A resident who was fully continent at admission now wakes to wet sheets three nights a week, and her care plan has not been updated since the spring. Across Canadian long-term care (LTC) homes, this is common — and it usually signals that continence care has drifted into routine rather than assessment-driven practice. The goal is not just keeping residents dry; it is protecting dignity, skin, and quality of life. Here is a practical look at adult incontinence recommended practices for LTC teams.
Start with a Person-Centered Continence Assessment
Incontinence is rarely a single condition. It can be transient — triggered by a urinary tract infection, a new medication, or constipation — or progressive, tied to mobility decline, cognitive change, or pelvic floor weakness. A person-centered assessment tells the difference by reviewing history, medications, fluid intake, bowel patterns, and toileting ability.
Health Canada and the Public Health Agency of Canada recognize that continence management in long-term care must be individualized, with care plans reflecting each resident’s needs rather than a facility-wide default. When assessment drives the plan, residents who can regain independence get that chance; others are fitted with the right product from the start.
Choose Products by Resident, Not by Habit
Product selection is where costs creep up silently. Pull-up briefs suit mobile residents who can toilet with cueing; tab-style briefs work for those who are bed-bound or need staff assistance. Disposable pads add absorbency between changes, and underpads protect the bed — a necessary layer, not an optional extra.
Match absorbency to output. A heavy-absorbency product on a resident with light leakage is wasted budget; a light product on a heavy-output resident means more changes, more skin exposure, and more laundry. CliniEco’s disposable underpads (30x36 inch, heavy absorbency) suit high-output residents, and the CliniEco urology care kit bundles incontinence pads with underpads so care teams can standardize on one system. For more detail, see our guide on choosing the right underpad for long-term care.
Protect Skin Health and Manage Moisture
Prolonged exposure to urine and feces is the main driver of incontinence-associated dermatitis (IAD), which raises the risk of pressure injuries. A structured routine — cleanse, moisturize, protect — should follow every incontinent episode, not just scheduled changes.
Check skin at every change and document redness or breakdown promptly. Early identification means early intervention; waiting until a wound forms turns a manageable issue into a pressure injury investigation.
Build Scheduled Toileting Into the Day
Scheduled toileting — offering the toilet or bedpan every two to three hours — is one of the most effective continence care protocols in LTC. For residents with dementia, prompted voiding pairs the schedule with verbal cueing. Both reduce wet episodes, cut product use, and give residents back a measure of control.
Pair the schedule with hydration. Restricting fluids leads to dehydration, urinary tract infections, and confusion. Encourage regular daytime fluids and time toileting around them.
Train Staff and Document Everything
Continence care fails when it depends on individual habit. Standardized training covers assessments, product application, IAD recognition, and how to communicate changes. A short in-service on product fitting alone can cut waste — a brief that is one size too large leaks, and a leaking brief means a full change plus a load of laundry.
Documentation serves continuity and accountability. Bedside continence records track output, product changes, and skin status, so the care team and provincial inspectors can see care is consistent and responsive.
Reduce Waste and Control Costs Without Cutting Care
Waste reduction starts with right-sized purchasing. Review consumption data quarterly; if one wing uses twice the underpads of a comparable wing, check fitting, change frequency, and product choice before assuming the census changed.
Environmental impact follows the same logic. Every unnecessary change is packaging, product, and laundry. Efficient absorbency — like CliniEco’s heavy-absorbency underpads — means fewer changes per resident per day, lowering both cost and waste.
A Practical Checklist for Care Teams
- Complete a person-centered continence assessment at admission and re-assess quarterly or after any change in status.
- Match product type and absorbency to each resident’s output, mobility, and cognition.
- Follow a cleanse–moisturize–protect skin routine after every incontinent episode.
- Offer scheduled toileting every two to three hours, with prompted voiding for residents with dementia.
- Document output, product changes, and skin status each shift.
- Review product consumption and costs quarterly by unit.
Building a Continence Program That Lasts
Strong continence care is not a single product or policy; it is a system connecting assessment, products, skin care, toileting, training, and documentation. When those pieces work together, residents stay drier, staff spend less time on cleanup, and the facility’s supply budget goes further.
If your team is reviewing its continence program, browse CliniEco’s medical supplies to compare underpads, incontinence pads, and urology care kits for Canadian LTC settings.
Related reading: explore our long-term care and home care resources.
start with our underpad buying guide for absorbency, sizing and cost.
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Frequently Asked Questions
How often should staff offer the toilet during the day?
Scheduled toileting means offering the toilet or bedpan every two to three hours. For residents with dementia, prompted voiding pairs that schedule with verbal cueing. Both approaches reduce wet episodes, cut product use, and give residents back a measure of control. Encouraging regular daytime fluids and timing toileting around them supports the schedule instead of working against it.
Should fluids be restricted to reduce wet episodes?
No. Restricting fluids leads to dehydration, urinary tract infections and confusion, which usually makes continence harder to manage rather than easier. Encourage regular daytime fluids instead, and time toileting around them. Pair hydration with the scheduled toileting round so intake and voiding stay predictable and can be documented at the bedside.
What is the right routine after an incontinent episode?
Follow a structured cleanse, moisturise, protect routine after every episode, not only at scheduled changes. Prolonged exposure to urine and feces is the main driver of incontinence-associated dermatitis, which raises the risk of pressure injuries. Check the skin at every change and document redness or breakdown promptly, so early identification leads to early intervention rather than a pressure injury investigation.
How do we tell whether incontinence is transient or progressive?
Run a person-centred assessment that reviews history, medications, fluid intake, bowel patterns and toileting ability. Transient incontinence is often triggered by a urinary tract infection, a new medication or constipation, and can resolve. Progressive incontinence tends to track mobility decline, cognitive change or pelvic floor weakness. The assessment drives the care plan, so residents who can regain independence get that chance and others are fitted correctly from the start.
How can a facility cut incontinence supply waste without cutting care?
Review consumption data quarterly and match absorbency to output. A heavy-absorbency product on a resident with light leakage wastes budget, while a light product on a heavy-output resident means more changes, more skin exposure and more laundry. If one wing uses twice the underpads of a comparable wing, check fitting, change frequency and product choice first. CliniEco's urology care kit bundles incontinence pads with underpads so teams can standardise on one system across the home.
CliniEco Medical is a licensed medical device establishment (MDEL #35334).
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