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Incontinence in Care Homes: Impact on Residents and Staff

Introduction

Adult incontinence is a common issue that affects hundreds of millions of people every day [1]  —ranging from occasional leakage to complete loss of control. It is a condition that is heavily stigmatized despite being so prevalent, especially amongst older adults.

Incontinence is also the leading cause of admission to nursing homes [2]  . It can be brought on by a number of factors, including cognitive impairment (e.g. dementia), a weakening of the pelvic floor muscles or a change in diet.

Unfortunately, in many countries, the “quality of continence care in institutional settings is not consistent with recommended prevention and treatment guidelines and falls far below the public’s expectations.” ( Ostaszkiewicz J et al. ), indicating there is significant room for improvement. This can be accomplished in various ways—such as staff training, addressing underlying causes and using high-quality incontinence products—which we will explore throughout this article.

 

1. Prevalence of Incontinence in Care Homes

It is estimated that 50-70% of care home residents are affected by some form of incontinence (urinary and/or fecal), requiring a lot of care and attention from caregivers [3] .

Why are these rates so high in institutional settings? As mentioned above, besides being the leading cause for institutionalization, there are a few factors that can contribute to this phenomenon, including:

  • Age-related changes
  • Chronic illnesses
  • Cognitive decline
  • Sedentary lifestyle
  • Diet changes
  • Medication side-effects

By identifying any potential underlying causes and addressing them, the severity of incontinence episodes can be reduced, lowering the strain on staffing and supplies.

2. Emotional and Psychological Impact

Despite its prevalence, m any residents are afraid to discuss their incontinence openly due to feelings of embarrassment, shame, and fear of losing dignity. This can cause them to withdraw from social activities, putting them at an increased risk of isolation and developing depression or anxiety.

With this in mind, it is crucial for staff to be trained on how to approach the topic, and how to discuss it with residents when brought up—without stigmatizing or shaming them. A proactive approach can be highly effective due to residents’ hesitation to talk about it themselves.

3. Physical Health Consequences

 Beyond the psychological impact incontinence can have on residents, the physical health consequences cannot be ignored. One of the most common incontinence care solutions is absorbent pads or pants. However, cheaper products often lack breathability—trapping excess moisture—or contain harmful chemicals and materials.

 This can result in skin irritation, referred to as incontinence-associated dermatitis (IAD). IAD can lead to higher chances of developing pressure ulcers, disrupt daytime and nighttime routines, deteriorate quality of life and increase care costs for care homes due to additional dependence on staff.

This is why high-quality pads and pants  are a crucial component of holistic incontinence care. They can help residents gain independence thanks to superior breathability, comfort and absorbency. This means fewer changes needed, more uninterrupted sleep time and a lower chance of skin irritation.

4. The Role of Staff Training and Systems

Studies have demonstrated the effectiveness of incontinence-related training in improving the quality of care and attitudes towards incontinence. Individualized care plans that increase residents’ activity levels, improve their nutritional status, hydration, and opportunities to use the toilet can have a significant impact on quality of life and incontinence severity [4] .

Registered nurses and nursing home leaders have a vital role in creating a therapeutic environment that facilitates continence, so another important factor to consider is the staff-to-resident ratio. In an effort to cut costs, many care homes run a tight ship when it comes to staffing, which can lead to poorer care and burnout. Conversely, care homes with a higher ratio of nurses to residents have been shown to have a better continence status [5]  amongst residents.

Given the high number of residents diagnosed with dementia in nursing homes, it is also highly beneficial to train staff on the prevention and management of incontinence in people with dementia.

Holistic Incontinence Care

In this article, we have covered the various components of holistic incontinence care in nursing homes, comprised of:

 When combined, these approaches have been shown to make a huge difference in care standards, resident quality of life and often improves symptoms of incontinence—which in turn can reduce dependency on staff and lower incontinence supply needs.

Discover the difference ABENA’s absorbent, breathable Pants and Pads can make in managing incontinence. Request free samples today.

 

[1] https://discovery.ucl.ac.uk/id/eprint/10053056/1/JWOCN-D-18-00021%20-%20with%20corrections.pdf
[2] https://link.springer.com/content/pdf/10.1186/s12877-024-04748-1.pdf
[3] https://www.publish.csiro.au/CJ/pdf/CJ23017
[4] https://www.publish.csiro.au/CJ/pdf/CJ23017
[5] https://www.publish.csiro.au/CJ/pdf/CJ23017

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