RespiteMatch.com Health Blog

Questions to Ask

Is incontinence a sudden, recent experience?
Has incontinence been an ongoing problem?
When do “accidents” occur?
Is the person constipated?
Does the diet include fibre
Does the person have a bladder or urinary tract infection?
Is the person experiencing urine retention (not emptying the bladder completely)?
Are there signs of dehydration?
Does the diet include adequate amounts (six cups) of liquids daily?
Is illness or surgery affecting urine or stool production?
Is illness or surgery affecting bladder or bowel control?
Is mobility or accessibility a problem?
Have there been recent changes in medication?
How do current medications affect bladder or bowel control?
Does the physician or health care professional have expertise in assessing or treating incontinence?
What kinds of home/environmental changes would make it easier for the person to use the toilet?
What treatments, continence management techniques and products are available to deal with the particular type of incontinence?
Is the recommended treatment, continence management technique or product suitable for the incontinent person?
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Steps to Take

Keep a bladder or bowel diary for one or two days before meeting with the physician.
Bladder or bowel diary

when the incontinence occurs — time, day, night
what is involved — problem reaching toilet, soiled underwear, diaper change, bed-wetting
how often — frequency
how urgent — urgency
how much — volume : large, small
where — circumstances : what happened
why — possible reason for the accident
fluid intake — amount and type of fluids taken
type of meals — high-fibre, low-fibre
any other information you consider relevant

Arrange for a medical assessment by a family physician, urologist or other specialist trained to assess and consult in incontinence.

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Medical assessment

age
medical history : including the history of the incontinence problem, a woman’s childbirth history, a man’s prostate history
physical examination
pelvic exams: vaginal and rectal
urinalysis: to rule out bladder or urinary tract infections
medications
mental assessment (if necessary)
assessment of the person’s environment
Discuss treatment options with the physician or specialist
Discuss side effects and risks associated with each form of treatment
Determine the treatment the most appropriate for the incontinent person
Learn at-home coping strategies for managing incontinence
Learn about helpful products to manage incontinence
Contact health associations and organizations that specialize in dealing in incontinence.

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At-home Coping Strategies
Learn skills and strategies to prevent and manage incontinence.
Provide cues and prompts to encourage toileting. Try to establish a bathroom schedule.
Modify the surroundings, where possible. Keep the bathroom safe by removing clutter.
Select clothing that is easy to undo and remove.
Consider the comfort and dignity of the incontinent person.
Change the diet, if necessary.
Talk to the physician, urologist, physiotherapist, nurse, pharmacist or medical supplier about about helpful products to manage incontinence.

Handle incontinence first with routine, consistent toileting, then diapers, then catheters.
Reward the incontinent person for eliminating at the right time.

Set a watch or beeper to sound at timed intervals. Place clean bedpans or bedside commodes where they can be seen easily.
Install a higher toilet seat, possibly with armrests. Install grab bars in the bathroom.
Jogging suits have no buttons or fasteners. Clothing that fastens in the back with Velcro may be suitable for people who are confined to bed.
Plastic bedpans are warmer to the touch than metal bedpans. Sprinkle a little talcum power on the bedpan to prevent it from sticking to the skin.
Ask the pharmacist for a cream for adult diaper rash.
Include high fibre foods and six cups of fluid daily. Check with the physician before substituting herbal teas for coffee, cocoa, cola or soft drinks. Herbal teas may interact badly with certain medications and illnesses.
Use washable cushions or slip covers and bed pads.
Caution: Unless the physician advises it, DO NOT treat incontinence by cutting back on fluids. If the body does not take in enough fluids, the urine will become more concentrated. This highly concentrated urine will irritate the bladder and lay the groundwork for bladder and urinary tract infections.

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Helpful Products

Products for continence management can be purchased from a variety of sources: pharmacies, groceries, health stores, medical supply stores, catalogues. Disposable products, such as pads and adult diapers, are particularly expensive and can cost individuals and caregivers several thousand dollars a year. Depending on the degree and type of incontinence, a combination of products may have to be used. The right products will be those that come closest to meeting the needs of the incontinent person.

Ask whether samples or trial packages are available. You may be able to save by buying in bulk. Ask about home delivery.

Continence management products

mattress pads: washable and disposable
chair pads
disposable pads and liners
disposable briefs with inserts for disposable pads or liners
washable briefs with inserts for disposable pads or liners
catheters for men
urine collection bags
yrinals: for men and women
bedpans
penile clamps to block off the urethra
urethral plugs and caps for women
vaginal pessaries or cones for women
protective clothing with absorbent back panels
easy-to-remove clothing with Velcro fasteners

Menstrual pads are useful for catching drips of urine. They may also cost less than pads sold specifically for incontinence.
Male drip collectors, called pocket pouches, are useful if a man leaks only small amounts of urine.