“Continence is essential to human existence.” I recently heard these powerful words shared by a person who had lived with incontinence. That bladder and bowel function is central to our identity is so well captured in this heartfelt statement. Having researched incontinence for the past 20 years, this is a description I have heard in many different guises from many different people and has been the driving force to unpicking how things can be improved.
Incontinence or promoting continence has been the focus of my nursing career, having ventured into the world of academic research only 3 years after qualifying. The golden thread has been targeting incontinence from different perspectives to enable people as well as health and social care professionals to be empowered to promote continence rather than manage incontinence. This work was the reason for the award of my RCN Fellowship in 2023.
Even in today’s world where we now talk openly about so many health and social issues, incontinence remains shrouded in secrecy and embarrassment. This creates an enduring barrier to understanding symptoms and accessing help for improvement. Living with incontinence rules many peoples’ lives, every day, yet is not recognised for the life-limiting consequences that it imposes. These are described in a report from a project in which I collaborated with Health Innovation West of England, formerly the West of England Academic Health Science Network.
But how big a problem is this? It is estimated over 14 million (1 in 5) people in the UK experience bladder leakage and over 6.5 million (1 in 10) have difficulty with bowel control. Across Europe as a whole, incontinence is estimated to affect 55-60 million Europeans. However, these statistics are likely to be just the tip of the iceberg as we know that many people who experience bladder and bowel leakage do not disclose their symptoms, but just learn to ‘get by’.
Within nursing it also can be difficult to raise conversations about incontinence, or know what to do if patients disclose symptoms, because staff often feel poorly prepared in this area. This was highlighted in a recent study: “I think staff knowledge [needs improving] … with knowledge, we can then give patients the confidence that they can manage their own continence,” said one participant. We all can be change agents without needing to be clinical experts if we give people the opportunity to talk about their symptoms and signpost available resources.
During this World Continence Week, we all can raise awareness of the self-help and education that is available to help people understand their incontinence and some of the ways that they themselves can try at home to improve their symptoms. NHS web pages provide education and advice on urinary incontinence and bowel incontinence. The CONfidence app is a free, discreet, self-help, NHS-approved resource. A wealth of resources is also available on the World Federation of Incontinence and Pelvic Problems website to support awareness raising during World Continence Week.
Incontinence is far more common than is generally understood and is hidden in plain sight. If we all take one step to raise awareness this World Continence Week, we can make progress in bringing incontinence out of the shadows and have a much more honest approach to bladder and bowel health.
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