This week is World Continence Week 2023, an annual initiative run by the World Federation of Incontinence and Pelvic Problems (WFIPP) to break the stigma surrounding bowel and bladder issues and offer a discussion into best practice and care among individuals and professionals. There can often be misconceptions made regarding dementia and continence issues, the National Institute for Health and Care Research (NIHC) highlight the importance of high quality and personalised care for people living with both dementia and continence issues.
Dementia and Continence
Statistics suggest that of those with Alzheimer’s, one of the most common forms of dementia, between 60% – 70% can develop incontinence issues. This is not to be considered a normal part of the ageing or dementia progression, and discussions with a GP or medical professional can be made to develop either a treatment plan or to rule out any other ailments that could be causing incontinence issues. Common causes of continence issues regarding cases of dementia can be urinary tract infections (UTIs), problems with certain kinds of medication or pre-existing conditions, prostate issues in men and constipation due to poor diet or hydration issues.
Changes in a person’s brain because of dementia can cause interference signals being passed between the brain and bladder and/or bowel that can lead to incontinence issues. This can include but is not limited to delays in reaction to the sensation of needing to go to the bathroom, mobility issues, declining help due to embarrassment, not being able to understand prompts to go to the bathroom among more. This can be embarrassing for a person with incontinence and dementia to discuss with family that can also lead to a delay in treatment. Recognising the signs and symptoms early on and booking an appointment with the GP can result in early management, advice and treatment.
It is important to remember that continence problems can impact a person emotionally, as well as physically and continence issues can be particularly distressing for a person living with dementia. Embarrassment can often lead to a delay in diagnosis and treatment, but it is important to remember that you are not alone. It is important for caregivers to remain calm, firm, patient and gentle when dealing with continence problems. Some suggestions for dealing with bowel and/or bladder issues and dementia are:
Communication
Communication: watch for non-verbal cues that a person with dementia may need to use the bathroom, such as pulling at clothing. Use short and simple communication and familiar language, reassure the person and do not rush them and provide step-by-step instructions.
Clothing: consideration to clothing that may be easier to remove and put back on, such as elasticated waistbands. Protective clothing and disposable pads can also be implemented if applicable.
Bathroom Aids
Bathroom aids: floors should ideally be kept clear to prevent trips and falls, aids such as raised toilet seats or wall mounted bars can also be considered if applicable to make toileting easier for a person.
Skin care: ensure skin is washed and cleaned in the event of an accident and is then kept clean and dry to prevent rash.
Environment
Environment: Any environmental factors that can make using the bathroom as simple as possible for a person with dementia. This can include distance to the bathroom, poor lighting, keeping the door open when not in use and removing locks, lack of privacy, lack of contrasting colours between the bathroom floor, toilet seat and seats/beds being too high for a person to get out of, among many more.
Swansea Services & Beyond
In Swansea, the SBUHB has the Community Healthy Bowel and Bladder Service. They’re run by a team of specialists and professionals that can offer confidential help, advice and support with any concerns with bowel and/or bladder problems that have experience in the assessment, treatment and management of contingence problems. You can self-refer to this service by contacting the team on 01792 532424 or via email on SBU.CommunityHealthyBladderandBowelService@wales.nhs.uk.
Alternatively, your GP, district nurse, hospital nurse or another health and social care professional can make this referral on your behalf.
The Healthy Bowel and Bladder Service is offering drop-in sessions for continence week, one of which will be at the Dementia Hwb on Wednesday 21st June 2023 between 11am and 3pm. Attached below is a complete list of all the drop-in sessions available this week if you are unable to make it to the Dementia Hwb.
The Community Healthy Bladder and Bowel Team will be available at the following locations during world continence week
Monday 19th June
Gorseinon Hospital – Main reception
09:00-12:00
Brynhyfryd Medical Centre – Brynhyfryd
13:00-16:00
Tuesday 20th June
Frederick Place Surgery – Llansamlet
09:00-12:00 – 13:00-16:00
Wednesday 21st June
Swansea Dementia Hwb – The Quadrant Shopping Centre
11:00-15:00
Thursday 22nd June
Simply Gym – Gorseinon
09:00-12:00
Simply Gym – Llansamlet
13:00-16:00
Friday 23rd June
Port Talbot resource centre
09:00-13:00
There are a number of helpful organisations that provide more information on continence:
For information regarding webinars and how to get involved with World Continence Week 2023, please visit: World Continence Week 2023 – WFIPP.org
Bladder and Bowel Community are a charity that strive to end the stigma and taboo among bladder and bowel related conditions by raising awareness and helping people. They provide a number of different kinds of support, such as wellbeing support, a carer support page and advice regarding incontinence. They can be found here: Supporting Your Bladder & Bowel Health | Bladder & Bowel Community (bladderandbowel.org)
Bladder & Bowel UK (bbuk.org.uk) offers a confidential national helpline with specialist nurses and continence product experts that can offer advice, signposting to local services and continence management. They can be contacted on 0161 214 4591.
Community Healthy Bladder and Bowel Service – Swansea Bay University Health Board (nhs.wales) are a team of medical professionals within Swansea that can offer help, advice and support regarding bladder and/or bowel problems. This link offers more information on the healthy bowel and bladder assessment, referrals, helpful links and information among more.
Continence Product Advisor are an independent, evidence-based not for profit organisation that can aid with the selection of continence products.
Products such as a RADAR Key or Toilet Cards are available for people with bowel and/or bladder problems that allow access to accessible bathrooms as well as ones not used by members of the public. Please note, Toilet Cards are available through different organisations and prices may vary and there is currently no guarantee they will work everywhere.
If you miss the pop-up at the Dementia Hwb this week, there is still lots of information on continence that you can pick up any time, or speak to someone over the phone about. The Hwb opening times are 11am – 3pm every day, with the telephone number being 01792 304519. You can also contact us via email on support@dementiafriendlyswansea.org