Continence and constipation

This fact sheet from The Canadian Continence Foundation provides an overview of fecal incontinence, lifestyle changes and treatments. Available in a print out version.   

Appendix G from the RNAO A Proactive Approach to Bladder and Bowel Management in Adults — Fourth Edition shows how the best practice guideline recommendations can be applied in the clinical setting.  Registered Nurses’ Association of Ontario (RNAO). A proactive approach to bladder and bowel management in adults. 4th ed. Toronto (ON): RNAO; 2020. (p.131).

This tip sheet from Smart Tips for Stroke Care, highlights key considerations for supporting individuals experiencing bladder and bowel incontinence after a stroke. Smart Tips for Stroke Care (2023) was created by members of the Regional Stroke Networks of Ontario.   

Appendix Q from the RNAO A Proactive Approach to Bladder and Bowel Management in Adults — Fourth Edition shows pictures of stools to help improve assessment of constipation. Registered Nurses’ Association of Ontario (RNAO). A proactive approach to bladder and bowel management in adults. 4th ed. Toronto (ON): RNAO; 2020. (p. 147).

This resource has illustrations and procedures on how to do intermittent catheterizations in adults. Reference: Vahr, S. Cobussen-Boekhorst, H, Eikenboom, J, Geng, V, Holroyd, S, Lester, M, Pearce, I and Vandewinke, C. 2013. Evidence-based Guidelines for Best Practice in Urological Health Care Catheterisation Dilatation, urethral intermittent in adults. European Association of Urology Nurses. © EAUN  

Appendix O from the RNAO A Proactive Approach to Bladder and Bowel Management in Adults — Fourth Edition is a comprehensive list of physical, emotional and other factors that contribute to constipation.  Registered Nurses’ Association of Ontario (RNAO). A proactive approach to bladder and bowel management in adults. 4th ed. Toronto (ON): RNAO; 2020. (p.144-145)

A one time, single resident risk assessment for dehydration based of the University of Iowa Dehydration BPG. References: Mentes, J. C. & The Iowa Veterans Affairs Nursing Research Consortium. (2004). Evidence-Based Practice Guideline: Hydration management. Iowa City, IA: The University of Iowa Gerontological Nursing Interventions Research Center Research Translation and Dissemination Core. Mentes, J. C. & Iowa-Veterans Affairs Research Consortium. (2000). Hydration management. Journal of Gerontological Nursing, 6-15.

This algorithm looks at a multidisciplinary approach related the management of urinary incontinence in the community or long term care homes. It addresses: presenting symptoms, clinical assessments, presumed etiology, treatment/management and evaluation. This one page tool can be laminated and posted for reference. © 2001 The Canadian Continence Foundation

This powerpoint presentation for health care providers, shows how to distinguish between the types of urinary incontinence and interventions to treat urinary incontinence.  A poster and patient handout are also part of this module which is also available in French. © 2025 Regional Geriatric Program of Toronto. 

Appendix P from the RNAO A Proactive Approach to Bladder and Bowel Management in Adults — Fourth Edition is a list of the major drug groups that can contribute to constipation.  Registered Nurses’ Association of Ontario (RNAO). A proactive approach to bladder and bowel management in adults. 4th ed. Toronto (ON): RNAO; 2020 (p. 146).

Ostomy Canada Society (OCS) is a non-profit volunteer organization for people with ostomies and their families. The OCS website has practical ostomy care information on a variety of topic with good visuals. Resources are aimed at patients and families, but are applicable to health care professionals. © 2025, Ostomy Canada Society. 

This resource from the Canadian Continence Foundation, provides a list of some medications used for overactive bladder treatment.    

This resource from the Canadian Continence Foundation explains pelvic muscle exercises, how they may help with incontinence and how to properly perform them.  

The best practice guideline (BPG) A Proactive Approach to Bladder and Bowel Management in Adults, Fourth Edition (2020) replaces the RNAO BPGs Promoting Continence Using Prompted Voiding and Prevention of Constipation in the Older Adult Population, both of which were last updated in 2011. This BPG provides evidence-based recommendations for effective strategies to support adults (aged 18 years and older) who live with urinary incontinence, fecal incontinence and/or constipation that will improve quality of care and lead to positive health outcomes. The BPG includes good practice statements on conducing a focused initial assessment and recommendation areas that address the following: toileting strategies, physical activity, adequate intake of fibre and/or fluids, interprofessional approach and bowel protocol. This BPG can be used by nurses, members of the interprofessional team and caregivers across the continuum of care and in all domains of practice such as administration, clinical, education, policy and research.  The evidence-based recommendations in this BPG are applicable to all practice settings where persons who live with urinary incontinence, fecal incontinence and/or constipation are accessing services (e.g., acute care, long-term care, primary and community care, and rehabilitation settings). Registered Nurses’ Association of Ontario (RNAO). A proactive approach to bladder and bowel management in adults. 4th ed. Toronto, ON. Author.

