Abrams P, Andersson KE, Birder L Fourth international consultation on incontinence. Recommendations of the International Scientific Committee: evaluation and treatment of urinary incontinence, pelvic organ prolapse, and fecal incontinence. Neurourol Urodyn. 2010; 29:(1)213-240

Adams D, Bucior H, Day G, Rimmer JA. HOUDINI: make that urinary catheter disappear-nurse-led protocol. J Infect Prev. 2012; 13:(2)44-46

Aguilar-Navarro S, Navarrete-Reyes AP, Grados-Chavarría BH, García-Lara JM, Amieva H, Avila-Funes JA. The severity of urinary incontinence decreases health-related quality of life among community-dwelling elderly. J Gerontol A Biol Sci Med Sci. 2012; 67:(11)1266-1271

Alaszewski H, Holdsworth L, Billings J, Wagg A. Privacy and dignity in continence care: research review. Nurs Residential Care. 2009; 11:(8)393-396

Arnold SD, Forman LM, Brigidi BD Evaluation and characterization of generalized anxiety and depression in patients with primary brain tumors. J Neurooncol. 2008; 10:(2)171-181

Association for Continence Advice. Guidance for the provision of absorbent pads for adult incontinence: a consensus document. 2017. (accessed 16 December 2020)

Axelsson SB, Axelsson R. From territoriality to altruism in interprofessional collaboration and leadership. J Interprof Care. 2009; 23:(4)320-330

Candy B, Jones L, Drake R, Leurent B, King M. Interventions for supporting informal caregivers of patients in the terminal phase of a disease. Cochrane Database System Rev. 2011; 15:(6)

Clary PL, Lawson P. Pharmacologic pearls for end-of-life care. Am Fam Physician. 2009; 79:(12)1059-1065

Continuity of care for older hospital patients: a call for action. 2012. (accessed 16 December 2020)

Continence Product Advisor. Products. 2017. (accessed 16 December 2020)

Demaagd GA, Davenport TC. Management of urinary incontinence. Pharmacy Therapeutics. 2012; 37:(6)345-361

Understanding and improving transitions of older people: a user and carer centred approach. Final report. 2012. (accessed 16 December 2020)

Ellis G, Gardner M, Tsiachristas A Comprehensive geriatric assessment for older adults admitted to hospital. Cochrane Database System Rev. 2017; 9:(9)

Expert Group on LUTS. Who cares? Uncovering the incontinence taboo in social care. 2014. (accessed 16 December 2020)

First patient; HSE and Tallaght Hospital: patient centred care: first patient project; phase 1; an evaluation. 2013. (accessed 16 December 2020)

General Medical Council. Treatment and care towards the end of life: good practice in decision making. 2010. (accessed 16 December 2020)

Continence care service England 2013 survey report. 2013. (accessed 16 December 2020)

Health Foundation. Person-centred care made simple: what everyone should know about person centred care. 2014. (accessed 16 December 2020)

Health Information and Quality Authority. National standards for safer better healthcare. 2012. (accessed 16 December 2020)

Health Information and Quality Authority. Guidance for designated centres: intimate care. 2014. (accessed 16 December 2020)

Health Information and Quality Authority. National standards for residential care settings for older people in Ireland. 2016. (accessed 16 December 2020)

Health Service Executive. National healthcare charter: you and your health service. 2012. (accessed 16 December 2020)

Health Service Executive. Person-centred care and support: supporting services to deliver quality healthcare. 2014. (accessed 16 December 2020)

Hospice Friendly Hospitals. Quality standards for end-of-life care in hospitals: making end-of-life care central to hospital care. 2010. (accessed 16 December 2020)

Jack B, O'Brien M. Dying at home: community nurses' views on the impact of informal carers on cancer patients, place of death. Eur J Cancer Care. 2010; 19:(5)636-642

Imamura M, Abrams P, Bain C Systematic review and economic modelling of the effectiveness and cost-effectiveness of non-surgical treatments for women with stress urinary incontinence. Health Technol Assess. 2010; 14:(40)1-188

Kadivar M, Marjan-Hamooieh M, Kouhnavard M. Concept analysis of human dignity in patient care: Rodgers' evolutionary approach. J Med Ethics History Med. 2018; 11

Luppa M, Luck T, Weyerer S, König HH, Brähler E, Riedel-Heller SG. Prediction of institutionalization in the elderly. Age Ageing. 2010; 39:(1)31-38

Manley K, O'Keefe H, Jackson C, Pearce J, Smith S. A shared purpose framework to deliver person-centred, safe and effective: organisational transformation using practice development methodology. Int Pract Develop J. 2014; 4:(1)1-31

