Providing continence care can affect your wellbeing and relationships

Providing continence care can affect your wellbeing. Some carers feel like incontinence issues take over their lives.

Providing continence care can also arouse fears about the progression of the disease as it may bring home the progressively worsening condition of the person you’re caring for.

Providing intimate care can cause some carers to experience feelings of humiliation, disgust, or they may actually feel they’re doing something immoral.

This can be compounded if they’re also experiencing continual resistance and conflict when trying to support the person with their continence problems.

Some carers may have feelings of guilt and disappointment in their inability to cope with the situation or for considering the option of respite or longer term care.

Cultural expectations will influence how people feel about providing intimate personal care and differ from family to family.

It’s not always easy for a carer to share with other family members that their loved one is having continence issues or that they need help to manage.

Depending on the nature of the relationship you have with the person that you’re caring for, you may find it difficult, if not impossible, to cross certain boundaries linked to continence care.

This might include awkwardness or embarrassment around asking questions about toilet habits, coping with hygiene challenges, seeing the person naked or needing to carry out intimate personal care.

Gender often influences expectations.

For example, should sons assist their mother or should it only be females who provide this type of care?

Some male partners are reluctant or unable to provide this type of care at all.

However, situations arise and the carer may have little choice, putting them under tremendous physical and emotional pressure.

Spouses and partners providing intimate continence care may lose their attraction and be reluctant to engage in a sexual relationship with a person with dementia. This can result in both losing out on the benefits of this type of relationship.

If this is the case, there are services such as psychology, counselling and sexual health that can be helpful in finding solutions.

The person you’re caring for may resisting your support due to embarrassment or an attempt to maintain their independence and dignity.

To maintain dignity for both parties, it’s important to focus on the what the person with dementia can still do and encourage them to do these things – even if it makes the process longer.

You may only need to provide support with certain parts of the process and the person you’re caring for may be able to complete the rest.

It may be that a prompt or showing the person what needs to be done by mimicking the action is all that’s required.

The person may try to manage the process themselves, resulting in hiding wet or soiled clothes. They may put these aside to be dealt with later but the items are then forgotten, causing odour to develop.

Carers can sometimes be reluctant to seek help for continence problems due to their concern about the dignity and personhood of their loved one.

However, it can be helpful to have support from a professional. They can ask questions that you might not feel comfortable asking and the person you care for may feel more comfortable talking to a professional rather than to you.