Parents may also have to explain their child’s condition and associated care to school, extended family and others who look after their child, such as out-of-school clubs or nurseries.

What is often forgotten is that a bladder or bowel condition in one child can affect other children in the household as well. It is not easy to invite friends to play or to sleep over if you are worried about any lingering smells at home due to episodes of incontinence, or how others may react to a brother or sister’s toileting routine. There may be anxiety that if friends find out that a sibling has a bladder or bowel issue, they may tease or bully both the affected child and their sibling. Many children will also be conscious of the additional pressure that managing the bladder or bowel issue causes for their parents.

Difficulties managing journeys and finding appropriate places to clean and change a child who has experienced urinary or faecal incontinence, and any associated embarrassment or perceived stigma, may limit the activities that a family feel confident to do. This may result in all the children missing out on holidays, day trips, visits to wider family and friends’ homes or other outings that their peers take for granted.

Children who have bladder and/or bowel issues are more likely to struggle with self-confidence and self-esteem, and there may be psychological impacts from the issue, but these may also affect the child’s brothers or sisters. They may become upset when they realise that their brother or sister should be clean and dry, or if they perceive others are responding negatively to them due to the wetting or soiling. Parental attention may be focussed on the child with the problem: on the practicalities of managing, attending appointments and undertaking recommended treatments. This may result in parents having a reduced capacity to provide support and attention to other children in the family.

Different rules about what is acceptable for different children within a family may be difficult for young people to understand. Differing boundaries may give rise to disharmony and feelings of neglect or resentment and may induce anxiety in other children. Occasionally, younger siblings of the affected child may respond by regressing in their own toileting.

The way that families approach managing bladder and bowel symptoms can help all the children in the family. When families understand that children do not wet or soil to be naughty or because they are lazy, but because they have an underlying problem, then the first steps can be made to work on a solution.

Talking to all the children about the issue, what is thought to be causing it and things that can be done to help, will reduce any feelings of isolation that the affected child has and allow their brothers and sisters to offer support, encouragement and to feel involved. This positive response may also eventually help to reduce the taboo in society on discussing bladder and bowel health issues.

Healthy eating, drinking and toileting habits are often recommended as first-line interventions for both bladder and bowel issues. All children in the family can be involved in these and in offering support and encouragement. Positive role modelling and motivators for all the children to exhibit desired behaviours can create a sense of solidarity and involvement.

Other children in the family should not have to provide direct care to the child with the issue, but some may want to be involved and offer practical, as well as moral support. They may also be able to give different perspectives about how the child is managing when away from home e.g. in school or when with wider family members.

Every child and family are different. Therefore, how bladder and/or bowel symptoms in one child affect the other members of the family will be unique. Some basic principles that can help other children in the household feel included and helpful are:

• Ensuring that all the immediate family know how the bladder and bowel work and how to promote bladder and bowel health.
• Provide opportunities for children to ask questions, to be involved and to help support a sibling who is affected by a bladder and/or bowel condition.
• Seek support from your child’s school nurse, health visitor or other healthcare professional who can help you support all your children when one of them has a bladder and/or bowel issue.

For more information about bladder and bowel conditions in children and how they may be managed please visit the Bladder & Bowel UK website.

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Prevalence of Incontinence  

This article discusses the importance of considering sustainability when selecting/recommending incontinence management solutions. It is estimated that 14 million men, women, young people and children of all ages are living with bladder problems. 1 in 10 of the population are affected by faecal incontinence. Over half a million adults suffering from faecal incontinence. Urinary and faecal incontinence are conditions affecting one in three people living in residential care. As well as, two in three nursing home residents.

Anyone of any age or with any medical condition who has a continence problem should seek healthcare professional support and advice. Often there solutions to resolve the problem or reduce the impact. However, for some, achieving continence is not possible, so effective containment is vital to quality of life, independence, dignity and self-esteem. 

We are all aware of the importance in reducing our climate footprint. How can we be more sustainable when it comes to incontinence products?

 Sustainability

Sustainable healthcare is a major goal both worldwide and for the NHS. Single-use products are a key contributor to plastic waste (Sustainable Development Unit, 2020). Incontinence management is heavily dependent on single-use products; many of which contain non-biodegradable materials including plastics. These include urinary drainage sheaths and catheters as well as containment products. NHS Inform (2020) estimates that three million to six million people in the UK experience urinary incontinence and that demand for containment products is likely to rise because risk factors for incontinence are increasing. These include advancing age, lifestyle factors, dementia, neurological conditions, complex comorbidities and obesity.

A more sustainable approach to containment product provision currently depends on a reduction in use of single-use products and their substitution with reusable alternatives. There are advantages and disadvantages to both washable (reusable) and single-use products. A ‘mix and match’ approach is key.

For many people, the introduction of washable products may be acceptable. However, some will only be able to manage these in combination with other single-use versions for specific times of the day. Working towards strategies for sustainability in continence care; such as reduce, reuse, recycle – requires a thorough understanding of the lifecycle of products and associated processes. This is the responsibility of us all. This includes product manufacturers, policymakers, purchasing agencies, prescribers, researchers, health professionals and end users.

