Continence care is one of the most personal aspects of aged care — and one of the least openly discussed. For families thinking about residential aged care for a loved one, questions about how continence is managed can feel difficult to raise, even though they are among the most important questions you can ask. For older Australians themselves, the prospect of needing help with bladder or bowel control can feel confronting, even shameful — even though incontinence is extraordinarily common and, in most cases, very manageable with the right support.

Good continence care in aged care is not just about providing a pad and moving on. It is about preserving dignity, protecting skin health, maintaining the highest possible level of continence function, and ensuring that every resident feels respected and comfortable in the most intimate aspects of daily life. When done well, it is largely invisible — residents simply feel comfortable, clean, and cared for. When done poorly, the consequences range from skin breakdown and infection to profound loss of self-worth and quality of life.

This guide covers everything Australian families need to know about continence care in residential aged care in 2026: how common incontinence is in this population, how it is assessed and managed, what products are used and why, how skin is protected, what dignity in continence care actually looks like in practice, and what to expect from a quality aged care provider.

How Common Is Incontinence in Australian Aged Care?

Incontinence is far more prevalent in Australia than most people realise — and it is growing. According to 2024 data from Deloitte Access Economics, commissioned by Continence Health Australia, over 7.2 million Australians experience incontinence, representing approximately one in three people over the age of 15. Significantly, this represents a 53% increase in people living with incontinence in Australia since the last national survey was completed in 2010 — a trend driven by the ageing of the population and improved identification and diagnosis.

The cumulative annual cost of continence care and incontinence management in Australia has been estimated at $100.4 billion, encompassing direct health costs including continence products and medical appointments ($66.6 billion) and the broader wellbeing cost of reduced quality of life and employment ($33.8 billion).

In residential aged care specifically, the prevalence is significantly higher than in the general community. Research consistently shows that more than 70% of aged care residents experience some level of incontinence — whether urinary, faecal, or both. Incontinence is also one of the top three contributing factors in the decision to transition into residential aged care, meaning that for a significant proportion of residents, continence care in aged care is a central reason they are there.

Despite this prevalence, incontinence remains heavily stigmatised. Surveys show that more than 70% of people living with incontinence do not seek professional help, and 78% of Australians have never discussed it with their GP. This silence leads to delayed management, avoidance of social activities, depression, and — in the aged care context — conditions that are poorly assessed and inadequately treated.

7.2M+Australians affected by incontinence — up 53% since 2010, representing 1 in 3 people over 15 (Deloitte Access Economics, 2024)

70%+Of residential aged care residents experience some level of incontinence — the most prevalent clinical condition in aged care

$100.4BEstimated annual cost of incontinence in Australia including health costs and lost wellbeing (Deloitte, 2024)

Continence Care in 2026: What Has Changed?

Australia’s aged care system has undergone significant reform over the past 12 months, and those changes have direct implications for how continence care is funded, delivered, and assessed — both in residential settings and at home.

The Aged Care Act 2024 and Strengthened Quality Standards

The strengthened Aged Care Quality Standards, which took full effect on 1 November 2025 under the new Aged Care Act 2024, significantly raised the bar for continence care in residential aged care. Standard 5 (Clinical Care) now explicitly requires providers to conduct individualised continence assessments, develop documented continence management plans, use evidence-based assessment tools, provide products matched to each resident’s assessed needs, and deliver care that upholds dignity, privacy, and resident choice. These are now enforceable legal obligations — not aspirational guidelines.

Support at Home and the Continence Funding Concern

From 1 November 2025, the Support at Home program replaced Home Care Packages for older Australians living in the community. This shift has introduced a new co-contribution model in which participants pay towards certain service categories. A February 2026 Senate inquiry heard alarming evidence from the Inspector General of Aged Care, Natalie Siegel-Brown, that some older Australians under the new funding model can no longer afford their continence pads — a finding that sparked serious concern across the aged care sector.

For families of residential aged care residents, continence products remain covered within the Basic Daily Fee and this issue does not currently affect residential aged care funding. However, it serves as an important reminder that continence care affordability is a live policy issue in 2026, and one worth monitoring as further reforms unfold.

Continence as a Specific Service Code Under Support at Home

Under the Support at Home service framework, continence support is now coded as a distinct, specific service category — separate from general personal care. From July 2026, continence support in home care settings requires its own documentation, outcome reporting, and clinical justification. For families with loved ones receiving continence support through home care, this change means greater transparency about what is being provided and why.

What Is Continence Care in Aged Care — and What Does It Involve?

Continence care in aged care is the full spectrum of assessment, management, product use, skin care, and person-centred support that a facility provides to help residents maintain bladder and bowel comfort, function, and dignity. It is not simply a matter of applying a continence product — it is a clinical and care discipline that spans nursing, allied health, individual care planning, product selection, skin integrity monitoring, and ongoing review.

Best practice continence management in residential aged care is built around a principle the sector now calls continence promotion first: before defaulting to continence products, the care team should do everything possible to support and maintain a resident’s natural continence function. This might mean establishing regular toileting routines, adapting the environment to make the bathroom more accessible, addressing medication side effects that contribute to urgency or frequency, managing fluid intake timing, or engaging a physiotherapist for pelvic floor assessment.

