Continence Care in Australia

Continence Care in Australia: A Practical Guide for People Living with Incontinence and Their Carers

This article is intended for general informational purposes only. It does not constitute medical advice. Please consult your GP, continence nurse, or healthcare professional for personalised assessment and treatment.

Introduction: You Are Not Alone

If you or someone you care for is managing bladder or bowel leakage, the first thing to know is this: you are far from alone.

According to a 2024 Deloitte Access Economics report commissioned by Continence Health Australia, more than 7.2 million Australians are currently living with incontinence — that is 1 in 3 people over the age of 15. By 2032, that number is projected to rise to 8.6 million. And yet, despite how common it is, many Australians still feel embarrassed to talk about it, delay seeking help, or simply do not know where to start.

As a registered nurse who has worked in both acute and community care settings across Australia, I have seen this firsthand. Incontinence affects people of all ages, backgrounds, and health conditions. It is not just an older person's issue. It is not a normal, inevitable part of ageing that you simply have to accept. And importantly — it is manageable.

This guide is designed to help you understand what continence care involves, what your options are, and how to build a daily routine that supports your comfort, skin health, dignity, and quality of life.

What Is Incontinence? Understanding the Basics

Incontinence refers to the involuntary loss of bladder or bowel control. It can range from minor leakage when coughing or sneezing, to a more constant and significant loss of control.

There are several main types:

Stress Urinary Incontinence (SUI)
Leakage that occurs when pressure is placed on the bladder — during exercise, laughing, sneezing, or lifting. This is the most common type, particularly in women who have given birth.

Urge Incontinence
A sudden, intense urge to urinate followed by involuntary leakage before you can reach the toilet. This is often associated with an overactive bladder.

Mixed Incontinence
A combination of stress and urge incontinence. Many people experience both types simultaneously.

Overflow Incontinence
Occurs when the bladder does not empty fully, leading to frequent dribbling. More common in men with prostate issues.

Functional Incontinence
Where a person has normal bladder or bowel control but cannot physically reach the toilet in time due to mobility, cognitive, or environmental barriers.

Bowel (Faecal) Incontinence
The involuntary leakage of stool or gas. According to Continence Health Australia data, 1 in 30 Australians experience this condition, though it is widely under-reported due to stigma.

Understanding which type you or your loved one is experiencing is an important first step — because each type has different management strategies and treatment pathways.

Who Does Incontinence Affect in Australia?

The data paints a clear picture. Incontinence is not a niche health issue — it is a widespread community concern:

• 7.2 million Australians over 15 are living with incontinence right now

• Women are twice as likely to experience incontinence as men — nearly 4 in 10 women versus 2 in 10 men

• 71% of people with incontinence are under 65 years of age — this is not purely an aged care issue

• 9 in 10 people with incontinence live in the community, not in residential care

• The average age of someone experiencing incontinence in Australia is 51

• 1 in 3 people who have incontinence have been living with it for over five years without adequate support

Despite these figures, a 2025 Continence Health Australia National Survey found that 70% of people in the community still lack awareness about incontinence and its management options. Many suffer in silence for years before seeking help.

There is no need to wait. Help is available, and the sooner it is sought, the better the outcomes.

Common Causes of Incontinence

Incontinence is a symptom, not a diagnosis in itself. It can be caused or contributed to by a wide range of conditions, including:

In Women:

• Pregnancy and childbirth (particularly vaginal delivery)

• Pelvic floor weakness or prolapse

• Menopause and hormonal changes

• Urinary tract infections (UTIs)

In Men:

• Prostate enlargement (benign prostatic hyperplasia)

• Prostate surgery or treatment for prostate cancer

• Urinary tract infections

In Both:

• Neurological conditions including multiple sclerosis, Parkinson's disease, and stroke

• Diabetes

• Chronic constipation (which places pressure on the bladder)

• Obesity

• Certain medications including diuretics, sedatives, and some blood pressure medications

• Ageing and associated muscle changes

• Cognitive decline or dementia

Understanding the underlying cause is essential to choosing the right treatment approach. A GP or continence nurse can help determine what is driving the symptoms and refer to appropriate specialists if needed.

Seeking Help: Where to Start in Australia

One of the most important things I tell patients is this: please speak to someone. Incontinence is a health condition, just like any other. It is not something to be ashamed of, and there are trained professionals in Australia whose entire role is to help manage it.

Your GP (General Practitioner)
Your GP is always the right starting point. They can assess your symptoms, rule out underlying causes such as infection, refer you to specialists, and connect you with continence-specific services. GPs can also provide referrals under a GP Management Plan for allied health services with Medicare rebates.