Environmental sustainability

Both cloth and disposable containment products have environmental impacts. Some of these include: the consumption of natural resources, energy usage, health issues, air and water pollution and waste disposal. However, the damaging impact from cloth containment products is less than that of disposable containment products.

Disposable containment products are usually made with wood pulp, oil and plastics. Cloth products are often made of cotton or other natural fibres. Choosing cloth instead of disposable containment products represents a significant way to reduce oil and tree consumption.

Billions of containment products end up in landfills and an estimated three billion disposable containment products are thrown away every year in the UK. This accounts for 2-3% of all household waste, according to recycling charity WRAP. Methane is released into the air during the decomposition of disposable containment products. This contributes significantly to global warming. Disposable containment products have a negligible recycling rate. The absorbent gels and plastic components found in disposal containment products take up to 500 years to decompose.

For the millions of people who are affected by incontinence, management products are an important part of their lives and ensure dignity, self-esteem and allow them to continue with their usual activities

Introducing Washables Incontinence Underwear

Washable incontinence underwear is largely produced from natural materials such as cotton or bamboo, biodegradable and renewable resources. A pack of seven washables can be used up to 250 times per pair – lasting about two years at very low cost. Therefore, healthcare providers can save significant amounts of money each year and increase sustainability by sensibly switching to washables for the right patients according to a good clinical care pathway.

Washable pants may provide adequate absorbency during the day for some patients who have light to moderate bladder leakage, or those who experience only occasional light leakage (perhaps just after urinating) and want some form of protection “just in case”. They are very good at staying in place and are relatively discreet. They may be the best solution for those who are physically active. Overnight use of washable containment products may be better suited for men and women who sleep on their backs with light leakage. When selecting washable containment products, it is important to consider whether they are the right size, the right absorbency, and whether the patient and/or their carers/relatives can manage them.

Most washable containment underwear for adults is adapted to fit either male or female anatomy. With more padding at the front for men and more padding in the middle for women. There are a diverse range of styles available, ranging from classic briefs to boxers for men and full cut pants through high leg, lace and mid-rise to bikini styles for women. Similarly, for children there are pant and boxer styles available.  

Initial Preparation & Washing:

The garment should be washed once before using. Underwear can be washed in a normal wash cycle without bleach or fabric softener. The garment must be fully dry before it is worn.

In a care home setting, it can be useful to label underwear with indelible ink. It may also be helpful to put the used product into the washing machine in a net bag to ensure easy identification.

To conclude, sustainability is vitally important to us all. The NHS is the first health service in the world to commit to reaching carbon net zero. This is in hopes to address the increasing threat to human health of climate change.  All those with an interest in continence care should be adopting solutions that maintain the dignity, independence and quality of life of patients while reducing the reliance on disposable single-use containment products.

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Incontinence (leakage of wee or poo), difficulties with toilet training, or other issues with toileting can result in difficulties at home, nursery, school or in the wider community. They are a source of stress and frustration for families, not only due to the difficulties of practical management of ‘accidents’, but also because of the impact on your child.  

Children who are struggling with learning the skills required for toilet training, or who have toilet trained but have new or continuing wetting or soiling (urinary or faecal incontinence) are often embarrassed and upset about the problem. However, some children will behave as if they do not care about an issue that they cannot control. This may make you feel the wetting or soiling is deliberate, laziness, or naughty behaviour. This is very rarely the case. Childhood incontinence, or issues such as appearing to leave it to the last minute to go to the toilet, is nearly always caused by a bladder and/or bowel health problem. Most of these can be successfully treated. 

Wetting and/or soiling in children and young people may be associated with emotional problems, difficulties with mental health, poor self-esteem and reduced social opportunities. Furthermore, the additional washing and clothing needed may be expensive. Therefore, it’s important you know where to turn for more help and information.  

In this blog post, we outline what you should be able to expect from the different professionals who may work with you and your children within health or education.  

Nursery

Nurseries should ensure that all children in their care are kept safe and supported to learn and develop according to their individual needs. This includes providing support for bladder and bowel health. 

• It is reasonable to expect nursery to support the needs of your child, as an individual, whilst in their care and review this support regularly.  
• Staff at nursery should be trained in supporting you and your child with learning the skills that they need to be successful with toilet training. You should not be expected to wait until a particular age for this. 
• Healthcare professionals can train nursery staff to complete any procedures your child needs for their bladder or bowel health e.g. catheterisation. 
• If nursery identify a cause for concern, they should discuss this with you and suggest that you contact your local GP or health visitor for further assessment, advice, and support.  

Health visitors

Health visitors are qualified nurses that sit under the umbrella of universal services. This means they should be available to all families with children who have not yet started full time primary school. They work to identify health needs as early as possible and to improve young children’s health. Your health visitor should meet you when your baby is about ten days old. They will see you either at home, in a local child health clinic, or at your GP surgery. 

