Promoting continence following head injury.

Assessment and identification of related problems are crucial in the management of incontinence and the promotion of continence. Assessment checklists and regular recording of incontinence using appropriate charts (toilet charting) help the nurse to diagnose the problems. It is not sufficient just to identify incontinence as the problem; assessment should be much more specific, e.g. identifying problems such as nocturia, nocturnal enuresis, urgency, urge incontinence and polyuria. Planning and implementing care should always promote the optimum level of continence as its final ideal goal. Appropriate and adequate management of any specific aspect/type of incontinence should be considered only if the ideal goal is unachievable. The tools and charts used for assessment are also useful in evaluating the effectiveness of care. Incontinence aids should be chosen only after careful assessment and should be used to lessen the specific problem and help promote continence. They should not be used to encourage continuing incontinence.