The Big Picture
Urinary incontinence means losing control of urine from the bladder. It might be temporary or permanent, and it happens in different ways.
Some clients leak urine during movement. Others suddenly need to urinate, have an overly full bladder, face barriers getting to the toilet, or lose urine at predictable times.
Care depends on the type of incontinence and the client’s care plan. Good care also protects comfort, skin, dignity, and self-esteem.
Look for Nova Scotia CCA Notes throughout this page for current provincial guidance.
Quick tip: Tap, click, or press Enter on any term with a dotted underline and an ⓘ icon to see its plain-English definition.
Start Here If You’re Overwhelmed
Focus on these core ideas:
- Urinary incontinence means loss of bladder control.
- Learn the five main types: stress incontinence, urge incontinence, overflow incontinence, functional incontinence, and reflex incontinence.
- Give clients regular opportunities to urinate and follow the care plan for their individual needs.
- Provide proper skin care and clean, dry garments after episodes of incontinence.
- Change wet bed linens promptly. Leaving a client in wet linens is considered neglect.
- Treat clients with patience, kindness, understanding, and respect for their dignity.
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Course Notes: Key Ideas You Need to Know
What Urinary Incontinence Means
Urinary incontinence is the loss of bladder control. It might be temporary or permanent.
A person might experience one type or more than one type. Mixed incontinence means more than one type occurs.
Incontinence sometimes follows surgery involving the intestinal, rectal, or reproductive system.
The Five Types of Urinary Incontinence
Stress Incontinence
Stress incontinence is leaking urine during exercise or certain movements.
The amount lost is small, less than 50 mL. This small leakage is often called dribbling.
Leakage occurs with activities such as:
- laughing
- sneezing
- coughing
- lifting
- exercise or other movements
Pregnancy later in life and obesity are listed causes. Stress incontinence is common in people who have given birth.
Pelvic muscles weaken due to pregnancies and aging. This weakening is known as pelvic organ prolapse, or POP.
Urge Incontinence
Urge incontinence is loss of urine after a sudden, urgent need to void . The client does not reach the toilet in time.
Three common patterns occur with urge incontinence:
- Urinary frequency: needing to urinate at frequent intervals
- Urinary urgency: needing to void immediately
- nighttime voiding
Causes include:
- urinary tract infections, or UTIs
- nervous system disorders
- bladder cancer
- an enlarged prostate
Overflow Incontinence
Overflow incontinence is leaking urine when the bladder becomes too full.
The client feels as though the bladder never empties completely. The person experiences dribbling or a weak urine stream.
Causes include:
- diabetes
- an enlarged prostate
- some medications
Functional Incontinence
Functional incontinence occurs when the client has bladder control but does not reach the toilet in time.
Physical conditions or barriers in the environment interfere with getting to the toilet.
Causes include:
- immobility
- restraints
- unanswered calls for help
- no call bell within reach
- confusion
- disorientation
- difficulty removing clothing
- not knowing where the bathroom is
Reflex Incontinence
Reflex incontinence is loss of urine at predictable intervals.
Urine is lost when the bladder becomes full, even though the client does not feel the need to void.
Common causes include:
- nervous system disorders
- injuries
Quick Comparison of the Five Types
| Type | Main Pattern |
|---|---|
| Stress incontinence | Small urine leaks during exercise or certain movements |
| Urge incontinence | Sudden urgent need to void, followed by urine loss before reaching the toilet |
| Overflow incontinence | Leakage when the bladder becomes too full |
| Functional incontinence | Bladder control is present, but the client does not reach the toilet in time |
| Reflex incontinence | Urine is lost at predictable intervals when the bladder becomes full |
Challenges Related to Urinary Incontinence
Incontinence often causes embarrassment. Wet clothing and linens, odours, feeling cold, and discomfort add to the difficulty.
Clients also face physical risks. Incontinence is associated with:
- skin irritation
- skin breakdown
- infection
A strong urge to urinate also creates an injury risk. Some clients rush to the washroom and slip or fall on the way.
Incontinence affects emotional and social well-being too. It affects pride, dignity, and self-esteem. Some clients avoid activities, outings, or visits because they fear experiencing incontinence in public.
Clients need support, understanding, and compassion.
Help the Client Urinate Regularly
Regular opportunities to urinate help minimize incontinence.
Useful times include:
- before and after each meal
- before and after activities
- before going to sleep
- upon awakening
Answer calls for assistance promptly. A client asking for help might have an urgent need to void.
Encourage urination at scheduled intervals when this forms part of the client’s care.
Follow the Care Plan
Check with your supervisor and consult the care plan for the best ways to meet the client’s needs.
Care measures depend on the type of incontinence. Different clients need different approaches.
The care plan might include:
- scheduled urination
- bladder training
- pelvic muscle exercises
- directions about fluid intake
- incontinence products
- other individual care measures
Monitor the client’s bladder training program when directed.
Encourage pelvic muscle exercises as directed by the care plan.
Some clients require catheterization, which means insertion of a catheter, to control incontinence.
Record Urinary Output as Directed
Urinary output is the amount of urine a person excretes.
The care plan determines whether urinary output is measured and recorded and how often. Directions include:
- after every hour
- at the end of each shift
- at the end of each day
- no measurement or recording
When urinary output is recorded, include both:
- episodes of incontinence
- successful use of the toilet, commode , bedpan , or urinal
Measure and record urinary output according to the care plan.