Continence Nurses and Nurse Practitioners
Registered nurses with specialist continence training — often called Continence Nurse Advisors (CNAs) — are among the most skilled professionals in this field. They can conduct thorough assessments, develop personalised management plans, teach pelvic floor exercises, recommend appropriate products, and provide ongoing support. Many work within community health services, aged care facilities, and hospitals.

Physiotherapists Specialising in Pelvic Health
Pelvic floor physiotherapy is a first-line evidence-based treatment for many types of incontinence, particularly stress and urge incontinence. A pelvic floor physiotherapist can assess muscle function and develop a targeted exercise programme. Medicare rebates may be available with a GP referral.

Urologists and Gynaecologists/Urogynaecologists
For complex or persistent cases, specialist referral may be appropriate. A urologist or urogynaecologist can investigate structural or functional issues further and discuss advanced treatment options including procedures or surgery.

The National Continence Helpline
Available on 1800 33 00 66, this free telephone service is staffed by continence nurse advisors who can provide confidential advice, referrals, and information about local services and support groups. This is an excellent first port of call for anyone who is unsure where to start.

Treatment and Management Options

It is important to understand that in many cases, incontinence can be significantly improved — and sometimes resolved — with the right treatment. It does not have to be permanent.

1. Pelvic Floor Muscle Training

Pelvic floor exercises (often called Kegel exercises) are one of the most well-researched and effective treatments for urinary incontinence. Regular, correctly performed pelvic floor exercises can improve bladder control significantly, particularly for stress incontinence. The key word is correctly — many people perform these exercises incorrectly without guidance. A pelvic floor physiotherapist can ensure you are doing them properly.

2. Bladder Training

Bladder training involves gradually increasing the time between toilet visits to help retrain the bladder. It is typically used for urge incontinence and overactive bladder. A healthcare professional can guide you through a structured programme.

3. Lifestyle Modifications

Several lifestyle factors can worsen incontinence, and addressing them can make a meaningful difference:

• Fluid intake: Drinking too little concentrates urine and irritates the bladder. According to the National Health and Medical Research Council (NHMRC), the adequate intake of fluids per day is approximately 2.6 litres for men and 2.1 litres for women (including fluids from all food and beverages). For most adults, aiming for around 6–8 glasses (1.5–2 litres) of water as a drink throughout the day is a practical target — unless your doctor advises otherwise.

• Caffeine and alcohol: Both can irritate the bladder and increase urgency. Reducing intake often helps.

• Constipation management: Bowel and bladder health are closely linked. A high-fibre diet, adequate hydration, and regular physical activity support healthy bowel function.

• Weight management: Excess weight places increased pressure on the pelvic floor and bladder. Even modest weight loss can reduce symptoms.

• Smoking: Smoking contributes to chronic cough, which places repeated pressure on the pelvic floor. It is one of many reasons to quit.

4. Medications

Several medications are used to manage incontinence, particularly for overactive bladder and urge incontinence. These should only ever be prescribed by a doctor following a proper assessment. Medication is not appropriate for all types of incontinence and always comes with potential side effects that need to be considered.

5. Devices and Procedures

In some cases, insertable devices (such as pessaries for pelvic organ prolapse) or minimally invasive procedures may be recommended. Surgical options also exist for appropriate candidates. These are always discussed with a specialist following thorough investigation.

The Role of Continence Products in Daily Life

For many people living with incontinence, continence products play an important and everyday role. They do not replace medical treatment — but they are a practical, essential part of managing daily life with dignity, comfort, and confidence.

Products have improved significantly in recent years. They are no longer the bulky, uncomfortable items of the past. Modern continence products are designed to be discreet, skin-friendly, and effective — and the right product, used correctly, can make a real difference to quality of life.

Understanding the range of continence products available:

Pull-On Incontinence Pants / Briefs
These are worn like regular underwear and are suitable for moderate to heavy urinary incontinence. They have an elastic waistband, pull up and down independently, and are designed for people who are mobile and manage their own toileting. They offer a good balance of discretion, comfort, and protection.

Tabbed / Open Briefs (Slips)
Suitable for people with heavier incontinence or those who require assistance with changes. They have adjustable tab fasteners on both sides, similar to a nappy design, allowing carers to change the product without the person needing to stand. They offer high absorbency and security.

Incontinence Pads / Liners
Designed for light to moderate urinary leakage. These are worn inside regular underwear and are a discreet option for people who want to continue wearing their own clothing.