• Health visitors should be trained in children’s bladder and bowel health and assessment of any possible issues.  
• Health visitors are often the first point of contact for assessment and guidance of your child’s bladder and bowel issues.
• It is reasonable for these health professionals to discuss your child’s bladder and/or bowel issues with their GP. They may also, with your consent, talk to other professionals supporting you with your child e.g. social worker or family support worker or other healthcare professionals.  
• Once they have completed their assessment they will work with you, your child and your child’s GP to provide a plan of care. This may include some treatment or referral for more specialist support. 
• You should be provided with verbal and written information about your child’s bladder or bowel issue and any treatment options.

School nurses

School nurses are trained nurses that are also part of universal services and work with children aged 5 -19 years old. They work in schools and other settings to promote health, identify health needs and offer suggestions to prevent health issues getting worse. They can also refer to other services as required. School should be able to provide you with information about how to contact your school nurse.  

• School nurses should be trained in children’s bladder and bowel health and assessment of any issues. 
• You can contact your child’s school nurse if you have any concerns about your child’s bladder and/or bowel. 
• If your child is at secondary school, they may be able to ask to see the school nurse at a regular ‘drop-in’. They do not have to say why they want to see the school nurse.  
• They should be able to offer initial assessment and suggestions to help. 
• The school nurse may discuss your child’s bladder and/or bowel health with their GP. They may also ask your consent to talk to other professionals who are supporting your child e.g. social worker, family support worker, other healthcare professionals.  
• Once they have completed their assessment they will work with you, your child and  your child’s GP to provide a plan of care. This may include some treatment or referral for more specialist support. 
• You should be provided with verbal and written information about your child’s bladder or bowel issue and any treatment options. 

General Practitioners

General Practitioners (GPs) are doctors who treat common medical conditions and can also refer on for more specialist advice and treatment if this is required.  

• You can contact your GP if you have concerns about any aspect of your child’s bladder and or bowel health. You do not have to have seen a health visitor or school nurse first. 
• Your GP will review any assessments completed by your child’s health visitor or school nurse, if you have already spoken to them, and discuss with treatment options and provide general lifestyle advice to help. 
• It is reasonable to expect that they may wish to complete a face-to-face physical assessment of your child. This may include examining their tummy or asking for a urine or stool sample.   
• Dependent on your child’s condition and/or progress they may refer your child for further assessment and treatment with another health professional in a specialist service. This can be a specialist nurse, therapist or paediatrician. Referrals may take some time as many services are very busy and have long waiting times. 
• You should be provided with verbal and written information about your child’s bladder or bowel issue and any treatment options. 

School or collage

Schools or colleges are often able to identify health concerns in children and young people. They should discuss any such concerns with you and they may also ask the school nurse for support and advice.  

Schools have a duty to support children and young people with medical conditions. There is more information about what you can expect from school if your child has a bladder or bowel issue in the guidance: Managing Bladder and Bowel Issues in Nurseries, Schools and Colleges.

• Professionals in school such as your child’s teachers, teaching assistants, special educational needs coordinator (SENCO) may raise any concerns with you.  
• Education staff may ask for the school nurse to contact you and request consent to assess your child or they may ask you to contact the school nurse or your GP, and, as appropriate, seek further advice from your GP regarding your child’s continence. 
• Schools must make reasonable adjustments to meet your child’s bladder and bowel needs whilst they are in their care. This includes during school trips and sports sessions 
• Schools should provide safe, clean, and accessible toilet facilities for your child. They should allow them access to these as required. 
• Schools should allow children and young people to drink water regularly during the day, to ensure they stay well hydrated.
• It is reasonable to expect that school will discuss a care plan for your child with you and with your child if this is appropriate for their age and development. 
• School may request that other professionals involved in your child’s care contribute to any care plan to ensure that your child’s needs are met, and difficulties addressed promptly. 
• School may request support and training from a specialist team, if they are involved with your child’s care and your child needs support for interventions that need to be carried out in school e.g. catheterisation or stoma care. 
• Schools should be able to make suggestions about where you can get further information and support about your child’s bladder and/or bowel issue.  

Specialist services

Specialist services for children and young people’s bladder and bowel health vary across the UK. Some areas have a nurse-led, community-based children’s bladder and bowel service. Where these are not available your child may be referred to a paediatrician at their local hospital, if it is felt that a specialist service is needed.  

• A specialist service will assess your child’s bladder and bowel health. It is likely this will involve asking lots of questions about their general health and usual bladder and bowel habits. You may be asked to complete some forms that include information about their drinking and toileting patterns.  
• The service should explain what they think is causing any bladder and/or bowel issues and may provide written information about this and any treatment suggestions. 
• The specialist service may make suggestions about drinking and toileting routines and other lifestyle adjustments that may help. They may also recommend other treatments. 
• The service should offer regular reviews and treatment adjustments after discussion with you and your child (depending on their age and level of understanding) until the bladder and/or bowel issue has resolved.  
• Some children may require onward referral for further investigations and treatment options. Reasons why this may be recommended should be discussed with you and your child if required.  