Other Elimination Care Measures
Care measures include promoting normal urinary elimination and normal bowel elimination.
Encourage the client to wear clothing that is easy to remove. Buttons, zippers, and undergarments sometimes delay the client long enough for incontinence to occur.
Help prevent UTIs as part of the client’s care.
Fluids and Personal Care
Encourage adequate fluid intake as directed by the care plan.
Before bedtime, decrease fluid intake when directed. The client’s total daily fluid intake is usually not restricted.
Other care measures include:
- encouraging cotton undergarments
- providing perineal care as needed
- keeping the perineal area clean and dry
- providing proper skin care
- providing dry garments and linens
- observing for signs of skin breakdown
Skin Care and Dry Clothing Are Essential
Frequent, proper skin care is essential for clients with urinary incontinence.
After each episode:
- provide proper skin care
- change the client into clean, dry garments
- promptly change wet bed linens
Failure to change wet bed linens is considered a form of neglect.
Incontinence Products
Clients with uncontrolled urinary incontinence have several incontinence products available.
The most suitable product for each client is selected by:
- a nurse
- the client
- the client’s family
Some clients use garment protectors or incontinence pads.
Use incontinence products, sometimes called briefs, as directed by the care plan. Follow the manufacturer’s instructions.
When a product becomes wet:
- remove it
- discard or wash it according to the product type and manufacturer’s instructions
Do not place a soiled brief on the floor while changing a client. Placing it on the floor spreads pathogens.
Put the soiled item directly into the proper container.
Incontinence Pads for the Bed
Incontinence pads help keep bed linens dry.
Some facilities, mainly hospitals, use disposable pads. Other facilities use multipurpose items that work as both transfer sheets and incontinence pads.
These multipurpose items have:
- two layers of padding
- a waterproof backing
Place the incontinence pad over the bottom sheet from the client’s head to mid-thigh.
Fluid passes through the first layer and is absorbed by the lower layer.
When a pad becomes wet or soiled:
- Change the pad.
- Change any damp bed linens.
- Place the wet or soiled linens directly into the correct linen hamper according to employer policies.
Do not place a dry incontinence pad over wet bed linen to save time. Doing this is considered possible neglect.
Care for Clients With Catheters
For a client with a catheter, follow employer policy for securing the catheter tubing to the client’s leg.
Many agencies use an adhesive strip. Securing the tubing helps prevent pulling and the injury that results from pulling.
Nova Scotia CCA Note
Sorrentino’s Canadian Textbook for the Support Worker, 5th Edition explains urinary incontinence care broadly, including toileting support, skin care, incontinence products, and catheter-related care. Current Nova Scotia standards place toileting, elimination, incontinence checks, changing, and cleaning within CCA personal care. (novascotiacca.ca)
Nova Scotia also separates routine CCA care from client-specific or delegated interventions. A CCA must stay within the CCA Occupational Standards of Practice and employer policies, and must not perform interventions that require regulated-professional competencies . (novascotiacca.ca)
Why this matters in Nova Scotia: Do not assume every incontinence-related intervention is a routine CCA task. Follow the care plan, employer policies, and the requirements of your assigned role.
Official source: Continuing Care Assistant Occupational Standards of Practice
Last checked: September 21, 2026
Caregiver Stress
Caring for a person with incontinence sometimes creates stress.
Some family caregivers struggle with the difficulties linked with incontinence and seek long-term care for the client.
Professional caregivers also experience stress because clients need frequent care, including:
- changing wet garments
- changing wet linens
- providing skin care
Do not lose patience with the client.
If you become short-tempered or impatient, discuss it with your supervisor immediately.
The client has the right to remain free from:
- abuse
- mistreatment
- neglect
Incontinence is outside the client’s control. The client does not choose for it to happen.
Show kindness, empathy, understanding, and patience.
Exam Clue Words
- Promptly: Answer calls for assistance promptly and change wet bed linens without delay.
- Immediately: Discuss short-tempered or impatient feelings with your supervisor immediately.
- Follow the care plan: Use directions in the care plan for fluids, pelvic muscle exercises, incontinence products, and other individual measures.
- Avoid: Do not put a soiled brief on the floor. Place it directly into the proper container.
Fast Review
Use these points for a quick review before a quiz or exam.
- Urinary incontinence means loss of bladder control and might be temporary or permanent.
- Stress incontinence involves small leaks, less than 50 mL, during exercise or movements such as coughing, sneezing, laughing, or lifting.
- Urge incontinence follows a sudden urgent need to void when the client does not reach the toilet in time.
- Overflow incontinence occurs when the bladder becomes too full and often involves dribbling or a weak urine stream.
- Functional incontinence occurs when the client has bladder control but physical or environmental barriers prevent timely toilet use.
- Reflex incontinence causes urine loss at predictable intervals when the bladder becomes full.
- Mixed incontinence means the person has more than one type of incontinence.
- Give regular opportunities to urinate and answer calls for help promptly.
- Provide proper skin care, clean dry garments, and prompt changes of wet linens.
- Record urinary output according to the care plan, including incontinent episodes and successful toilet, commode, bedpan, or urinal use.
- Use incontinence products according to the care plan and manufacturer’s instructions.
- If caregiving stress leads to impatience or a short temper, speak with your supervisor immediately.
Final Pep Talk
There are several incontinence types to separate, so focus on the pattern that makes each one different. Review the five types first, then connect each care measure with the client’s needs and care plan.