Incontinence Wipes / Cleansing Wipes
An essential part of the continence care routine. Quality incontinence wipes are used to gently cleanse the skin after each change. They should be alcohol-free, pH balanced, and designed specifically for this purpose — not general purpose baby wipes or household wipes, which may not be appropriate for frequent adult use and may cause skin irritation.

Barrier Creams and Skin Protectants
Used to protect the skin from moisture-associated skin damage (MASD) — a significant risk for people wearing continence products. A thin layer of barrier cream applied after cleansing helps protect skin integrity.

Bed and Chair Protection (Underpads)
Disposable or reusable underpads provide additional protection for mattresses, chairs, and surfaces. Useful overnight or during periods of rest.

Skin Health: An Often Overlooked Priority in Continence Care

As a nurse, skin health is something I feel strongly about — particularly in the context of continence care. Prolonged skin contact with urine or faeces can quickly lead to moisture-associated skin damage (MASD), sometimes called incontinence-associated dermatitis (IAD).

IAD is painful, distressing, and entirely preventable with good skin care practices. It presents as redness, inflammation, and in severe cases, skin breakdown and ulceration. It can significantly worsen quality of life and, in frail or elderly individuals, can be a serious complication.

Best practice skin care for incontinence:

Cleanse gently after every change
Use a purpose-formulated incontinence cleansing wipe or wash. Avoid rubbing — gently pat the skin clean. Look for products that are alcohol-free and pH balanced. The skin in the perineal area has a naturally acidic pH that needs to be maintained to support the skin's natural barrier function.

Dry thoroughly
Pat skin dry after cleansing. Avoid leaving any moisture on the skin before applying a new product.

Apply a barrier product where indicated
A thin layer of barrier cream or protective film helps shield the skin from repeated moisture exposure. This is particularly important for people who experience frequent episodes or who require full-time continence product use.

Check the skin regularly
At every product change, take a moment to inspect the skin. Early signs of IAD — redness, warmth, or mild irritation — are much easier to manage than established damage. If you notice skin breakdown, consult a healthcare professional promptly.

Choose the right products for the individual
Not all continence products are equal. Look for products with soft, breathable outer covers and moisture-wicking inner layers that draw fluid away from the skin quickly. Avoid products with harsh elastic edges or excessive fragrances that may irritate skin.

Choosing the Right Continence Product: What to Consider

With so many products available, choosing the right one can feel overwhelming. Here is a practical framework for making the right choice:

Level of absorbency needed
Products are rated by absorbency level, often indicated by droplet symbols or descriptions (light, moderate, heavy, severe). Match the product to the actual level of leakage — using a product with insufficient absorbency leads to leakage, while using one with excessive absorbency when it is not needed can be unnecessarily bulky and uncomfortable.

Mobility and independence
For people who are independently mobile and manage their own toileting, pull-on pants offer the most dignity and ease of use. For those requiring carer assistance, tabbed briefs may be more practical for both parties.

Body shape and sizing
Products come in a range of sizes, typically based on hip or waist circumference. A well-fitted product is critical for both comfort and leakage protection. A product that is too small will be uncomfortable and may cause skin irritation; one that is too large will gap at the edges and leak.

Skin sensitivity
For individuals with sensitive or fragile skin — common in older adults — look for products with hypoallergenic, dermatologically tested materials and soft inner layers.

Day versus night use
Some products are specifically designed for overnight use with higher absorbency capacity. Others are designed for daytime activity and are lower profile. Consider using different products for different times of day.

Lifestyle and activities
For active individuals, a well-fitted pull-on with a low-profile design supports continued participation in daily life. For people with limited mobility or those in aged care settings, higher absorbency tabbed products may be more appropriate.

Budget and supply logistics
Continence products represent an ongoing cost. Consider whether home delivery, bulk purchasing, or subscription options are available to reduce the burden of regular restocking. Some Australians may be eligible for subsidised continence products through government programmes (see below).

Government Support for Continence Products in Australia

Many Australians are unaware that there is government assistance available to help with the cost of continence products.

The Continence Aids Payment Scheme (CAPS)
CAPS is an Australian Government programme that provides eligible people with a payment to help cover the cost of continence products. To be eligible, a person must have a permanent bladder or bowel condition that requires the use of continence aids. The payment is made directly to the individual and can be used to purchase products of their choice.

Applications are made through Services Australia. A healthcare professional (usually a GP or specialist) must certify the person's eligibility.

NDIS (National Disability Insurance Scheme)
For Australians under 65 with an eligible disability, the NDIS may fund continence products and related supports under a participant's plan. A continence nurse assessment is typically required to establish funding needs.