Further information

There is more information about children’s bladder and bowel health and problems on the Bladder & Bowel UK website.

The post Who can help me if I am concerned about my child’s bladder and/or bowel health?  appeared first on Bladder & Bowel UK.

Incontinence is a very common condition. In fact, urinary incontinence is said to affect approximately 14 million people in the UK alone, while nearly half a million people are estimated to experience some form of bowel incontinence. 

However, despite these high figures, many people who struggle with incontinence can be reluctant to talk about it. This can be for all sorts of reasons, such as embarrassment or generational differences. At the same time, family members may find it hard to broach the subject as well, either due to the nature of their relationship or a lack of knowledge about the condition. 

But talking about incontinence is an important step towards getting your loved one the help they need, and preventing them from suffering in silence.  

In this blog post, we’ll provide you with some practical tips on how to approach a family member you believe may have incontinence with sensitivity and a positive mindset. We’ll also outline the steps you can take to help your loved one manage their condition. 

Conversation tips 

While incontinence may be a tough subject to talk about, if you believe your family member is experiencing incontinence, having that difficult conversation can make a huge difference to their overall wellbeing. It can feel tricky to start the conversation so you might want to try using an article, leaflet or advert as a prompt for the initial chat. 

Acknowledging that it’s an awkward topic can make the conversation a little easier for those who don’t like talking about bathroom habits. 

Remind them that incontinence is a very common problem and that there is plenty of help available. 

Another important aspect when talking about incontinence is to mirror the language your family member uses. For instance, if they refer to it as ’pee’ instead of ’urine’, match the terminology they use.  

Using language that is too formal could also make your conversation feel too clinical if your family member doesn’t usually talk in that way.   

It can also help to start the conversation side by side rather than face to face, for example, while out on a walk or in the car. Being side by side stops the conversation feeling like an interrogation and your family member may be more comfortable opening up. 

What is needed for a positive conversation? 

Making the conversation about incontinence a positive one gets you both off to a good start. Don’t rush the conversation and make sure to talk to them when you know you won’t be interrupted. It’s important to give the conversation the time and attention it needs. 

It’s also important for your loved one to feel relaxed, in control and free from judgement during your conversation. So, try not to talk about their situation with other people without their consent. Even though it may be coming from a place of love and concern, if your loved one found out, it could make them feel embarrassed or reluctant to talk about it at all.  

It can be useful to explain to your family member that incontinence is just like any other health problem, and encourage them to talk about it with their loved ones even if they feel embarrassed.

To ensure the conversation stays positive, maintain a sense of dignity and privacy throughout and respect their decisions. Keep the conversation confidential but let them know the door is always open if they want to discuss it further. 

Next steps 

Knowing what to do next is important for both you and your family member. This way, the conversation will be seen as productive and help promote their independence. One of the most important first steps they can take is to see a healthcare professional to rule out any potential underlying health conditions. 

Let your family member know there is a lot that can be done to help with incontinence. Even something as simple as assisting them when booking an appointment with the doctor can be enough for them to regain some confidence and control over their health.  

Arming yourself with information about incontinence before you have a conversation with your family member can also help you support them in making an informed decision. By ensuring they have more knowledge of their condition, they may feel confident enough to speak with you and a healthcare professional further.  

Helping them choose the right incontinence product can also be a big help. With so many options available, your loved one may feel overwhelmed. But by sharing the job between the two of you, they will feel supported and more secure in their decision. 

Visit Bowel & Bladder UK for printable resources which you can offer to your family member. They could read them in their own time and then talk with you about it afterwards.  

With different resources, you can provide them with a range of options and methods of support. Whether it’s their GP, a continence nurse, Bowel & Bladder UK or elsewhere, with the right help, your family member can feel confident in their incontinence management.

The post How to talk to a family member about incontinence appeared first on Bladder & Bowel UK.

Incontinence is a common issue that can affect people of all ages. But incontinence doesn’t affect everyone and is not an inevitability of ageing.  

There are also varying degrees of the condition, with some people only experiencing small leaks now and then, while others can lose control of their bladder or bowel completely if unable to reach a bathroom in time. 

In this article, we discuss the signs of incontinence across all age ranges. We also provide you with practical tips on how to support family members with incontinence and some of the best preventative measures that can be used to help.  

Signs to look out for in people of all ages

A lot of people will often feel embarrassed about their incontinence, and it is common for people of all ages dealing with incontinence to hide the fact there is a problem at all. 

When this happens, your loved one won’t receive the help and support they need to manage their condition, which can worsen their condition and lead to increased feelings of anxiety and isolation.  

If you discover one of your family members is dealing with incontinence, it’s normal to feel stressed about the situation – especially if you’re going to be caring for them. It’s important your family member doesn’t feel ‘caught out’ or as though there is something to feel ashamed of.  

People with incontinence deserve the same dignity and respect as those without the condition, so knowing how to support them during such a challenging time is essential.  

