Incontinence can be messy – accidental leaks and odors require regular cleanup to maintain proper hygiene. As a caregiver, it is important to take precautionary steps to prevent incontinence rashes and uphold a good quality of life for patients.

Incontinence & Skin Care

When caring for someone with incontinence, maintaining a healthy skin barrier can help prevent discomfort and irritation. Skin breakdown can occur due to improper hygiene practices and infrequent diaper changes. Changing incontinence supplies regularly and bathing are necessary for incontinence skin care. 

What is incontinence associated dermatitis (IAD)?

Incontinence rashes, also known as incontinence associated dermatitis, results when there is excess moisture in private areas allowing for bacteria to build up. Common symptoms include:

• Burning sensation or pain
• Inflammation, bumps, or lesions on the skin
• Itching 
• Tenderness
• Redness or harsh rash 

If the patient you are caring for is experiencing symptoms of incontinence rash, it is recommended to clean with a pH cleanser (~pH 5.5) and keep the affected areas dry. Applying a barrier cream and moisturizer can also help hydrate the skin.

How to Prepare a Bath for Incontinent Patient

Bathing an incontinent patient for the first time may be a daunting task. Luckily, there are ways to make bathing easier and more comfortable for both the patient and caregiver.

• Ensure a safe environment and use non skid mat in the tub
• Keep bathroom and water temperature warm for comfortable bathing experience
• Place towels nearby for easier access when drying
• Place blankets nearby in case patient gets too cold (if necessary)
• Utilize a shower stool or bath bench 
• Show patient the location of grab bars for added safety

Tips for Bathing a Patient with Incontinence 

If physically possible, it is best to encourage the patient to bathe themselves. This can help preserve one’s dignity as bathing is usually a personal activity. As a caregiver, you will be there on the side for assistance and support if they are unable to complete a task on their own.

• Build trust and ask for consent before bathing the patient
• Speak in a calm tone and keep patient informed during bathing process
• Protect the patient’s dignity and privacy at all times

How to Give Incontinent Patient a Bath

Following these steps on how to bathe a patient with incontinence:

1. Help undress the patient and remove undergarments
2. Dispose soiled incontinence products (i.e. diapers, pads, liners, etc.)
3. Check for signs of incontinence rashes or bedsores
4. Monitor the water temperature (if bathing in a tub or sit-in shower)
5. Assist patient into the tub or shower
6. Communicate with patient before rinsing their body with water
7. Wipe sensitive areas with a washcloth (wiping from front to back)
8. Wash the patient’s hair and other areas of the body 
9. Dry patient with a clean towel
10. Ensure sensitive areas are dry before applying moisturizers and creams

Bathing Alternatives  

Some patients may not be physically capable of being bathed in a tub or shower. There are other ways to bathe an incontinent patient, such as bed baths with a wash basin or a partial bath at the sink. Caregivers can use wipes and washcloths to remove debris and cleanse the skin. 

How to give a bed bath? 

A bed bath is an alternative way to bathe someone who may not be physically able to move from the bed. Giving a bed bath without getting the bed wet sounds tricky, but it is possible. It is recommended to keep the patient covered with a towel to offer more privacy and only expose parts of the body being washed.

1. Fill wash basin with warm water
2. Wet a washcloth and apply soap
3. Clean the patient with washcloth (start from cleanest area of the body)
4. Rinse the washcloth or use a new washcloth (when needed)
5. Assist patient with rolling over to their side to clean back side
6. Wear gloves and use a new washcloth to clean genital areas
7. Apply ointments or barrier cream in sensitive areas (if needed)
8. Dress the patient in clean clothes

After-Bath Care for Incontinent Patients

After giving an incontinent patient a bath, ask the patient if their diaper or underwear is fitted properly. This can help prevent unwanted incontinence leaks or excess friction that may lead to skin irritation. Be sure to change incontinence supplies when soiled to maintain proper hygiene.

​​Absorbent Incontinence Products to Reduce Skin Irritation

The quality of incontinence supplies is important for preventing skin irritation. It is recommended to find high quality products with maximum absorbency to ensure that moisture from urine is drawn away from the skin. In addition, it is advised to use moisturizers or barrier creams to restore and hydrate the skin. If the patient is experiencing symptoms of incontinence rash, it may be helpful to let the skin breathe without diapers. Using disposable incontinence bed pads are a great alternative to catch nighttime dribbles or leaks.