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Caregiving and night incontinence

If you are providing night care to patients, residents or clients who are incontinent, or need support to remain continent, it's important have effective tools and tricks at your disposal that are based on an understanding of the functions of sleep, and the effects of sleep deprivation. In this article you'll find useful information on a range of these topics, all of which are aimed at one simple goal: a better night's sleep for your patient, resident or client..

Why is sleep so important?

There’s a reason why regular periods of uninterrupted sleep are a sacred thing to most of us. Sleep helps us recover and revitalize, and repairs muscle tissue after an active and stimulating day. While you are resting, your immune system identifies intruding elements, and "charges" the recognition of those elements into its memory, to better resist infection. Sleep also consolidates your memories, making you sharper during your waking hours.

What happens when residents lose sleep?

In the case of the elderly, broken sleep patterns can lead to a whole range of negative consequences, including mood swings, impaired judgment and memory, increased sensitivity to pain, heightened risk of infection, greater risk of falling, and difficulty coping with daily activities and rehabilitation programmes.

At the same time, our bodies change as we get older, and some of these changes can make it harder for the elderly to get a good night's sleep. In general, our sleep becomes shallower, with frequent awakenings. Our kidney function also declines, and our bladder grows less elastic, which results in needing to empty more frequently at night.

Old age also increases the risks involved in nighttime trips to the bathroom. Research1 of over 400 falls that occurred among hospitalised patients over the age of 60 showed that more than 1/3 of all falls were related to toileting, and almost half of these occurred at night. The study also showed that the majority of falls happened due to lack of sufficient assistance.

Tips for an efficient nighttime caregiving routine

Taking good care of residents who are incontinent requires an individualised care plan, with appropriate continence management, good staff cooperation, and knowledge about how various factors affect sleep. Here are a few steps you can take to minimize sleep interruptions and make your nighttime caregiving routine more efficient.

Start with the basics

Seemingly obvious measures like not drinking coffee or too much liquid before going to bed, and voiding the bowel and bladder, are a good place to start. Coordinating the care recipients daytime sleep schedule to cut down on the frequency and length of their naps may help too. Make sure they are on a consistent sleep cycle, with regular bed times, and think about their medication regiment. Some medications like diuretics increase thirst and fluid intake, and should be administered earlier in the day to allow time for new fluids to pass through the system.

Good habits for better sleep

Consider behavioural factors that may be contributing to loss of sleep. Is the resident getting enough fresh air and exercise in their daily routine? Perhaps they are experiencing new sources of sleep-depriving pain or irritation, which changes to their analgesic regime could alleviate. Watching TV in the evening may be too stimulating for some care recipients, and although alcohol does induce drowsiness, it actually interferes with the body's sleep-regulating mechanism. Instead, encourage activities like gentle stretching, reading, or listening to calm music, to promote a restful frame of mind.

Safety

Hurried trips to the bathroom alone at night carry a risk for older people. One way to enhance safety and streamline the whole process is to install a chair-style commode next to the bed. If this is not feasible or desirable, at least make sure the resident can see where they are going at night, and has a clear path. Install motion sensor lights, if possible, and be sure to clear the path of loose rugs and other hazards. If advanced dementia is present and night wandering is a concern, a bed alarm can be useful to alert you if the resident should get up and wander off.

Take care of fragile skin

The discomfort of a nagging skin condition can have a serious impact on a care recipients sleep, and may in some cases contribute to an increased need to urinate at night. To help maintain natural skin health, TENA has developed a three-step skin health solution for those living with incontinence.

 A package of TENA ProSkin Comfort incontinence pads

Keep it dry using TENA ProSkin fast-absorbing products to reduce moisture on the skin, both day and night.

A package of TENA ProSkin wet wipes

Keep it clean with TENA ProSkin wipes and wash creams.

A package of TENA ProSkin Barrier Cream

Keep it protected by applying TENA ProSkin Zinc cream for sensitive skin, or TENA Barrier cream for protection against irritants.

Offer protection, support, and comfort

In spite of your best efforts, night incontinence episodes may simply be a fact of life for some care recipients. But you can help make their experience considerably less uncomfortable with protective measures and purpose-made products. Waterproofing their mattress is a good starting place, and padding their bed will let you avoid the disruption of changing linens in the middle of the night. When it comes to incontinence products, make sure it is the right combination of type, size and absorption capacity, and that it is fitted correctly. TENA has an excellent product selector tool to help you make the right choice with a product for your care recipient.

TENA believe in looking after delicate skin and TENA Proskin is the first continence range to be endorsed by the Skin Health Alliance

TENA ProSkin Pants Night - designed for night useage

TENA ProSkin Pants Night are specifically designed for use at night. With 16% more absorbency at the back2 where it matters most when lying down, they keep fragile skin drier and protected for longer. Made of breathable materials, and offering Triple Protection for dryness, softness and leakage security, TENA ProSkin Pants Night have an excellent success rate. Fully 99% of caregivers say their residents stay dry all night3, and lab tests have shown them to be 32% drier after 7 hours of use4. Finally, like all products in the TENA ProSkin range, they have been dermatologically tested and accredited by the Skin Health Alliance.

Learn more
TENA ProSkin Pants Night - designed for night useage

1 Rose G, Decalf V, Everaert K, Bower WF. Toileting-related falls at night in hospitalised patients: The role of nocturia. Australas J Ageing. 2019;00:1-7. https://doi.org/10.1111/ajag.12696

2 Compared to TENA ProSkin Pants Super

3 5602: TENA Pants Night, Quant In-home CUT, Poland, Nov 2019, n=128

4 Lab tests show that TENA ProSkin Pants Night is significantly drier (32%) after 7 hours (Rewet Lab Data and 7th hr measurement of TENA ProSkin Pants Night vs TENA ProSkin Pants Super).