Some of the key signs of incontinence – to look out for in people of all ages – can include:  

• Choosing different drinks – for example, drinking decaffeinated drinks instead 
• Stopping drinking after a certain time of day 
• Hiding incontinence products  
• Being secretive about going to the bathroom 
• A smell on their person or in their home 
• A strong scent of cleaning products in the bathroom on a regular basis 
• Personal hygiene issues 
• Staining of their underwear 
• Frequent changing or washing of clothes 
• Buying toilet rolls more often due to increased use 
• Finding tissue in their underwear or washing machine 
• Avoiding social situations 
• New changes to their diet 
• Carrying spare clothes whenever they leave the house 
• Going to the toilet more frequently 
• Needing to get to the bathroom quickly 
• Staying in the bathroom for longer than usual 
• Using sanitary pads 
• Wearing more than one pair of underwear 
• Changes in their mood 
• Finding laxatives in their home that weren’t there before 

If you spot any of these signs, it’s important to speak with your family member in a way that displays empathy, sensitivity and understanding.  

Try to have possible solutions and support in mind before having the conversation. That way, you can help give your loved one hope and ensure they feel fully supported.

Incontinence in children

Children can also experience incontinence. Although you might think it’s easier to spot, children are still good at hiding things they are embarrassed about.  

Here are some signs that a child might need help with their incontinence: 

• Finding wet or soiled underwear 
• Denying wetting or soiling themselves despite their underwear or bedding being wet or soiled 
• Needing to use the toilet more often  
• Often needing to go at the last minute  
• Withholding (standing or sitting in different positions, such as with their legs crossed, to prevent accidents) 
• Avoiding social situations, especially ones like sleepovers or school trips  
• Excessive use of sanitary products  
• Needing to leave the classroom a lot to use the bathroom 
• Trying to avoid going to school – such as claiming to be unwell or becoming angry in the mornings or Sunday evenings

It’s worth remembering that bullying and mental health problems can be linked to incontinence in children. Sometimes changes in behaviour can be misconstrued as ‘naughtiness’. However this isn’t the case; incontinence can not only cause feelings of shame in children but also cause them to behave in ways that they feel will be most helpful to manage the wetting or soiling.

What to do next

If you think a family member or someone close to you is struggling with incontinence, it’s important to talk to them about it from a place of understanding and sincerity. Try to encourage them to speak with a healthcare professional as well so that they can get the support they need.  

If they are embarrassed about the situation, you could even offer to assist them when talking to the healthcare professional. 

In our article, How to talk to a family member about incontinence, we provide further tips and information on how best to approach this difficult subject, such as finding out more information and researching different incontinence products to help them manage the incontinence while they wait for assessment and treatment.  

Doing your own research, for example, can help ease the pressure on your family member’s shoulders. By providing them with options you can help them feel less overwhelmed and ensure they are on the way to getting the right support for them.

Bladder & Bowel UK is a registered charity that has multiple resources to help loved ones support and spot signs of incontinence in both adults and children. They also have a confidential helpline where you can receive specialist continence advice. 

Finding support for both you and your loved one is important when dealing with incontinence. Whether you help them speak to a healthcare professional or find the right incontinence product, showing that you’re there for them can make a big difference. 

The post Signs a family member may need help with incontinence appeared first on Bladder & Bowel UK.

Incontinence can have a serious impact on wellbeing for the person experiencing the issue. What is less often talked about is how hard it can be to support someone suffering with incontinence. 

In fact, we know that in some serious situations, difficulties with managing incontinence can contribute to families making the tough decision to move loved ones to supported housing or care homes.  

Struggling with bladder and/or bowel control can create feelings of isolation, but it is important to know you are not alone if you, or someone you know, are affected. Silence around the issue can be a barrier to getting the help you and your loved one needs, which is why it’s important to shine a light on the issue. 

In this article, we look at the different ways incontinence can impact anyone giving support, including family members and friends, and why it is such an important issue. 

Difficulties for caregivers 

If someone we care about is struggling with incontinence, it is normal to want to help them. However, it’s realistic to acknowledge how difficult this can sometimes be.

Challenges in communication, or wanting a reluctant family member to seek medical help, can cause strain in relationships. Supporting with intimate care, including helping an individual change, use the toilet or washing wet or soiled clothing, may cause physical or emotional strain and impact the caregiver’s own well-being or mental health.

Emotional impact of incontinence

Not only can incontinence be distressing for the individual, causing embarrassment, frustration, or anxiety, practical support may be required from family members which can be difficult to accept. This can lead to a decline in self-esteem, a reluctance to engage in social activities and cause difficulties with mental health. If it is happening during the night, it can also affect sleep, which has an impact on daytime functioning and mood for both the individual and those caring for them.

Family members may experience stress and worry about their loved one’s well-being. They may also feel a sense of responsibility and frustration that impacts their own psychological and emotional wellbeing, mental health and feelings of struggling to cope. Adjusting to a new role of carer, particularly when this involves supporting with intimate care tasks, may be difficult.

Financial impact of incontinence 

Money worries can worsen stress when supporting someone struggling with their bladder and/or bowel.  

