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1 CONTINENCE TIPS Images are of models, for illustrative purposes only. Brought to you by

2 IT NEEDN T COMPROMISE YOUR LIFESTYLE Continence challenges can affect people of any age, gender, culture or socioeconomic background. Although more common as people age, bladder or bowel weakness can often be cured or significantly improved and always managed better with appropriate strategies after proper assessment. This booklet offers you continence tips and highlights ways to maintain good bladder and bowel health. It s common Incontinence affects almost 4.8 million Australians^. INSIDE Understanding incontinence & its effects 3 What causes it? 4 Toileting 5 Fluid intake 6 Diet 7 Exercise 8 Help is at hand 10 Financial assistance 10 Protection 11 Choosing the right protection 12 Free product sample 16 1 in 3 women over the age of 35* 1 in 10 men over the age of 35* ^ Continence Foundation of Australia * IPSOS (2010) U&A and ABS 2

3 UNDERSTANDING INCONTINENCE & ITS EFFECTS Continence is the ability to exercise voluntary control over natural impulses such as the urge to urinate or defecate. Incontinence is any involuntary loss of urine or faeces. It doesn t have to mean total lack of control it might only be at times, when urine dribbles or there s a bit of soiling or leaking. Faecal incontinence may include loss of wind and faecal smearing. Incontinence can affect a person emotionally, psychologically and socially. Those facing it may feel that they re seen as lazy or attention seeking, feel ashamed, embarrassed, annoyed, angry, frustrated or guilty. If not well managed incontinence can lead to social isolation and skin complaints. That s why it s important to be proactive and manage it well. Don t passively accept it. Your doctor or a continence nurse advisor can help and remember, they help with these issues regularly so there s no need to feel embarrassed. Your doctor or a continence nurse advisor can help identify which type of incontinence you re facing and this will influence treatment. Stress incontinence is urine leakage after movement like when you cough, sneeze, lift, bend, laugh or play sport. Urge incontinence is a sudden desire to urinate, without enough time to make it to the toilet. Reflex incontinence is loss of urine without bladder sensation, due to damage to the nerves controlling bladder function. Overflow incontinence is where the bladder doesn t empty properly, perhaps due to outlet obstruction or low bladder tone. Functional incontinence is where a person s ability to reach or use the toilet is compromised perhaps because of poor building design or loss of mobility or memory. Key point Incontinence isn t an inevitable part of ageing. It s a symptom, not a disease, so it s important to find out what s causing it. 3

4 WHAT CAUSES IT? While the body s ageing process can contribute to incontinence, there can be a variety of contributing factors. Often the main reason for bladder control problems is either weak pelvic floor muscles or interruption of the signal to the brain that indicates the bladder is full. Urinary incontinence contributors include pregnancy and childbirth, urinary infections, side effects from medication, prescribed or natural diuretics including caffeine, and chronic constipation. Other factors could be bladder stones and other obstructions, diabetes, menopause, prostate gland surgery, obesity and neurological disease or injury such as Parkinsons, stroke or spinal cord damage. Constipation is one of the most common causes of faecal incontinence in the aged and disabled. Other causes include diarrhoea, environmental issues such as inability to reach the toilet, neurological impairment, nerve or muscle damage and cancer of the rectum or anal fissure. Did you know? If you re having problems fully emptying your bladder on the toilet, after you ve passed urine count to 10, then pass some more. It may help to use the ball of your hand or fist to apply pressure over the bladder while passing urine. 4

5 TOILETING When to go With the bladder, it s best not to go just in case as this minimises bladder storage capacity and means small amounts of urine will have to be emptied frequently. With the bowels it s important to go to the toilet as soon as you get the urge to defecate. This is because if you put it off, the urge will disappear until a later time possibly the next day and because faeces gets harder and drier the longer it stays in the bowels, this may cause constipation and contribute to urinary incontinence. Quick tips Going to the toilet after meals can help promote bowel motions, as the body s digestive system usually has muscular contractions after eating. To make toilet use easier, consider raising the toilet seat to a higher level and installing wall hand rails. Another help could be leaving the toilet light on at night. Positioning When on the toilet, the lower back should be straight, not slumped Lean forward, back or remain upright depending on what allows the bowels to open with least effort Have your legs comfortably apart (having clothing pulled to your ankles may help) It may help to have your knees raised higher than your hips, with the use of a small footstool but ensure it s not too high as you don t want your lower back to slump. (For safety, ensure the stool is stored away when not in use and avoid its use if you have mobility, balance or other medical issues where leaning forward to arrange the stool may not be safe). 5

