Guest blog: Uncovering the incontinence taboo in social care


Today’s guest blog is from Professor Paul Abrams, Chair of the expert group on LUTS and highlights the issues that arise when continence isn’t given the prominence it deserves.

According to the Department of Health, incontinence is second only to dementia as a precipitating factor in care home admissions and affects nearly 2 in 3 in nursing homes.

Despite this, new analysis published by the expert group on lower urinary tract symptoms (LUTS) demonstrates that the majority of local authority commissioners do not view incontinence as a priority.

Our new report, Who Cares? Uncovering the incontinence taboo in social care, reveals the results of a Freedom of Information request to local authorities to determine if high quality continence care is mandated in contracts with all local social care providers.  Key among our findings:

  •  almost half – 42 per cent – of responding authorities (n=109) do not stipulate within their contracts that effective continence care must be delivered to people receiving social care
  • only ten per cent of local authorities that responded had assessed the number of people in their local population who receive social care and have a continence problem, to establish the level of need and provision required

It is extremely disappointing that this report has uncovered how patchy current support is and the potential risk that this poses to people who rely on social care.  Our calculations suggest that over 90,000 older people who receive local-authority-funded social care are at risk of distress and indignity arising from poor continence support.

In the absence of a local authority contractual requirement, families and those being cared for have no guarantee that people will be supported with the most fundamental aspects of continence and toileting care.  This can include:

  • Help to use the toilet and wash afterwards
  • Efforts to maintain a person’s privacy and dignity when they need help
  • Access to expert advice from a GP or continence nurse specialist to manage or treat the problem

Poor management of incontinence is not only distressing and degrading for individuals, it can also place an additional financial burden on the NHS due to the costs of treating the complications of incontinence which can arise from mismanagement of the condition (Department of Health: Social Care and Local Partnerships Programme, Prevention and early intervention continence services, July 2011). Given the ageing population and current pressures on the NHS, there is a real opportunity to reduce unplanned hospital admissions and prolonged stays due to poorly managed incontinence in social care.

We are encouraging local authorities to take urgent action in response to these findings and drive open and honest conversations about how high quality, compassionate and dignified continence care can be provided, without compromise, within social care.  People with continence problems, who rely on social care, deserve nothing less.


For further information on incontinence, you can visit the relevant Age UK website pages, and read the expert group on LUTS’ report Who Cares? Uncovering the incontinence taboo in social care. You can also find out more about Age UK’s Care in Crisis campaign



Astellas Pharma Ltd. initiated the development of the expert group on LUTS and nominated its membership. Astellas pays MHP Health to provide secretariat support for the group.  Astellas has no editorial control over the content of expert group materials except for reviewing compliance with the ABPI Code of Practice.
NPR13155UKg  April 2015

Author: Age UK

Age UK is dedicated to helping everyone make the most of later life. In the UK we help more than 7 million older people each year by providing advice, combating loneliness and enabling independence. Locally, we work as part of a network of independent charities which includes Age UK, Age Cymru, Age NI and Age Scotland and over 150 local Age UK partners in England and Wales.

One thought on “Guest blog: Uncovering the incontinence taboo in social care”

  1. Incontinence Diaries – totally inappropriate for elderly Alzheimer’s sufferers! I was asked to fill one in for my mam aged 82. She has severe incontinence. Measure input in ml . OK. Output ??? Are these people having a laugh? What are you expected to do ? Wring out her pads?!! Ticking boxes for folk or paying. Lip service to a system that has been thoughtlessly implemented is just not right. Pity us poor harassed carers dear NHS officials and rethink this one!

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