There is a financial cost to disposable continence products (pads), as well as for toileting aids, additional clothing and washing. There can also be increased expenses related to medical care, such as travel to appointments for assessment and treatment, and the cost of medications that may be recommended to help. Some people may require home modifications to make their living environment more accessible. Some family carers may have to also give up work or reduce their hours to provide required support, adding to financial strain.

Social isolation

Incontinence may impact a person’s confidence to develop new friendships or relationships, or continue existing ones. Fear of leakage, odour, embarrassment, or a lack of accessible toilets in the community may result in the person with incontinence withdrawing from social activities. It may also limit or deter participation in previously enjoyed activities that may exacerbate the incontinence, such as high impact sports, distance running, remote camping, or long country walks. All of these, together with the time it takes to provide practical support, can also impact their life partner or family members.  

Family members might be hesitant to engage in activities that could be challenging for the person with incontinence, or that they previously enjoyed together. Being unable to leave their loved one, or becoming too tired or emotionally drained to continue with their usual activities will also worsen the situation. 

Changes in daily routine

Those providing care may need to adapt their schedules and routines to accommodate an individual who is living with incontinence. This may include assisting with regular bathroom visits, including at night, helping with personal hygiene, changing of pads and being mindful of the availability of suitable toilets in public spaces. These may impact their ability to work, enjoy leisure and maintain social activities and friendships. 

There may be additional washing and cleaning as well as anxiety about controlling odour, avoiding damage to furniture and managing if car seats or wheelchairs need to be cleaned and dried.  

Communication challenges

The misconception that incontinence is always inevitable, along with taboos surrounding bladder and bowel issues, make it difficult to discuss incontinence or know how to access help. These can reinforce feelings of isolation and make it difficult for family members to offer support, search for solutions or improved management options.  

While open communication is key, discussing incontinence can be a sensitive topic that requires empathy and understanding. Challenges may be compounded when there are gender issues, such as a son talking to his mother, or a father to their teenage daughter, or where to do so would breach cultural norms. 

To address these difficulties, it is crucial for the family member to foster open communication, encourage and support those that they care for to ask healthcare professionals for support, and explore available resources. Community support can also be valuable, and connecting with others facing similar challenges can be beneficial for both the individual suffering from incontinence and their caregivers. Seeking medical advice and implementing recommended practical strategies for managing incontinence, can help mitigate the impact on both the individual and the family. Additionally, support groups and counselling may be beneficial for the emotional wellbeing of both the person with incontinence and their caregivers. 

The post Supporting someone with incontinence: Shining a light on the impact on families   appeared first on Bladder & Bowel UK.

Definition of sustainability: using resources responsibly so they are available for future generations, while doing as little harm to the environment as possible.

Urinary incontinence is a common problem, thought by the NHS to affect millions of people. If you or someone you care for has a continence problem, it’s important to see a medical professional as there are lots of options which can improve or eliminate the problem. However, this isn’t always possible, so whether we’re talking about the short or long term, using the correct products for incontinence management is vital for physical health, independence, and quality of life. 

So how can we combine greater awareness of sustainability with proper management of the condition?

Disposable products are the norm

‘Sustainable healthcare is a major goal both worldwide and for the NHS, where single-use products are a key contributor to plastic waste.”

Sustainable Development Unit, 2020 (UK Government Body)

Making incontinence products more sustainable

A more sustainable approach to incontinence management includes reducing the amount of single-use products, recycling, and finding longer lasting, multi-use alternatives.  Thankfully, there is innovation happening within this area.

Multi-use options include: 

•  Washable incontinence underwear: these can be washed and re-worn multiple times. 
•  Female bladder support devices: they are inserted into the vagina to support the bladder neck and can reused.  
•  Male urethral control devices: these are wrapped around the penile shaft to restrict urine flow.  
•  Male body worn urinal: they have an inner receptacle lining that drains urine from the penis and direct-connect leg collection bag. 

These options are more sustainable because they result in fewer products being thrown away and fewer products being produced in the first place. They can also be more cost-effective than the disposable products.  

Hygiene, comfort, and quality of life 

For people with continence difficulties, hygiene, comfort and quality of life are the priorities.

Appropriate use of the right product for the right person reduces the likelihood of skin irritation, dermatitis, rashes, skin infections and moisture lesions. It is also important to consider effective containment, lifestyle, maximising independence and personal preference.

Pros & cons of disposable pads 

• Disposable, single-use pads usually need to be changed several times during the day, when the pad reaches its absorbency capacity (some have a wetness indicator to guide changing), or is soiled.  This has a time and cost implication.  

• Disposable pads are often designed to reduce odour and lock urine and moisture away from the skin. Some new generation products have devices that alert an app when the product needs to be changed.  

• They come in many sizes and designs, meaning that there should be a product available for all levels of incontinence and different body shapes.  

• They are widely available.

• They are non-recyclable for hygiene reasons and are often made with non-biodegradable materials. 

Pros & cons of washable products  

• Washable products usually require a larger initial financial outlay.   