6 FLUID INTAKE It s important to consume 6 8 glasses or 1500mL of water a day to maintain bladder capacity, overall body functioning and prevent dehydration. This fluid intake does not include caffeine-containing drinks. If you find it difficult to drink this much, consider other options like fruits, vegetables, wet foods like curries and stews, soups and jellies which are high in water and easier for the body to digest and absorb. Minimise processed or other foods that require more effort in digestion. Consult your doctor if you are on a fluid restriction regime. Did you know? Withholding fluid intake to try and prevent a urinary accident can prevent the bladder muscles from being toned and also result in concentrated urine, irritating the bladder. Caffeine, alcohol and juices Caffeine-containing fluids like coffee, tea and Cola soft drinks can irritate the bladder and cause it to draw water from other parts of the body to dilute the caffeine. This can result in dehydration and constipation. An irritated bladder may contribute to urine leakage. Alcohol increases the passing of urine but it also reduces the ability to co-ordinate the act of holding on to urine before going to the toilet. Citrus juices can irritate the bladder so health professionals suggest just one glass in the morning. 6

7 Did you know? Excess body weight can aggravate bladder or bowel weakness by putting stress on muscles. A 5 10% weight loss can help improve control by reducing intra-abdominal pressure. DIET What you eat is important to provide the body with the nutrients to keep it in optimum function as well as to prevent constipation. A high fibre diet is vital in maintaining bowel regularity. A diet low in fibre, or if you increase fibre intake without increasing fluid intake, leads to constipation. And faeces retained in the body can put pressure on the bladder and lead to urine leakage. Drinking cranberry juice can help support a healthy urinary tract and bladder. Avoid spicy foods as they can irritate the bladder. 7

8 EXERCISE Keeping active and regular exercise is important for continence promotion and maintenance. Both general exercise for total body, bowel and bladder health and pelvic floor exercises. The pelvic floor is a large muscle slung across the pelvis from the front to the back. It s similar to a hammock and supports the pelvic and abdominal organs so they are maintained in correct position. Weak pelvic floor muscles are the most common cause of bladder weakness and can lead to urine leakage when laughing, coughing, sneezing or exercising. Pelvic floor exercises Recommended for women and men who experience any urine leakage, pelvic floor exercises also strengthen the muscles around the bladder and bladder opening. The exercises improve incontinence symptoms. They can be done anywhere, anytime, while sitting, lying or standing. No one else will know you re doing them. Finding the muscles Imagine stopping the flow of urine. The muscles used to stop the flow are pelvic floor muscles. 8

9 Two types of exercises Pull up and hold or tighten pelvic floor muscles as if stopping the flow of urine. Clench or tighten buttocks together, as if stopping wind escaping from the anus. Two ways of doing them 1. Quick pelvic floor exercises where you pull up or tighten and then relax straight away. 2. Slow pelvic floor exercises. Tighten the muscles and hold for 3 5 seconds. When the muscles get stronger, tighten for 10 seconds or longer. Relax for 3 5 seconds, then tighten them again. Do 3 5 of these exercises at a time, at least three times a day. Things to remember It s best to empty your bladder first. Don t hold your breath breathe normally. Tighten the pelvic floor muscles, not the abdominal or chest area. It may take several weeks to notice an improvement but if symptoms do not improve, ask your doctor for help. Quick tips Pelvic floor exercises should be done regularly so its best to set up triggers to remind you. For example, you might decide to do them every time you stop at traffic lights or whenever you walk through a doorway or when the first set of commercials start on television or when you answer the phone. Be creative and think of triggers that suit your lifestyle. 9

