Incontinence Care in Assisted Living: What to Know

Talking about incontinence with your parent can be embarrassing and uncomfortable for both of you. But when you’re discussing a loved one’s long-term care needs, understanding all their medical conditions is essential. Reinforce to your parent that incontinence is just like any other medical condition that deserves to be treated properly.

The embarrassment surrounding incontinence — some seniors consider it to be a state worse than death^[01] — can lead many older adults to struggle with incontinence alone without support. If you suspect your parent may be having issues, be prepared to have a conversation using the following facts.

Urinary incontinence (UI) is an involuntary loss of urine, while fecal incontinence (FI) is an inability to control bowel movements. There are many causes of urinary and fecal incontinence, including, but not limited to, the following:

• Chronic illness
• Stress
• Nerve damage
• Physical disability
• Late-stage Alzheimer’s disease and other forms of dementia

Seniors may wear incontinence briefs for any of the reasons above. Some older adults with UI and FI are still very mobile and can use the restroom by themselves, and they might even be able change their own briefs. However, seniors who have limited mobility or significantly reduced cognitive abilities will rely heavily on caregivers to monitor, clean, and change them.

You may be considering what steps senior communities take to manage incontinence as your loved one’s care needs rise. When exploring potential communities, many caregivers have this basic question on their mind: Does assisted living change diapers? Read on to find out exactly how assisted living services can help and what to expect.

Is assisted living the right fit?

Assisted living communities offer assistance with activities of daily living (ADLs) that help manage incontinence, including toileting, mobility, and bathing. In fact, research shows that between 50-90% of older adults receiving long-term care deal with incontinence issues.^[02] However, assisted living facilities offering these services may charge additional “personal care” fees.

Incontinence care services in assisted living may include the following options:

• Bathroom reminders. While making their rounds, assisted living staff might remind or encourage individuals with incontinence to use the restroom.
• Scheduled restroom visits. Many assisted living communities will offer planned restroom visits where an aide will escort a senior to use the bathroom once every few hours.
• Adult diaper or brief changes. Assisted living communities may offer hands-on assistance like adult diaper changes, but because every state has different regulations for assisted living services, there’s no guarantee that every community offers complete continence care.
• Continence management specialists. Some long-term care facilities may have a continence nurse or advisor with specialized experience in continence management, which includes preventative actions like pelvic floor exercises, education on causes and treatments, and more.

At the root of all these services is a common goal among assisted living caregivers: to help residents preserve their privacy and dignity. This means making sure seniors have privacy and are tended to quickly.

“Understanding dignity as a concept is critical to understanding incontinence and its management,” according to research published by BioMed Central Geriatrics.^[02] “Dignity-protective incontinence care is care that is delivered with compassion and respect.”

Assisted living questions? Get expert help

Many assisted living communities welcome residents with incontinence issues and have staff trained to manage these conditions. However, not all assisted living spaces are open to residents with UI or FI. Communities may deny residents with incontinence due to limited community staffing or a facility’s inability to provide proper care as defined by state guidelines. For seniors who can’t help with the management of their incontinence, a skilled nursing facility may be a better fit.

When talking with assisted living communities, be sure to ask the following questions:

• Does assisted living change diapers or briefs for incontinent residents?
• How often are residents evaluated for adult diaper changes?
• Does the community have a continence nurse or specialist on staff?
• Are bed linens changed every day for residents with overnight incontinence challenges?
• Do you charge additional fees for incontinence management?
• Are families responsible for providing briefs or other related cleaning supplies?

You’ll likely have to explore an assisted living community’s website or conduct interviews to determine what level of incontinence care they can offer. By getting the answers to the questions above, you can pick a community that best serves your loved one.

Once you’re ready to start the search for an assisted living community, our experts can help. If you know your parent needs incontinence care as part of their assisted living experience, be sure to share that and other requirements with one of A Place for Mom’s Senior Living Advisors. Once they understand all the needs of your family member, an advisor can arrange interviews with local assisted living options to help simplify the process — all at no cost to you.

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