Continence Promotion

Urinary incontinence, or loss of bladder control, affects nearly 60 percent of all nursing facility residents in the United States. Incontinence is not a normal part of the aging process, but is often related to underlying issues including chronic medical conditions, dementia, mobility impairments and some medications.

Incontinence often plays a part in the decision to pursue nursing facility placement and can increase the risk of falls, fractures and skin breakdown. Residents with incontinence are often reluctant to participate in activities, leading to social isolation.

Many residents can achieve partial to total reversal of incontinence when individualized continence promotion plans are put into place. For a continence promotion plan to be successful, it must be based on the resident’s specific needs and toileting habits.

This topic includes information regarding the types and causes of incontinence, tools to aid in assessing continence, treatment strategies, and tips to promote bladder health and function.

Resources Created by DADS

• Evidence-Based Best Practice: Promoting Continence (PDF)

• Sample Care Plan (PDF) illustrates simple measures nursing staff can implement from best practice recommendations.

• Prompted Voiding Algorithm (PDF) illustrates steps in promoting continence using prompted voiding.

Resources from Other Organizations

• Urinary Incontinence offers information on definitions, symptoms, causes, risk factors, tests and diagnosis, complications, and treatments; including behavioral intervention.

• Promoting Continence Using Prompted Voiding is an evidence-based guideline for implementing a treatment plan for older adults with incontinence.

• MedlinePlus has a comprehensive page on urinary incontinence that includes interactive tools, exercises and images as well as links to other organizations.

• The Simon Foundation for Continence is known for its innovative educational projects and efforts on behalf of people with incontinence.

• Toilet Training Procedures for Persons with Developmental Disabilities (PDF), provides steps to achieve bladder training.

• 3 Day Voiding Trial (PDF) can be used to track trends of fluid intake, voiding intervals and incontinence patterns. The worksheet provides interpretation of collected data, and aids in establishing an individualized plan of care.