Twelve Days of Continence!

Sarah Coombes is a Continence Nurse Specialist at the University Hospitals of Leicester NHS Trust (UHL) and Minal Patel is a Specialist Registrar (ST5) in Geriatric Medicine working in the East Midlands South Deanery. In this blog they look at lifestyle changes for improving continence care with a special Christmas spin!

The other day I overheard someone say ‘incontinence is just a part of ageing and we just have to live with it’. Well, let me stop you right there! Yes, we all know that the prevalence of continence problems increases with age but in no way does anyone in this day and age have to just put up with it.

People are still often too embarrassed to talk about these issues. Factors contributing to reduced healthcare-seeking include lack of knowledge of the condition and available treatments, with the misconception that it’s a normal part of ageing and not a problem to bother your GP about. It not only has a physical impact but also a huge psychosocial impact; how often have we heard patients say they don’t do things they used to because they were worried they would have ‘an accident’? With faecal and urinary incontinence affecting at least 1 in 10 men and women, this should not be a taboo topic and we need to empower our older population to talk about it over a biscuit and a cup of tea  (decaffeinated of course!).

It’s about acknowledging the problem, providing knowledge about it and most importantly, agreeing there’s actually something we can do to improve it! It’s not always about a pill to solve all problems but using a holistic approach focusing on our patient’s individual needs. Simple lifestyle changes are often the first steps in improving symptoms, giving individuals back their confidence and overcoming the feeling of shame.

We start by thanking our friend caffeine that gives us the energy to wake up in the mornings and start the day with a spring in our step. Not such a good friend to the bladder though! Cutting down the number of cups of tea or coffee a day and switching to decaffeinated products may make all the difference to an overactive bladder. Although patients should cut down on the cups of caffeine, by no means should they cut down on the fluid intake – it is still recommended to have 6-10 cups a day. However, trying to drink less before bedtime and thereby avoid the night-time toilet calls will also allow some continuous beauty sleep! Remember to tell patients that there are many other drinks that contain caffeine such as fizzy drinks, green tea and hot chocolate too; as well as other bladder irritants like acidic juices and alcohol – beware, mulled wine season is upon us!

Teaching our patients some simple steps such as regular toileting and not delaying the urge, as well as manoeuvres such as double voiding and toileting position (it’s all about squatting!) may help relieve some of their symptoms.

Regular exercise and pelvic floor exercises for both women and men will help strengthen the pelvic floor – and it may feel like people around you know you’re exercising your pelvic floor while doing your Christmas shopping, but trust me, no-one does!

Encourage people to include regular fruit and veg in their diet as urinary and bowel problems often go hand in hand. These simple things really can make a big positive impact to our patients’ experience. Incontinence is treatable, so don’t let them suffer in silence!

As this unique year draws to an end, we thought of using an innovative way of teaching and remembering some lifestyle changes to improve continence care. We challenge you this Christmas to hone into your inner Mariah Carey (you know which song I mean…) and join us in singing along to our version of the ‘12 Days of Continence’.

We’d like to say thank you to:

• The Continence Team at UHL for making this a fun learning and singing experience!
• Mediaway.co.uk who donated their creative services to produce the festive video.
• And last, but not least, our great NHS!

We hope this fun way of remembering some of the lifestyle changes to help with continence problems will have you smiling through this holiday season.

Wishing you all a Merry Christmas!