Continence Care: empowering people with the independence to lead a dignified life

The elderly, or those with illness, disabilities or injuries, often suffer with incontinence. For women, incontinence may also occur during pregnancy, after childbirth and during menopause. Acquiring continence care knowledge and skills offers you the ability to make a vital difference by providing normalcy, dignity and independence through all these stages of life.

The prevalence of incontinence

Incontinence is relatively rare in healthy women early in life. In Canada, a degree of incontinence is found in only 16% of women age 18-40. However, many experience urinary incontinence during pregnancy. For some, it may be mild and infrequent, yet more severe for others. Incontinence can continue after childbirth or may subside only to return after age 40. The problem often worsens around the age of menopause and then increases steadily from ages 60 to 80 years.¹ Incontinence is found in 33% of Canadian women aged 41-64, with that number growing to 55% for women aged 65 and over.²  

Incontinence is not just a “female problem”. Among Canadian men, a degree of incontinence is found in 10% aged 18-40, 16% aged 41-64, and 30% aged 65 and over.² Underlying conditions such as prostate removal for cancer treatment, spinal injury or diabetes can all contribute to incontinence in men. Smoking and heavy drinking can also increase a man’s risk of urinary incontinence.

The impact of incontinence

The impact of this troublesome, yet common condition, greatly impacts a person’s health, independence and overall well-being. Both the physical and mental issues that may arise from incontinence can be devastating.

• Physical impact: increased risk of infections, as well as falls resulting in fractures; reduced physical activity leading to a sedentary lifestyle that can contribute to the development of serious health conditions like osteoporosis, hypertension and heart disease.
• Mental/emotional impact: research has found an association between incontinence and declining mental health and an increased risk for the onset of psychological distress and depressive symptoms. For example, seniors with urinary incontinence are significantly more likely to report feelings of loneliness than those who do not have this condition. And, when urinary incontinence is severe enough, the incidence of a stress disorder is increased by 4 times.³  

The need for improved continence care

In an aging population, such as Canada’s, the need to improve continence care is critical. Effective continence care has numerous benefits, including an enhanced quality of life, as well as lower health care and societal costs, especially in a community home setting.

Continence care from a nursing perspective

For those who work in the nursing profession – whether in acute, primary, community or long-term care, retirement homes or rehabilitation facilities, continence care knowledge and skills are vital. Understanding the causes and issues surrounding incontinence and how to deal with them through conservative, holistic measures can also be helpful to social workers, occupational therapists, personal care attendants and other healthcare professionals.

Nursing professionals with the knowledge, skills and credentials to implement empathetic continence care management and treatment to vulnerable people are in demand. As incontinence impacts health care and societal costs, nursing and other health care professionals who provide continence care are rewarded and valued by employers and patients alike. Those in the nursing professions looking to upskill or achieve a specialist position would do well to acquire continence care training and credentials. As Nursing Times states, “Continence care is every nurse’s business”. ⁴  

Why pursue continence care?

To have the skills to implement evidence-based and person-centered continence care can add meaning to an already rewarding profession.

When you:

 Understand the contributing factors and learn to implement management techniques, you can greatly improve the quality of life of those suffering from incontinence.

 Acquire in-depth knowledge of behavioural and educational interventions used in the conservative management of bladder and bowel incontinence, you can make informed continence care actions that lead to success.

 Gain decision-making skills and leadership abilities, you can offer your patients comprehensive and holistic continence care on a daily basis.

 Discover advanced concepts, as well as specific bladder and bowel incontinence issues that can arise due to underlying medical issues, such as spinal cord injury, acquired brain injury, and multiple sclerosis, you can broaden your delivery of continence care to a wider range of patients.

Choosing the right Continence Care program is key. Look for one that offers:

• A curriculum specifically geared to RPNs, RNs and NPs as well as other professionals in health care settings such as acute care, primary care, community care, long-term care, retirement homes and rehabilitation facilities.
• An opportunity to participate in a local clinical placement. This will allow you to focus on the assessment and management of incontinence in a real-life health care setting, based on your area of interest, such as urology, urogynecology, acute care, rehabilitation, primary care, community, and long-term care.

If you want to have a life-changing impact in your nursing and/or health care career, a continence care program could be right for you.

As Jennifer Skelly PhD RN and creator of the Nursing Concepts in Continence Care program, a collaborative program involving the McMaster University School of Nursing and McMaster Continuing Education says,

“Once you feel comfortable understanding the issues surrounding incontinence, you feel tremendous satisfaction helping an individual learn how to manage it and get their lives back.”

¹ The Prevalence of Urinary Incontinence

²  Impact of Incontinence in Canada

³  Statistics Canada: Urinary incontinence and loneliness in Canadian seniors

⁴  Nursing Times

Learn more:

Nursing Concepts in Continence Care