• They require individuals to have access to a washing machine, and appropriate facilities to dry them, such as a tumble drier, well-ventilated house, or access to outside drying.  This can be time consuming for the individual or their carers. 

• They have a reduced carbon footprint thanks to their multi-use nature: less production, and less waste. 

• New innovation means that a wider range of washable products are available. Like disposables they come in a range of sizes, designs and absorbencies which are discrete and effective.

• Washable products may be worn throughout the day and night, like disposable products. 

Most washable products are made from soft natural fibres, so are comfortable. 

Support to make the right decision

For the millions of people who are affected by incontinence, management products are an important part of their lives and ensure dignity, self-esteem and allow them to continue with their usual activities. 

There are lots of things to consider when deciding on the best option for anyone managing a continence issue. It is important to be aware that treatment is possible for many conditions.  Where this is not an option, or is not immediately possible, it is helpful to know that there are other products than just the disposable pad that has been available for many years. Happily, research and development continues to explore innovative and increasingly sustainable alternatives. 

Your healthcare professional can provide more advice, information and support

This article is part of the Education Spotlight on Urinary Incontinence, supported by iMedicare. You can also read more about constipation in our information library here.

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Because urinary incontinence (UI) is rarely talked about openly, there is a lot of misunderstanding around the issue. Therefore, whether someone is dealing with short term, long term or permanent incontinence, they might experience difficulties socially and psychologically. This article discusses the experience of stigma amongst people suffering from urinary incontinence, to create greater understanding and empathy around this common medical condition.

Stigma and UI: the basics

Definition of stigma: feelings of disapproval that people have about particular illnesses or ways of behaving.

Men, women and children can experience urinary incontinence and associated stigmas. Causes in adults can include stroke, some cancers, neurological conditions, dementia, obesity, presence of lower urinary tract symptoms and decreased mobility. Women are generally reported as having a higher prevalence of urinary incontinence, due to different anatomies and causes of urinary incontinence, and additional causes can include childbirth and menopause. It is also common for men to experience urinary incontinence following a prostatectomy, with rates increasing from 5% to 60% prevalence among this group.

Stigmatisation is a process of exclusion. When an issue, such as incontinence, is stigmatised, this leads to two groups existing: those who do have the trait, and those who don’t. Stigma can have a big impact on a person’s self-identity, and it is now well understood to have a serious negative effect on physical and mental health.

Why might UI be stigmatised more than other conditions?

We are brought up to understand from an early age that passing urine and faeces (wee and poo) should be done in private, and in a tidy way. Incontinence can rupture this social norm. Many people affected by urinary incontinence fear associations of uncleanliness, sexual impotence, or being ‘an outsider’ socially. They may fear being perceived – or may perceive themselves – as weak, dependent, or doddery. They may be embarrassed or ashamed.

Research has shown that the stigma of urinary symptoms is tied to how far the problem is perceptible – whether visually (such as marks on clothing or visible products), due to odour (such as the smell of urine in the home or on somebody themselves), or behaviourally (such as avoiding activities, or needing to make frequent trips to the bathroom). If someone has an ‘accident’ or is not able to contain their incontinence, they may be distraught and worried about what others might be thinking. This is an understandable response, but it’s important to bear in mind that urinary incontinence is a medial condition that should be treated with empathy.

The stigma of incontinence is a serious issue. Stigma creates stress, and then worsens people’s ability to deal with the stressful situation. It can lead people to stop living their normal lives, leaving the house, and going about their day-to-day activities, causing them to become isolated and withdrawn. This might mean they are less active, in turn causing greater physical and mental health issues. It can also remove people from their social support networks, cutting them off from people who can help.

Crucially, the shame felt as a result of bladder and bowel health problems, including urinary incontinence, can be a barrier to treatment. People might deny or conceal their condition, and put off seeing a doctor, especially if the matter is concealed from even close family and friends. This delays timely treatment which might lead to a cure. Remember, there are lots of management and treatment options out there. Without medical advice and help, a potentially resolvable problem can stay untreated.

Stigma has a strong link to mental health concerns, such as reduced self-esteem, increased anxiety and depression, and can affect relationships, employment and overall life stability. Many people with incontinence symptoms report feelings of powerlessness, and feel a lack of agency over their own body. If you are struggling with your mental health as a result of urinary incontinence, it is important to speak to your doctor, or reach out to a mental health organisation, such as a local NHS service, or Mind.

“Crucially, the shame felt as a result of bladder and bowel health problems, including urinary incontinence, can be a barrier to treatment.”

What can be done to reduce people’s exposure to stigma?

New treatment and management options have been developed to provide a broader range of choices to people. These can lead to rehabilitation or better management of incontinence, meaning reduced exposure to stigma, and improved quality of life. Urinary incontinence is common but every patient’s position is unique. The good news is that product innovation continues, leading to a wider range of available products to help people best manage their particular condition.

Just as stigma can cause an obstacle to treatment and management, effective treatment and management can help people regain feelings of agency, and get their self-identity back. This is why seeking help from medical professionals and experts in incontinence products is important.