La ligne directrice sur les pratiques exemplaires (LDPE) Une approche proactive de la gestion de la vessie et des intestins chez les adultes Quatrième édition, remplace les LDPE de la RNAO Favoriser la continence par le déclenchement de la miction et Prévention de la constipation chez les personnes âgées - Lignes directrices sur les pratiques, toutes deux mises à jour pour la dernière fois en 2011. Cette LDPE fournit des recommandations fondées sur des preuves pour des stratégies efficaces pour soutenir les adultes (âgés de 18 ans et plus) qui vivent avec l'incontinence urinaire, l'incontinence fécale et/ou la constipation qui amélioreront la qualité des soins et mèneront à des résultats de santé positifs. Le LDPE comprend des énoncés de bonnes pratiques sur la réalisation d'une évaluation initiale ciblée et des domaines de recommandation qui traitent des éléments suivants : stratégies d'élimination des toilettes, activité physique, apport adéquat de fibres et/ou de liquides, approche interprofessionnelle et protocole intestinal. Ces LDPE peuvent être utilisées par les infirmières, les membres de l'équipe interprofessionnelle et les soignants dans tout le continuum de soins et dans tous les domaines de pratique tels que l'administration, la clinique, l'éducation, les politiques et la recherche. Les recommandations fondées sur des données probantes de ce LDPE s'appliquent à tous les milieux de pratique où les personnes qui vivent avec une incontinence urinaire, une incontinence fécale et/ou une constipation accèdent à des services. Registered Nurses' Association of Ontario, Une approche proactive de la gestion de la vessie et des intestins chez les adultes, (2020). Toronto, (ON). Author.

Appendix S from the RNAO A Proactive Approach to Bladder and Bowel Management in Adults — Fourth Edition provides systematic approaches to decreasing constipation. Registered Nurses’ Association of Ontario (RNAO). A proactive approach to bladder and bowel management in adults. 4th ed. Toronto (ON): RNAO; 2020. (p.150-151).

A one-time, single resident assessment for 30 signs and symptoms of dehydration. Author and Date unknown

This comprehensive website from the Canadian Continence Foundation has resources on both urinary and fecal incontinence. Including information about bladder health, causes of urinary incontinence, diagnosis and treatment of urinary incontinence, pamphlets and videos.  Reference: The Canadian Continence Foundation. 

This information sheet from the Canadian Continence Foundation- describes what bladder training is, provides tips to decide whether bladder training is feasible and how to get started. Canadian Continence Foundation.    

This powerpoint presentation aimed at health care providers, describes bladder physiology, classifies and identifies medications that contribute to incontinence and pharmacological treatments used for urinary incontinence. It is also available in french Alston, Jillian ( 2020) Urinary Incontinence & Medications- Clinician Learning Series. Ontario. Retrieved from https://www.rgptoronto.ca/resource/urinary-incontinence-medications-clin... © 2025 Regional Geriatric Program of Toronto. 

This resource highlights a treatment plan for an elderly person with a diagnosis of memory impairment who develops a urinary tract infection that results in delirium.  © 2025 Alzheimer's Society.

This is a one-page algorithm that is part of Public Health Ontario’s Urinary Tract Infection (UTI) Program. It clearly describes signs and symptoms of UTI’s and promotes ‘watchful waiting’ as an acceptable alternative before treating probable UTI’s. Is suitable for posting on a bulletin board. Reference: Public Health Ontario (PHO). 2019. Assessment algorithm for urinary tract infections (UTIs) in medically stable non-catheterized residents. © 2019 Ontario Agency for Health Protection and Promotion

This PHO resource provides basic facts about asymptomatic bacteriuria. Public Health Ontario, 2014, Asymptomatic Bacteriuria Fact Sheet. Revised: November 2019

This fact sheet is part of Public Health Ontario’s Urinary Tract Infection (UTI) Program. It succinctly describes the evidence for not using dipsticks to diagnose UTI’s. Is suitable for sharing with staff, residents and families. Public Health Ontario (PHO). Revised 2019.  

This resource can be used by health care providers at the long-term care homes (LTCHs) when consulting or meeting with friends and families of residents who have questions about a LTCH’s approach to managing suspected UTIs. Reference: Public Health Ontario (PHO). Revised 2016.

This PowerPoint presentation is part of Public Health Ontario’s Urinary Tract Infection (UTI) Program. It provides an overview of how to implement a UTI program. Reference: Public Health Ontario (PHO). 2017. UTI Program (PHO) Management of UTIs in Non-catheterized Long-Term Care Home Residents.  © 2017 Ontario Agency for Health Protection and Promotion

This sample policy and procedure is part of Public Health Ontario’s Urinary Tract Infection (UTI) Program. It is a comprehensive policy that could be adapted by long term care homes and other health care organizations. It is complimented by a guidance document available on the PHO website. Reference: Public Health Ontario (PHO). Revised 2019. UTI Program: Sample policy and procedure for assessment and management of urinary tract infections (UTIs) in non-catheterized residents. Revised: November 2019    

This Public Health Ontario resource provides a list of UTI symptoms, contrasts between non-catheterized and catheterized residents and when not to send a specimen. Reference: Public Health Ontario, 2014, When To Collect A Urine Specimen For Culture And Sensitivity Fact Sheet. 

Public Health Ontario (PHO) has developed the Urinary Tract Infection (UTI) Program in response to concerns about the overuse of antibiotics for presumed UTI's in residents in long-term care homes (LTCHs) and the associated antibiotic-related harms. The Program contains a number of tools for assessment, planning, implementation and evaluation of a program to reduce UTI’s in LTC homes. Reference: Public Health Ontario (PHO), 2019. Urinary Tract Infection (UTI) Program. © 2025 Ontario Agency for Health Protection and Promotion   

This is a comprehensive list of reasons for delirium that need to be considered before assuming that a change in mental status is due to a UTI.  Public Health Ontario (2019). UTI Program (PHO)- Causes of Delirium and Mental Status Changes