Incontinence care

The first national audit of continence care for older people in the UK shows widespread failure to diagnose and manage continence problems. The audit, undertaken by the Royal College of Physician’s Clinical Effectiveness and Evaluation Unit and commissioned by the Healthcare Commission, examined the quality of care for older people with urinary and faecal incontinence.

  

Urinary incontinence affects some 24 per cent of older people and 30-60 per cent of people in institutional care.Faecal incontinence occurs in approximately 1-4 per cent of adults and up to 25 per cent of people in institutional care. Both cause much distress and loss of dignity for the older person. 

 

Stakeholder Response: The Royal College of Physicians

 

 

Dr Adrian Wagg, chairman of the Continence Working Party, said: "This is probably the largest audit on continence care world wide and we are extremely grateful to everyone who has participated.

 

"It shows that care for people with continence problems is patchy at best, that a cure is seldom attempted and that the single mandatory target for continence in the NSF has not been met.

 

"There is a wealth of opportunity for improvement, something that we will be attempting to encourage over the coming months"

 

Stakeholder Response: The Alzheimer’s Society

 

 

Clive Evers, director of information and education at the Alzheimers’ Society, said: “It is shocking that incontinence care throughout the country is so appalling.  There is no justification for poor incontinence management and the Alzheimer’s Society demands strong and urgent action to ensure everyone affected by incontinence receives a good level of care.

 

"Incontinence can be distressing and humiliating for the person concerned, and their family, and it is vital that everything possible is done to reduce this distress.

 

"Incontinence is not an inevitable symptom of dementia, but many people with dementia do experience it. People with dementia often experience incontinence for quite unique reasons; they may forget to go to the toilet, or be unable to find where the toilet is. It is essential that the cause of incontinence is established and a plan is put in to place as quickly as possible.

 

"The Alzheimer's Society's helpline often hears from people who do not feel this problem is being adequately addressed. We also hear of unacceptable practices such as pads being rationed or the quality of pads being compromised by the NHS for cost reasons.

 

“It is disgraceful that people are denied such basic care and that staff are not trained in how to support people who are incontinent. The Healthcare Commission needs to ensure that any service providing incontinence care meets the requirements for incontinence management under the National Service Framework for Older People. The standard of incontinence care that this audit uncovers reflects the lack of dignity and respect that we afford older people within the UK.”

 

Stakeholder Response: Help the Aged

 

 

Dr Lorna Layward, research manager for Help the Aged, said: "The report rightly highlights that incontinence is still treated as a taboo subject and has not been given the priority it needs, greatly affecting the one in ten older people who have to live with it. 

 

"As a consequence, it has a massive impact on the quality of life for older people, many of whom end up isolating themselves because they are afraid to go out.  We urgently need to look at ways of treating the underlying causes of incontinence rather than just treating the symptoms."

 

Stakeholder Response: Age Concern

 

 

Gordon Lishman, director general, Age Concern England, comments: "This report highlights the urgent need for better continence services for older people. These services are essential in preserving dignity and enabling a good quality of life.

 

"The Department of Health must do more to make sure that all parts of the NHS are providing continence services to the best possible standards.

 

"The lack of services is shocking in light of this widespread problem. Continence problems are common but too many people find it embarrassing to discuss, so they suffer in silence. 

 

"More than one in three men and women in the UK have been affected by bladder problems."