Continence support and products: getting assessed

1. Start with the GP or continence service

Explain what leaks, how often, urgency, pain, bowel changes, night waking, constipation, medicines, mobility and the effect on daily life. A diary of drinks, toilet visits and leakage can make patterns clearer if the clinician asks for one.

2. Look for causes and treatment options

Assessment may include questions about health, medicines and routines, and sometimes urine tests or an examination with consent. Treatment depends on the cause. A clinician may discuss pelvic floor exercises, bladder training, bowel management, medicines or referral for further care.

3. Match products to need, not habit

Options include absorbent pads, close-fitting pants, washable underwear, bed or chair protection, urinals and other devices. A continence professional can help assess fit, absorbency, skin contact, changing ability, washing, storage and disposal.

4. Ask what the local NHS service supplies

NHS provision is based on local policy and assessed clinical need; it is not a blanket free-pad entitlement. Eligibility, quantities, product range, collection or delivery and review arrangements vary. England, Scotland, Wales and Northern Ireland have different NHS and trust pathways, and services may prioritise people with particular needs.

5. Plan outings, disposal and private access

For outings, pack spare supplies and plan toilets; the National Key Scheme, often called a RADAR key scheme, opens some locked accessible toilets, not all. Wrap disposable products for household waste unless local instructions differ; never flush pads or wipes. Follow local council disposal guidance.

6. Explain how a product works in everyday life

At assessment, describe whether the person can put the product on, reach the toilet, change it privately and manage clothing afterwards. Give examples of when leakage happens rather than asking only for a larger pad. Mersey Care explains that increasing pad size does not increase absorbency. Ask the nurse to assess size, fit and the type of support needed to hold a shaped pad in place. Show the nurse how the current arrangement is used if the person agrees. Describe slipping, tightness or leaks at the edges, and ask whether the fit or product type needs changing before increasing the supply.

7. Ask about assessment if leaving home is difficult

Explain mobility or transport difficulties when requesting continence advice. Kingston and Richmond describes clinic assessment and district-nurse assessment for patients unable to leave home; ask your own local service which route it offers. Also ask what happens if the person cannot manage separate pads and pants. The local service may offer a different arrangement, so do not assume that every type seen elsewhere is supplied. Request a demonstration of fitting and a written explanation of the review route. Tell the nurse about any helper who changes products, and include the person's preferences about privacy and who should be present.

8. Make a manageable routine for changes and outings

Ask the continence team how to use any wetness indicator on the supplied product and how that fits the person's changing plan. Report skin redness or damage instead of assuming that a thicker cream will solve the problem. Mersey Care warns that some creams can prevent urine entering the absorbent layer. Check which skin protection is compatible before applying it. For trips, Kingston and Richmond suggests taking spare pads, pants and clothing, with a sealable bag for dirty clothes. Pack what the person can use independently where possible, and agree how a companion can help discreetly if changing becomes difficult away from home.

Common questions