McCormack B, McCance T, Maben J. Chapter 10: outcome evaluation in the development of person-centred practice, 2nd edn. In: McCormack B, Manley K, Titchen A (eds). Oxford: Wiley Blackwell; 2013

McCormack B, McCance T. Person-centred practice in nursing and healthcare.Oxford: Wiley Blackwell; 2017

Murphy C, De Laine CR, Macaulay M, Fader M. Continence pad provision: meeting patients fundamental care needs. Nurs Times. 2019; 115:39-42

National Health Service. NHS England's actions for end of life care 2014–2016. 2014. (accessed 16 December 2020)

National Disability Authority. Code of practice on accessibility of public services and information provided by public bodies. 2006. (accessed 16 December 2020)

National Institute for Health and Care Excellence. Urinary incontinence in women: management. CG171. 2013. (accessed 16 December 2020)

National Institute for Health and Care Excellence. Care of dying in the last days of life. NG31. 2015. (accessed 16 December 2020)

National Institute for Health and Care Excellence. End of life care for infants, children and young people with life-limiting conditions: planning and management. NG61. 2019. (accessed 16 December 2020)

National Institute for Health and Care Excellence. Constipation: overview. 2020. (accessed 16 December 2020)

Nazarko L. Person-centred care of women with urinary incontinence. Nurse Prescrib. 2015; 13:(6)288-293

Nazarko L. Providing dignified continence care to older at end of life. Int J Palliat Nurs. 2019; 25:(10)504-512

Norton C, Whitehead WE, Bliss DZ, Harari D, Lang J. Management of fecal incontinence in adults. Neurourol Urodyn. 2010; 29:(1)199-206

Rantell A, Dolan L, Bonner L, Knight S, Ramage C, Tooz-Hobson P. Minimum standards for continence care in the UK. Neurourol Urodyn. 2016; 35:(3)400-406

Riemsma R, Hagen S, Kirschner-Hermanns R Can incontinence be cured? A systematic review if cure rates. BMC Med. 2017; 15:(1)

Riskind P, Fossey L, Brill K. Why measure patient satisfaction?. J Med Pract Manage. 2011; 26:(4)217-220

Guidelines—Rome III diagnostic criteria for functional gastrointestinal disorders. J Gastrointest Liver Dis. 2006; 15:(3)307-312

Royal College of Nursing, Clinical Procurement Specialist Network, NHS. Small changes, big differences. Driving nursing leadership in procurement. 2015. (accessed 16 December 2020)

Russell B, Buswell M, Norton C Supporting people living with dementia and faecal incontinence. Br J Community Nurs. 2017; 22:(3)110-114

Santini S, Andersson G, Lamura G. Impact of incontinence on the quality of life for caregivers of older persons with incontinence: a qualitative study in four European counties. Arch Gerontol Geriatr. 2016; 63:92-101

Schluter J, Ward C, Arnold EP, Scrase R, Jamieson HA. Urinary incontinence but not fecal incontinence, is a risk factor for admission to aged residential care of older person in New Zealand. Neurol Urodyn. 2017; 36:(6)1588-1595

Spencer M, McManus K, Sabourin J. Incontinence in older adults: the role of the geriatric multidisciplinary team. BC Med J. 2017; 59:(2)99-105

Taylor DW, Cahill JJ. From stigma to the spotlight: a need for patient-centred incontinence care. Healthc Manage Forum. 2018; 31:(6)261-264

Thompson WG, Longstreth GF, Drossman DA Functional bowel disorders and functional abdominal pain. Gut. 1998; 45:(S2)II43-1147

The practice of system leadership: being comfortable with chaos. 2015. (accessed 16 December 2020)

Trowbridge MM, Wang B, Gutshall D, Rodenberg CA, Farage MA. A randomized, controlled trial comparing skin health effects and comfort of two adult incontinence protective underwear. Skin Res Technol. 2016; 23:(2)202-211

Whitehead J, Wheeler H. Patients' experiences of privacy and dignity. Part 2: an empirical study. Br J Nurs. 2008; 17:(7)458-464

World Health Organization. Alignment between the ‘Framework on Integrated People-centred Health Services' and the five strategies to be discussed at the 69th session of the World Health Assembly. 2015. (accessed 16 December 2020)

Yuan H, Williams B. Knowledge of ur inary incontinence among Chinese community nurses and community dwelling older people. Health Soc Care Community. 2010; 18:(1)82-90

Zahedi F, Sanjari M, Aala M The code of ethics for nurses. Iranian J Public Health. 2013; 42:(S1)1-8

Zirak M, Ghafourifard M, Mamaghani EA. Patients' dignity and its relationship with contextual variables: a cross-sectional study. J Caring Sci. 2017; 6:(1)49-51

Addressing and acting on individual ideas on continence care

02 January 2021
Volume 26 · Issue 1


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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