (and sizes) 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. Sometimes brands benefit from 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. So now I ring the LA service provider (NRS in our case) every three months to arrange a pants delivery. About a week later, three months’ supply of pants is 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 health conditions may qualify too. In some LAs you can choose the continence brand you prefer (we’re very grateful to 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’.
The continence service was not offered to us at any stage, we had to ask for it, so do raise it 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 sustainable versions of what I’ve described above, please do let me know and I’ll post about them. All tips welcome.