My Aged Care
For older Australians, continence support may be included in a Home Care Package. Contact My Aged Care on 1800 200 422 to discuss what support is available.

It is always worth asking your GP or continence nurse about what funding you may be entitled to. Many people are eligible but have never been told.

Emotional Wellbeing and the Psychological Impact of Incontinence

The physical aspects of incontinence are well documented, but the emotional and psychological impact is equally significant — and often underacknowledged.

Research consistently shows that incontinence is associated with reduced quality of life, anxiety, depression, social withdrawal, and a loss of independence and self-esteem. People modify their activities, avoid social situations, and limit travel or outings out of fear of an accident. Some withdraw from relationships and stop participating in things they love.

The 2025 Continence Health Australia National Survey found that people with incontinence reported feeling increasingly isolated — including in workplace settings — and that stigma remains a significant barrier to seeking help.

As a nurse, I want to be clear: these feelings are valid and understandable. Managing incontinence is genuinely challenging. But it is also important to recognise that isolation and withdrawal are not the only option. With the right products, the right routines, and the right support, most people can continue to live full, active lives.

A few strategies that may help:

• Connect with others through peer support groups. Continence Health Australia maintains a directory of support groups across Australia.

• Speak openly with your GP or a psychologist if you are experiencing anxiety or depression related to your condition. Mental health support is a legitimate and important part of holistic continence care.

• Plan ahead when going out — know where bathrooms are, carry a small continence care kit, and wear a product that matches your activity level. Preparation builds confidence.

• Talk to trusted family members or carers. Incontinence affects the whole family, and open communication reduces shame and increases practical support.

• Remember that asking for help is a sign of strength, not weakness.

Continence Care for Carers: Supporting a Loved One with Dignity

If you are caring for someone with incontinence — whether a partner, parent, or someone in a professional care setting — this section is for you.

Caring for someone with incontinence requires skill, sensitivity, and patience. It is one of the more intimate aspects of caring, and it is entirely normal to find it challenging at times. Here are some guiding principles:

Always prioritise dignity
The person you are caring for is an adult with a lifetime of experiences, preferences, and self-respect. Approach every interaction with this in mind. Use matter-of-fact language, avoid drawing unnecessary attention to the situation, and always explain what you are doing before you do it.

Establish a routine
Prompted or scheduled toileting — taking the person to the toilet at regular intervals rather than waiting for urgency — can significantly reduce accidents and improve confidence. A routine of every 2–3 hours during waking hours is a common starting point, adjusted to the individual's pattern.

Learn correct technique
Incorrect product application or improper skin care technique can cause unnecessary discomfort and skin damage. If you are new to providing continence care, ask a continence nurse or the person's GP for a demonstration or guidance. Many community health services offer carer education and support.

Take care of yourself too
Caring is physically and emotionally demanding. Carer burnout is real and common. Make sure you are accessing the support and respite you need. My Aged Care (1800 200 422) and Carers Australia (1800 242 636) are good starting points for carer support in Australia.

Know when to escalate
If you notice signs of skin breakdown, increased frequency or urgency, blood in urine, pain or discomfort, or significant changes in continence status, these should be reported to a healthcare professional promptly. These may indicate an underlying issue requiring medical attention.

Building a Daily Continence Care Routine

A consistent daily routine is one of the most effective ways to manage incontinence well. Here is a practical framework:

Morning:

• Complete morning hygiene routine, including gentle cleansing of the perineal area

• Apply barrier protection where indicated

• Fit a fresh, appropriately sized continence product

• Take any prescribed medications at the same time each day

• Have a moderate, consistent fluid intake with breakfast — avoid the temptation to restrict fluids

Throughout the Day:

• Follow a scheduled toileting routine where applicable

• Check product saturation at regular intervals — do not wait until leakage occurs

• Change products promptly when soiled or saturated — leaving a wet product on the skin is a primary cause of IAD

• Carry spare products and cleansing wipes when going out

• Maintain consistent fluid intake — typically 6–8 glasses of water per day, adjusted for climate and activity

Evening:

• Consider a higher-absorbency overnight product if urinary leakage is occurring during the night

• Complete a thorough skin check and cleansing routine before bed

• Limit caffeine and alcohol in the hours before bed, as both can increase urgency and frequency

Ongoing:

• Attend scheduled GP or continence nurse reviews

• Continue prescribed pelvic floor exercises consistently

• Reassess product type and size if needs change
  

A Note on Continence Products and Skin Health: What to Look For

Given how central continence products are to daily care, it is worth taking time to understand what makes a quality product — particularly from a skin health perspective.

