New Strategies for Observing, Listening to and Caring for Incontinence Patients

About 23% of adults worldwide are diagnosed with some form of urinary incontinence (UI)1. About half of these individuals depend on care either at home or in an institution2.  

Do you care for someone with UI? If you answered yes, this article is for you. Here, we will discuss how to improve patient observation techniques, as well as how to provide patient-centred care.   

Seeing as an Observer 

Observation requires more than sight alone. To observe is to assess, as well as to draw conclusions based on what you see.  

Nurses are in the first line of observation. In clinical settings, nurses usually see patients before the doctor. In care facilities or in home-care situations, patients interact almost exclusively with nurses. This means that nurses’ observations are the most thorough in the healthcare setting.

  1. Avoid Getting too Close: Restrict examination to the examination room or another designated examination space, like a bedroom or bathroom3. Doing so ensures the patient’s privacy and provides a contained observation environment
  2. Limit physical contact to necessary touch4. Touch can be a powerful observational tool and should only be used as such. If you do touch your patient, explain to them why touch is absolutely necessary. Helping change an incontinence pad or perform a routine cleanliness check are examples of necessary touch. 
  3. Keep private matters private5. Allow your patients to feel safe and welcome in your care, but abstain from revealing too much personal information. Likewise, avoid asking the patient for personal details they may not wish to share. UI treatment requires patients to “bare all,” which makes privacy even more crucial.  
  4. If you have multiple patients, divide your time as equally as possible6. Providing equal attention to each patient lessens the potential for oversight and mitigates favouritism
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Listening to the Whole Patient 

According to physician Neil Baum, working in healthcare today is much like working in the service industry: patients seek not only medical assistance but also treatment that caters to their emotional needs7

For Baum, transitioning from a traditional healthcare setting to a proactive, patient-centred facility involves two simple steps: observing, and using those observations to anticipate what will happen next. Below we’ve outlined what nurses should “listen” for in UI patients, as well as how to do so.  

Anticipate Questions 

  1. Provide the patient with an FAQ sheet about UI or about related conditions, such as obesity and Alzheimer’s disease. Understand that patients may have questions outside of these informational tidbits; prepare to answer them to the best of your ability
  2. Inform the patient about alternative treatments for UI if the patient resists standard protocol. Let the patient know every treatment option and help them make an informed decision. Look to lifestyle changes that benefit the bladder, like drinking less coffee

Anticipate Emotions 

  1. Know your patient’s demographics. Are they male or female? Are they work-oriented? Do they have a family at home, or do they live alone? Demographics are the first insight into what may affect a patient. Use them as a guide, especially when working with new patients. 
  2. If you have worked with a patient before, recall their reactions to past treatments. Knowing your patient well is key to understanding how they will react. This process takes time and will only improve with experience
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Providing Sensitive Care 

In the past, healthcare professionals were instructed to see their patients as subjects: they observed, they recorded, they diagnosed. Nurses and doctors still do these things, but in recent years have been encouraged to take a more sensitive approach. 

Sensitive care combines observing and listening, then adds empathy to the mix. Here are some ways to be more sensitive when working with UI patients. 

  1. Let the patient know about UI8. Tell them about the causes of UI and possible treatments, as well as about lifestyle changes and costs associated with UI. Providing patients with insight into their illness is a way to open communication and may ease the adjustment process9.  
  2. Provide information about how treatments function in relation to UI. For example, explain how bladder retraining helps patients minimize urges or leaks, or demonstrate how a healthy lifestyle reduces UI symptoms.     
  3. Respect the patient’s individuality. Over half of UI patients live independently at home10. While they are not medical professionals, they are free to decide which UI treatments to follow. 
  4. See the situation from your patient’s eyes. Especially if you know the patient well, step into their shoes and try to understand their perspective

For over 40 years, Ontex has worked to provide carers and care institutions with the best resources for caring for patients with UI. Go to our carer portal for more advice on providing the best patient care, and learn more about our products by clicking on the link below.   

1 Integrated care for older people (ICOPE). “Evidence profile: urinary incontinence.” World Health Organization, 2017. Source:

2 I. Milsom. “How Big is the Problem? Incontinence in Numbers.” Global Forum on Incontinence, 2011. Source:

3 V.K. Aravind, V.D. Krishnaram, & Z. Thasneem. “Boundary Crossings and Violations in Clinical Settings.” Indian Journal of Psychological Medicine, Jan.-Mar. 2012. Source:

4 Ibid. 

5 Ibid. 

6 Ibid. 

7 N. Baum. “Improve the patient experience with anticipatory patient service.” KevinMD, 15 Mar. 2017. Source: 

8 M. Malugani. “Five Tips for Culturally-Competent Nursing.” Monster, n.d. Source: 

9 L. Korsbek. “Illness insight and recovery: how important is illness insight in peoples’ recovery process?” Psychiatric Rehabilitation Journal, Sep. 2013. Source: 

10 I. Milsom. “How Big is the Problem? Incontinence in Numbers.” Global Forum on Incontinence, 2011. Source: