Ability to deal with incontinence

Adults with normal cognitive function

They should be able to manage pads and aids on their own unless they have problems with manual dexterity or visual impairment. In addition they should be able to take medication, manage diet and establish appropriate routines without help from others. This would include people with some types of spinal injuries, people recovering from a relapse of multiple sclerosis and from bowel and/or pelvic surgery. Some people with long-term neurological disorders affecting bowel function may need regular enemas to prevent faecal impaction with resultant spurious diarrhoea as part of their care administered by others.

Recurrent diarrhoea, faecal urgency and the need to go to the toilet quickly may occur in people with exacerbations of ulcerative colitis, Crohn’s disease and irritable bowel disease. These should respond to appropriate treatment of the condition within days or weeks, and not cause persistent or long-term incontinence. These symptoms do not cause any difficulty in walking and should not be considered to cause restricted mobility.

Adults with learning disabilities

This group may need considerable input from carers to deal with faecal incontinence. This will include ensuring pads are worn, help with changing, cleaning, skin care and personal hygiene. They will need to be encouraged to go to the toilet regularly, to be taken to the toilet, to eat a suitable diet, to drink adequate fluids and to take medication to control bowel function.

Elderly or frail people

Help is likely to needed by older people with poor manual dexterity, visual impairment, restricted mobility and dementia. They need assistance in putting on incontinence aids and changing them when soiled. They need help with personal cleaning and applying barrier creams to protect the skin from rashes or pressure sores. If they have limited mobility they need help to and from the toilet, and help on and off the toilet or commode. They may also need encouragement and reminding to go to the toilet at regular intervals. Consumption of a suitable diet, adequate fluid intake, and supervision of medication and administration of enemas are required to establish a regular bowel habit and avoid faecal impaction.

Amended April 2008