When evaluating continence products, I look for the following as a nurse:

Soft, non-woven inner layer
The material closest to the skin should be soft, smooth, and free of rough edges. Abrasive materials or tight elastics can cause friction injuries, particularly in individuals with thin or fragile skin.

Rapid moisture acquisition
The product should draw fluid away from the skin surface quickly and lock it into the absorbent core. Prolonged skin contact with moisture is the primary driver of IAD.

Odour management
Good quality products contain odour-neutralising elements within the absorbent core — not just masking fragrances. Products with excessive fragrance can irritate sensitive skin.

Breathable outer cover
A breathable, air-permeable outer layer reduces the heat and humidity that builds up under a product, supporting skin comfort — particularly important in Australia's warm climate.

Secure, comfortable fit
Products should fit snugly without digging in or gaping. Elastic waistbands and leg cuffs should be soft and flexible.

Dermatologically tested
Look for products that have been dermatologically tested and confirmed safe for sensitive skin. This is particularly important for individuals with a history of skin conditions, allergies, or compromised skin integrity.

The same principles apply to cleansing wipes used as part of the continence care routine. Purpose-formulated incontinence wipes should be large enough for effective cleansing, alcohol-free, pH balanced, and gentle on fragile skin.

Frequently Asked Questions

Is incontinence a normal part of ageing?
No — while incontinence becomes more common with age, it is not an inevitable or untreatable consequence of getting older. Many people of all ages successfully treat or significantly improve their incontinence with the right intervention.

Should I reduce my fluid intake to help with incontinence?
This is a very common misconception. Reducing fluids actually concentrates urine, which irritates the bladder lining and can worsen urgency and frequency. Aim for consistent, moderate hydration throughout the day — typically 1.5 to 2 litres — unless your doctor advises otherwise.

Can men experience incontinence?
Yes. While incontinence is more common in women, approximately 2 in 10 Australian men experience it. It is particularly associated with prostate conditions and their treatment, but occurs for other reasons too.

I feel embarrassed talking to my GP about this. What should I do?
This is completely understandable, but please do not let embarrassment delay getting help. GPs discuss bladder and bowel issues regularly — it is a routine part of their work. You might find it helpful to write down your symptoms before the appointment, or to call the National Continence Helpline (1800 33 00 66) first to speak confidentially with a nurse before approaching your GP.

What is the difference between incontinence pads and standard period pads?
Incontinence products are specifically designed to manage urine, which has different properties to menstrual flow. Incontinence pads absorb larger volumes of fluid more rapidly, and are designed to neutralise odour from urine. Period pads are not suitable substitutes for managing urinary incontinence.

Can incontinence be cured?
In many cases, yes — particularly when caused by a treatable underlying condition, or when addressed early with pelvic floor rehabilitation, bladder training, or appropriate medical or surgical treatment. Even where a complete cure is not achievable, symptoms can almost always be significantly improved with the right management.

Resources and Support in Australia

Continence Health Australia (formerly Continence Foundation of Australia)
Website: continence.org.au
National Continence Helpline: 1800 33 00 66 (free call, staffed by continence nurse advisors)

My Aged Care
Phone: 1800 200 422
Website: myagedcare.gov.au

NDIS (National Disability Insurance Scheme)
Website: ndis.gov.au

Services Australia – Continence Aids Payment Scheme (CAPS)
Website: servicesaustralia.gov.au/caps

Carers Australia
Phone: 1800 242 636
Website: carersaustralia.com.au

Pelvic Floor First (Continence Health Australia)
Website: pelvicfloorfirst.org.au

Final Words

Incontinence is common, manageable, and nothing to be ashamed of. Whether you are navigating this yourself or supporting someone you love, the most important step is the first one: reaching out.

Australia has excellent continence health resources, skilled professionals, and high-quality products designed to support you. The combination of the right clinical support, the right daily routine, and the right continence products can make an enormous difference to comfort, confidence, and quality of life.

You do not have to manage this alone. And you do not have to put your life on hold.

This article has been written for general informational purposes by John, a Registered Nurse practising in Australia. It does not constitute medical advice and is not intended to replace consultation with a qualified healthcare professional. Always consult your GP, continence nurse, or relevant specialist for advice tailored to your individual circumstances. Product references in this article are for illustrative purposes. Individual needs vary significantly and should be assessed by a healthcare professional.

For urgent health concerns, please contact your GP, call 000 in an emergency, or contact the National Continence Helpline on 1800 33 00 66.