Addressing and acting on individual ideas on continence care
Continence care should be individually delivered with dignity, decorum, distinction in all diverse contexts and circumstances. From the dependency of childhood to ultimately the end of life, continence care is essential for all, no matter what the setting is: at home, sheltered structures, community care, residential settings and nursing homes. Person-centred care is central to healthcare policies, procedures to the provision of personalised consultation, developing a collaborative partnership approach to continence assessment, promotion, and management.
Urinary incontinence is described as involuntary leakage of urine in an inappropriate place (Abrams et al, 2010), and the symptoms of urinary incontinence can naturally be distressing for individuals (Alaszewski et al, 2009). Similarly, faecal incontinence can be defined as involuntary loss of liquid or solid stool which is a social and hygienic concern (Norton et al, 2010). The prevalence rates of faecal incontinence is higher in the older age population, although it is not an inevitable part of ageing (Russell et al, 2017). Another complex continence-related condition is constipation, which can be challenging to define, but is described as defecation that is unsatisfactory in clinical characteristics, with difficult passing bowel motions, seemingly incomplete bowel emptying and infrequent bowel motions (Thompson et al, 1998). Constipation is a subjective symptom based on a person's expectations of bowel frequency, volume, consistency and ease in passing bowel motions. The Rome diagnostic criteria (Table 1) can help in the diagnosis of constipation (National Institute for Health and Care Excellence (NICE), 2020). According to Werth et al (2017), the prevalence rate of self-reported constipation in Australian community-dwelling adults was 21% of the population, and 38% of residents in nursing homes in Ireland experience constipation (Neacy, 2014).
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