Ultimately, people dealing with continence issues do not need to suffer in silence. All health concerns deserve to be treated with respect, and the right to comfort and dignity are human rights.  There are a greater number people who are affected by incontinence than you would think, and there are organisations and professionals who can provide support and guidance for improved quality of life.

This article is part of the Education Spotlight on Urinary Incontinence, supported by iMedicare. You can also read more about constipation in our information library here.

The post Understanding the stigma of urinary incontinence appeared first on Bladder & Bowel UK.

Stress urinary incontinence is when you leak from your bladder when coughing, sneezing, laughing, running or jumping, for example. Usually only a small amount of urine is passed. It occurs when the pelvic floor muscles around your bladder and anus (back passage) become weak or stretched.

What causes stress incontinence?

Stress urinary incontinence can happen at any age. It is caused by a weak sphincter (a muscle at the bladder outlet), or by poor support to the bladder outlet from the pelvic floor muscles and ligaments.

This usually happens because the muscles of the pelvic floor are weak or damaged. Pelvic floor muscles may become weakened by pregnancy, childbirth, and delivery, straining to empty the bowel, repeated heavy lifting, menopausal changes, long term coughing, constipation and being overweight, lack of general fitness and high impact sports.

What are the pelvic floor muscles?

The pelvic floor is made up of layers of muscles, stretching like a hammock from your pubic bone to the bottom of your backbone. These muscles help to hold your bladder and bowel in position, as well as the uterus (womb) in women. They prevent leakage from your bladder and bowel, only relaxing when your bladder or bowel is emptying.

What can I do myself to help with stress urinary incontinence?

You can help yourself by making some lifestyle changes in order to reduce pressure on your bladder and pelvic floor muscles.

• Exercise regularly, including pelvic floor muscle exercises. Avoid exercises that increase the pressure on your abdomen such as high impact aerobics, jogging/running.
• Avoid smoking, which can aggravate bladder weakness through coughing.
• Avoid gaining excess weight. If you are overweight, a weight loss diet might help your incontinence.
• Drinking plenty of fluid each day, typically 1.5-2 litres (6 – 8 large cups or glasses, unless otherwise medically directed ). Drinks containing alcohol or caffeine, for example tea, coffee, or sugary fizzy and energy drinks may irritate your bladder and should be avoided. You can have drinks that do not contain caffeine, such as decaffeinated tea or coffee.
• Limit the amount of caffeine and alcohol you drink to prevent bladder irritation and avoid increased urine production.
• Trying not to become constipated by eating a healthy diet with plenty of fruit and vegetables
• Doing pelvic floor exercises. These can improve your muscle tone (strength), your continence and quality of life. Your health care professional will explain these exercises.
• Seeking medical advice if you have a long-term cough

All of these can also be discussed when you attend your consultation with the doctor, physiotherapist or nurse specialist. They will be able to advise and support you make these changes.

When should I seek further treatment for stress incontinence?

Although you may feel embarrassed talking to someone about your symptoms, we would encourage you to have a chat with your GP if you have any type of urinary incontinence. They are used to having these conversations and you should be encouraged to know that this can be the first step towards finding a way to effectively manage the problem.

Many people wrongly think that incontinence is a normal part of ageing, or that it cannot be treated. We would recommend seeking further advice who can assess and guide on treatment and management.

Will I need any tests?

These are some initial tests that you may have as part of your assessment:

• Urinalysis: This test usesa sample of urine to find out if there is any infection or any blood in the urine.
• Bladder diary: You will be given a chart (bladder diary) so that you can keep a record of the amount of fluid you drink and the amount of urine you pass, for a 3 day period. You can also record other information on the chart such as incontinence. ( link to our diary )
• Bladder scan: This is to find out if there is any urine left in your bladder after you have passed urine. The nurse will check the residual urine using an ultrasound machine to scan the bladder.
•  Physical examination: Your health care professional may need to undertake a physical examination to make a further assessment, for example a pelvic/vaginal, rectal or prostate examination.

Some further tests may be required if the cause of your urinary incontinence is not clear. Your health care professional will usually start treating you first and may suggest these tests if treatment is not effective.

Pelvic floor exercises

These are exercises that improve and strengthen the pelvic floor muscles. It is important that you are shown how to do these correctly and you will be referred to the physiotherapist or specialist nurse for this treatment. They will assess your pelvic floor muscle strength and then advise an individual programme of exercises for you to follow.

Are there any other treatments?

If pelvic floor exercises and conservative options do not help, your health care professional will discuss further treatments, for example, you may benefit from a referral to a Bladder and Bowel specialist nurse, physiotherapist or a doctor who specialises in urinary incontinence.

Further treatments can include medication (tablets), nerve stimulation, physiotherapy or surgery.

Download this information as a leaflet (PDF)

This article is part of the Education Spotlight on Urinary Incontinence, supported by iMedicare. You can also read more about constipation in our information library here.

The post What you need to know about stress incontinence appeared first on Bladder & Bowel UK.