With good advice and some preparation, bladder and bowel problems can be managed discreetly as part of everyday life.
Help with daily life
If you need support to cope day-to-day at home after a stroke, contact your local council’s adult social services department (or health and social care trust in Northern Ireland). They can arrange a care needs assessment.
Occupational therapists can help you regain your independence through activities to support your recovery. They can also help if your home needs to be adapted, or if you need equipment to make it easier to get to and use the toilet. This could include walking aids, hand rails or raised toilet seats.
Dietitians can recommend a suitable, well-balanced diet and fluid intake, as well as any dietary changes that may help you.
Aphasia-friendly video on using public toilets
Self-help tips for living well with incontinence
1) Plan ahead when going out
- Planning access to toilets before you go out will help you manage better. If you are going somewhere unfamiliar, there are websites and apps which list public toilet locations.
- It can also be helpful to bring a change of clothing and a hygiene kit with you. This might include plastic bags, soap, a flannel, antibacterial wet wipes and disposable gloves.
- Carry a Just Can’t Wait card and a RADAR toilet key.
- The National Key Scheme (NKS), also known as the RADAR Scheme, provides keys to public disabled toilets. The scheme is available to people with disabilities or health conditions seriously affecting their continence. Keys can be bought from organisations including Disability Rights UK and some local councils.
- The Just Can’t Wait toilet card is available from organisations including Bladder & Bowel UK. Showing this card discreetly allows you to access toilets in many locations, such as cafes, shops and businesses. You can order a free card from Bladder & Bowel UK or see ‘Other sources of help and information’ for more information.
2) Find a routine that works for you
- A daily routine of regular visits to the toilet, staying hydrated during the day and reducing the amount you drink just before bedtime, should help avoid accidents.
- Try using alarms. An alarm can be used to schedule a visit to the toilet during the night, or you may prefer a moisture alarm on your bed. This will sound when wetness is detected and is designed to wake you so you can finish emptying your bladder in the toilet. You may wish to wear a silent vibrating alarm watch, which can be set to give a discreet reminder at regular intervals. A silent alarm is also useful at night to avoid disturbing others.
- Know your own bladder and bowel patterns and try to stick to your routine. Don’t go to the toilet ‘just in case’. Go when you feel the need to go.
3) Keep a supply of continence products
There are various continence products available.
- Absorbent products, such as incontinence pads or pull-on pants, can help absorb leaks. You might need an assessment through your local NHS continence service to see if you’re eligible to receive a free, regular supply of continence products, such as pads. Eligibility varies throughout the UK.
- Your GP surgery or continence adviser can tell you what is provided free of charge through your local NHS and what you can buy yourself. Continence advisers or GPs may prescribe specialised products. They include catheters, anal inserts, urine drainage bags and appliances for men.
- If you cannot get them free through your local NHS, you can buy them from most supermarkets, pharmacies, by mail order or online. If you buy them online or by mail order, you might need to complete an exemption form so you do not pay VAT (tax) on them.
4) Keep your skin healthy
Moisture, friction and bacteria due to urine or faeces next to your skin can cause skin rashes and infection.
- Careful hygiene and skin care are needed to avoid the risk of skin damage, such as redness, soreness and blistering (incontinence-associated dermatitis).
- Take care of your skin by using mild soap or specialised products, and clean and dry your skin gently and thoroughly. Your healthcare professional can advise you on any products you may need to help keep your skin clean and dry.
5) Aim for a healthy diet and lifestyle
- Drink enough fluids during the day. This will help to avoid bladder infections and constipation. Try to have 6–8 glasses of fluid each day, unless advised otherwise by a healthcare professional. You may need to drink more if you have a catheter.
- Cut down on caffeinated drinks, such as tea, coffee and cola, and avoid fizzy drinks as they can irritate the bladder. Alcoholic drinks can cause dehydration as they can make you need to wee more often.
- Eat a balanced diet with plenty of different fruit and vegetables. They contain valuable fibre, which helps bowel movements.
- Keep as active as you can. This can help to reduce bladder leakage and will help to stimulate your bowel to move regularly.
- If you need to wee frequently at night, avoid caffeine and alcohol later in the day, and try drinking less fluids as you approach bedtime. You can buy washable, waterproof bedding to help catch any leaks in bed.
6) Practice good daily habits and hygiene
- Remember to follow all the bladder and bowel training tips and exercises your nurse or continence adviser has given you. It takes time for the effects to show, so keep going with them.
- Empty your bladder fully when you go to the toilet. This can help to avoid infections. Sometimes sitting for longer can help, or you could try standing up and sitting down again.
- Wear clothes that are quick to remove, such as skirts or trousers with elasticated waistbands. You can also buy adapted clothing with Velcro fastenings which are easier to undo with one hand.
- Dispose of wet or soiled products safely. Ensure disposal bags are secure and leakproof and use a bin with a lid.
Remember you’re not alone. You can connect with others who understand stroke first-hand and share tips on our Online Community.
Help for carers
If you’re supporting someone with bladder or bowel problems, it can be a lot to cope with. It can feel like a change in your relationship with the person too if you’re involved with their personal care. You and your loved one may find it difficult to preserve their comfort and dignity while following a toileting routine, giving and receiving intimate care, or dealing with soiled clothes and bed linen.
Healthcare professionals should involve you and the stroke survivor in developing their incontinence treatment plan, and offer you any training you need to support the person. You may find it useful to speak to a specialist continence adviser or one of the organisations listed in ‘Other sources of help and information’. They can talk through your questions and concerns, help you consider all the options and make practical arrangements.
If you feel you need more support with your caring role, contact social services at your local council to ask for a carer’s assessment. You may be eligible for some support, such as respite care or training in safe lifting.
Our Stroke Support Helpline can answer questions you may have or help you find other sources of support. You can also connect with others who have experience of supporting stroke survivors on our Online Community.