As you grow older, problems with losing control of your bladder and bowel can increase. This involuntary loss of control is known as 'incontinence'.
Many people feel embarrassed or ashamed to talk about these problems. But if you experience incontinence, it is important to remember that you are not alone. According to the Continence Foundation of Australia, almost 4.8 million Australians are affected by incontinence.
Whether you're living in your own home or in an aged care home, there are services that can help.
What is incontinence?
There are two types of incontinence:
- involuntary loss of bladder control (urinary incontinence)
- involuntary loss of bowel control (faecal incontinence).
Urinary incontinence is a common condition that has many causes and includes four main types:
- stress incontinence – leaking of small amounts of urine from the bladder
- urge incontinence – loss of urine associated with a sudden and strong need to empty your bladder
- overflow incontinence – leaking of small amounts of urine from the bladder as a result of the bladder not emptying properly
- functional incontinence – when physical or cognitive problems prevent you from getting to the toilet on time to empty your bladder.
Faecal incontinence is more common as you grow older. This type of incontinence is sometimes referred to as anal incontinence and includes involuntary loss of flatus or 'wind'.
There are many causes for urinary and faecal incontinence and help is available to manage both conditions.
Visit the Bladder Bowel website to read more about incontinence. In many cases, incontinence can be managed or cured.
Who can help?
If you have problems with bladder or bowel control, it is a good idea to speak to your doctor.
Your doctor may be able to suggest different treatments, review and prescribe medication, order clinical tests and refer you to a specialist, continence nurse adviser or continence physiotherapist, if needed.
When you're visiting your doctor it may help to take along information such as:
- how often the incontinence occurs
- whether it's urinary or faecal incontinence
- when it started
- times of the day when the incontinence is worse
- whether there's complete saturation or just a small amount of urine or faeces
- whether you have had a fever or found it painful to go to the toilet
- what medication you're taking, if any.
Pharmacists may also be able to provide advice on incontinence products that are available for purchase, as well as direct you towards local clinics.
Continence services and clinics
These are specialist services where you can obtain a full assessment of your bladder or bowel problems. These services usually have a continence nurse adviser or continence physiotherapist who can advise you as to possible management options.
National Continence Helpline
Qualified continence nurse advisers can give you confidential, expert advice through to the National Continence Helpline. You can also ask about continence products, federal and state government subsidy schemes and printed information resources about incontinence that they can post you. The Helpline can also give you information about your local continence service or clinic.
Phone the National Continence Helpline on 1800 330 066.
Continence subsidy schemes
Visit the Australian Government Bladder Bowel website for information on the Continence Aids Payment Scheme or call the National Continence Helpline.
Different schemes are available in each state and territory to help with continence aids and appliances. Each scheme has its own rules for eligibility and a financial limit on the amount of supplies provided. Visit the Continence Foundation of Australia website for more information.
What about dementia and incontinence?
People with dementia often find it particularly difficult to recognise the need to go to the toilet. Or, they have difficulties finding, recognising or using the toilet properly.
It can be stressful and challenging for carers to manage these problems while still respecting the privacy and dignity of the person with dementia. Some tips that may help include:
- observing patterns of when the person empties their bladder and bowel and using this pattern to remind them, at regular intervals, to go to the toilet
- watching for non-verbal clues such as pulling on clothes and agitation and using short, simple words to suggest the person goes to the toilet
- making sure the person's bed isn't too high, the toilet paper can be easily seen and the toilet is clearly marked
- using aids such as grab rails to help the person get on and off the toilet
- simplifying clothing with elastic and Velcro waistbands
- using pads and protecting garments
- avoiding constipation by offering enough fluids, offering a high fibre diet and encouraging the person to undertake physical activity regularly
- limiting caffeine drinks.
Resources and support
There are a number of useful online resources that provide more information about incontinence and the help that is available including:
- Bladder Bowel website – an Australian Government website that provides information on the prevention, management and treatment of bladder and bowel problems, as well as the Continence Aids Payment Scheme
- Continence Foundation of Australia – the national peak body promoting bladder and bowel health.
- National Public Toilet Map – shows the location of more than 16,000 public and private toilet facilities across Australia.
Carers may also like to read more about caring for someone with incontinence.