Instructions

Screening Tools

Approaching the topic of incontinence can feel uncomfortable for patients. The clinician can help the patient to gain confidence and comfort by communicating with both empathy and without judgement. Showing genuine concern for the patient and assuring them that there are many treatment options and that an assessment will help to identify the best treatment path for them as an individual can help to ease awkwardness in talking about incontinence. Once the patient is open to discussion, the clinician can encourage them by acknowledging that the subject might be difficult to discuss and avoiding telling the patient how they should feel. For instance, telling a patient to not feel embarrassed may create more anxiety for the patient.

The clinician can then introduce some assessment questions to explore the issue of incontinence. For instance, to explore urinary incontinence, the clinician might ask:

Do you sometimes leak urine? If so, what are some things that you think might set that off?

Does the need to use the bathroom wake you up at night? How often would you say that happens?

Does anything you eat or drink seem to contribute to an urgency to use the bathroom?

The clinician can introduce the idea of a bladder or bowel diary that can be given to the patient as shown below. The clinician should go over the diary and suggest how to fill it out and how the diary will help to identify the management and treatment options best suited to them.

Fecal incontinence can be even more difficult for patients to discuss and seek care. Remember we mentioned that women were about three times more likely to seek care for fecal incontinence than men? Fecal incontinence can cause more than simple discomfort and patients may not know of management options that could diminish limitations that they may put on themselves due to discomfort and embarrassment. Respectful and frank discussion can put the patient on the path to improve their quality of life and re-open themselves to healthy social interactions.

A stool diary can help the patients and/or caregiver to identify fecal incontinence frequency and urgency. As with urinary incontinence diaries, patients and caregivers should be advised about how to fill out this form and how it can be used to determine treatment options--and it can also be used to monitor for results.