10 HELP IS AT HAND If you d like further information, advice or practical support, consider contacting: Your doctor A continence nurse advisor A continence clinic Specialist doctors such as a urologist, urogynaecologist or gastroenterologist The Continence Foundation Australia The National Continence Helpline freecall Visit For information on DEPEND, POISE or DryNites products, bladder or bowel weakness or to order a FREE PRODUCT SAMPLE, call or visit FINANCIAL ASSISTANCE You may be entitled to Government funding towards continence products. There are various subsidy schemes, funded by the Australian Government and State/Territory Government Departments. For example, the Continence Aids Payment Scheme better known as CAPS pays over $500 a year for continence products to individuals aged five and over who have permanent and severe incontinence due to an eligible condition. Eligibility criteria and funding varies between schemes. You may even be able to apply through several schemes. To find out more, phone the National Continence Helpline freecall or talk to your local continence clinic. 10

11 PROTECTION Good quality disposable continence protection such as DEPEND and POISE products will keep you dry and comfortable and feeling more confident. A variety of disposable continence protection products are available. Some are pads with adhesive backing or that are held in place by stretch pants, and others are designed like underwear. Some provide protection for bowel weakness. Furniture protection is also available. These sorts of products can give you extra peace of mind and the confidence to live the lifestyle you want. DEPEND, POISE and DryNites products offer superior light to maximum protection. Product selection should be based on level of absorbency, product type, size and fit. A continence nurse advisor can help you choose the product best suited to your needs or you can use the table overleaf. Quick tips Be proactive and positive. Don t let continence challenges compromise your lifestyle. SOURCING PRODUCT You ll find some DEPEND, POISE and DryNites products in supermarkets and pharmacies. The entire range is available through these distributors, who can organise discreet, fast home delivery: W T E info@brightsky.com.au W T E customerservice@ independenceaustralia.com W T E healthcare@intouchdirect.com.au 11

12 CHOOSING THE RIGHT PROTECTION Quick tips Try out the helpful interactive product selector at or Very light (Just in case) Light (eg. leakage when laugh, cough, exercise) Moderate (Frequent light leakage holds 1-2 cups) Maximum (Over 2 cups. Some suit bowel incontinence) Increasing absorbency POISE Liners Light Regular Extra Long POISE Active Microliners Microliners Long Regular Ultrathin Pads Super Ultrathin Pads POISE Pads Regular Super Extra Extra Plus Overnight DEPEND Shields for Men Shields Men DEPEND Guards for Men Guards Men DEPEND Pads (formerly DEPEND Shields) Pads DEPEND Undergarments Undergarments DEPEND REAL FIT Underwear For Women For Men DEPEND REAL FIT Underwear Super For Women DEPEND Underwear Unisex Super Super Plus DEPEND Anatomic Pads Normal Plus Extra Super Super Plus DEPEND Briefs Normal Super Super Plus DEPEND Flex Super Plus Light protection Moderate protection For women For men For women For men POISE Liners DEPEND Shields for Men POISE Pads DEPEND Guards for Men Regular 3 times more absorbent than period-only liners Breathable POISE Active Light Regular Microliners: 3 times drier than period-only liners Designed for active women Extra Long Thin & discreet Secure cup-like protection Soft side shields help stop leakage Dry touch cover Contoured shape for better fit & protection Wider front end for male anatomy gives excellent protection Adhesive strip ensures secure protection Cup-like shape for better fit Comfort-flex leak barriers to protect while active Discreet & comfortable Regular Super Extra Extra Plus Overnight Continued... Microliners Microliners Long Regular Ultrathin Pads Super Ultrathin Pads 12 13

13 Moderate protection For children, adolescents & smaller-framed adults DryNites Pyjama Pants Gender-specific designs for better protection Look and feel like real underwear Cloth-like outer cover reduces noise during movement Maximum protection For men DEPEND REAL FIT Underwear for Men Slim & comfortable, looks & feels like real underwear Masculine blue cotton-like stretch fabric Absorbent core zoned for men All-around leg elastics 4-7 years, 17-30kg / 8-15 years, 27-57kg S/M L/XL For women and men DEPEND Pads (formerly DEPEND Shields) (only available through distributors) Extra long for greater protection Soft, cloth-like cover for comfort & skin health Adhesive backing strip secures in place For bladder & bowel incontinence DEPEND Undergarments with Buttons Easy product removal & attachment Soft breathable cover Can be fitted while sitting, standing or lying For bladder & bowel incontinence For women DEPEND REAL FIT Underwear for Women Slim & comfortable, looks & feels like real underwear Feminine peach cotton-like stretch fabric Absorbent core zoned for women All-around leg elastics For women DEPEND REAL FIT Underwear Super for Women Slim & comfortable, looks & feels like real underwear Feminine peach cotton-like stretch fabric Absorbent core zoned for women All-around leg elastics Super absorbency for maximum protection S/M L XL For women and men DEPEND Underwear Unisex (only available through distributors) Underwear-like waistband Soft & comfortable All-around leg elastics Traps & locks in odour Available in Super and Super Plus absorbencies 14 S/M L XL Super: S/M, L, XL Super Plus: S/M, L

14 For women and men DEPEND Anatomic Pads (only available through distributors; worn with DEPEND Stretch Pants) Soft, cloth-like outer cover with full-length wetness indicator Longer side leakage guards boost protection Dry-lock core keeps wearer dry & reduces odour Breathable design for optimum skin health Normal Plus Extra DEPEND Stretch Pants (only available through distributors; worn with DEPEND Anatomic Pads) Washable, re-use up to 30 times Highly breathable, comfortable, latex-free Easy to put on & remove DEPEND Briefs Super Super Plus M, XL, XXL (only available through distributors) Can be fitted while sitting, standing or lying Soft, cloth-like outer with full-length wetness indicator Convenient, refastenable tabs For bladder and bowel incontinence Breathable design for optimum skin health DEPEND Flex (only available through distributors) Breathable belt Advanced odour protection Easy-use, secure re-fastening system Cloth-like cover optimises comfort & skin health DEPEND Cleansing Wipes Pre-moistened cleansing wipe ideal for continence care Large size (20 x 30cm) for full coverage Thick & strong so won t tear in use Soft, hypoallergenic & dermatologically tested Other protection DEPEND Underpads 55 x 40cm Fluid-proof protection for beds, chairs etc Super Plus M, L DEPEND Booster Pads Use with other DEPEND products to increase absorbency by up to 240mL Super thin so discreet Odour protection for increased confidence Normal S, M, L Super M, L Super Plus M, L or XL 15

15 FREE PRODUCT SAMPLE Order samples online or tick the product/s you d like below (max. 2 per household). See pages 12 to 15 for product details. (tick absorbency) POISE Liners Light Regular Extra Long POISE Active Microliners Microliners Long Regular Ultrathins Super Ultrathins POISE Pads Regular Super Extra Extra Plus Overnight DEPEND Shields for Men DEPEND Guards for Men DEPEND Pads DEPEND Undergarments with Buttons DEPEND REAL FIT Underwear for Women S/M (tick size) L XL DEPEND REAL FIT Underwear for Men S/M L/XL DEPEND REAL FIT Underwear Super for Women S/M L XL (tick absorbency / size) DEPEND Underwear Super: S/M L XL Unisex Super Plus: S/M L DEPEND Anatomic Pads (worn with Stretch Pants) (tick absorbency) Normal Plus Extra Super Super Plus DEPEND Stretch Pants (worn with Anatomic Pads) (tick size) M XL XXL Title Name Postal Address Suburb State Postcode Gender Male Female Year of Birth Phone DryNites Pyjama Pants (larger size suits light-framed adults) 4 7 years (17-30 kgs) Male Female 8 15 years (27-57 kgs) Male Female DEPEND Briefs (tick absorbency / size) Normal: S M L Super: M L Super Plus: M L XL DEPEND Flex Super Plus (tick size) M L DEPEND Underpads DEPEND Booster Pads Mail in a stamped envelope to: DEPEND Offer PO Box 784 Brookvale NSW 2100 Tick this box if you do not wish to be contacted by Kimberly-Clark Australia with further promotions. For more information on DEPEND, POISE or DryNites products, bladder or bowel weakness or to order a FREE PRODUCT SAMPLE, call or visit Health professionals visit BLDG423 Registered Trademark Kimberly-Clark Worldwide, Inc. KCWW 01/2015