Only when continence promotion strategies are insufficient — or where a resident’s clinical condition means that independent continence is not achievable — does the focus shift to containment and management using continence products. Even then, the goal is always the highest possible level of resident comfort, dignity, and skin protection.

Continence Assessment: The Starting Point for Good Care

Every resident entering an aged care facility should receive a thorough continence assessment as part of their admission process. This is not just about establishing whether the resident is incontinent — it is about understanding the nature, pattern, and likely causes of their incontinence, so that the most appropriate and individualised management plan can be developed.

Continence History

When did incontinence begin? What type is it — stress incontinence (leakage on physical exertion), urgency incontinence (sudden intense urge to void), overflow incontinence (incomplete bladder emptying), functional incontinence (inability to reach the toilet in time due to mobility or cognitive factors), or mixed? How severe is it and how does it affect daily life and social participation?

Bladder and Bowel Diary

A 3-day continence record charts the timing and pattern of voiding and incontinence episodes, helping to identify triggers, patterns, and the most appropriate toileting schedule. This is a core tool in any proper continence assessment in aged care and is referenced in the Continence SMART Care framework developed by Continence Health Australia.

Medical History and Medications

Many medications commonly used in aged care — diuretics, antipsychotics, anticholinergics, sedatives — have direct effects on bladder and bowel function. Medication review is an essential part of any good continence assessment and can reveal reversible causes of incontinence that are straightforward to address.

Mobility and Cognitive Function

Functional incontinence is extremely common in residential aged care. Understanding a resident’s functional capacity — their ability to walk to the bathroom, recognise the urge to void, and manage clothing independently — is essential to designing a practical continence management approach.

Fluid and Nutritional Intake

Dehydration is paradoxically a common cause of urinary incontinence, as concentrated urine irritates the bladder lining. Dietary fibre intake, fluid type, and meal timing all directly affect bowel continence and should be assessed as part of any comprehensive continence review.

Skin Condition

A baseline assessment of skin integrity in the perineal and surrounding areas is essential at admission — establishing a reference point for monitoring skin health and identifying any pre-existing skin damage that may affect product selection.

Following the assessment, a continence management plan should be documented in the resident’s care plan — specifying the type and severity of incontinence, the management approach, the products to be used, the toileting schedule if applicable, and the skin care regime. This plan should be reviewed at least quarterly, or whenever the resident’s condition changes.

💡  CONTINENCE SMART CAREContinence Health Australia (formerly the Continence Foundation of Australia) developed Continence SMART Care (CSC), a best practice continence care model designed specifically for residential aged care. It represents evidence-based, person-centred care that meets the Aged Care Quality Standards. The model emphasises assessment, individualised planning, promotion of natural continence where possible, appropriate product selection, and ongoing review — and is the benchmark framework for quality continence management in Australian aged care in 2026.

Continence Products Used in Aged Care: A Complete Guide

When it comes to continence products in aged care, the range available has expanded significantly in recent years. Modern continence products are far more effective, discreet, and comfortable than previous generations — but choosing the right product for the right person is a clinical decision that requires proper assessment, not a one-size-fits-all approach. Using an ill-fitting or inappropriate product causes leakage, skin damage, and a significant reduction in resident comfort and confidence.

Absorbent Continence Products

Absorbent continence products are the most widely used form of continence management in residential aged care. Selecting the right product depends on the type and volume of incontinence, the resident’s mobility, their ability to participate in self-care, and their skin condition.

Pull-Up Style Briefs

Designed to look and feel like regular underwear, pull-up style briefs are ideal for residents who can weight-bear, transfer, and participate in their own personal care. They preserve a sense of normalcy and independence. Modern pull-up products feature high absorbency cores, odour-neutralising technology, and soft, breathable outer layers that minimise skin irritation.

Tab-Style Incontinence Briefs

These open at the sides with adjustable tabs, making them easier for care staff to change a resident who is bedbound or has very limited mobility. Product selection should always match the resident’s assessed level of incontinence — too high an absorbency can cause skin overhydration, while too low a capacity leads to leakage and prolonged skin exposure.

Shaped Continence Pads

Lighter, shaped absorbent pads worn inside close-fitting underwear are suitable for residents with mild to moderate urinary incontinence. They are less bulky, more comfortable, and more dignity-preserving than full briefs — and should be the default product where a resident’s incontinence level allows it.

Bed and Chair Protection (Underpads)

Absorbent underpads protect bedding and chair surfaces. They should always supplement an appropriate body-worn product, never replace it. Using only an underpad beneath a resident significantly increases the risk of prolonged skin exposure and incontinence-associated dermatitis.

Catheters and External Collection Devices

For residents with specific clinical conditions, catheterisation may be used as a continence management strategy. The type used depends on the resident’s clinical profile, mobility, and medical history.

Indwelling Urinary Catheters (IDCs)

Indwelling urinary catheters are generally avoided in aged care where possible, due to the significant risk of urinary tract infections and long-term discomfort. When used, they require careful clinical management, regular monitoring for complications, and ongoing review of whether catheterisation remains the most appropriate approach.

Intermittent Catheterisation

Intermittent catheterisation — the regular, scheduled insertion and removal of a catheter to empty the bladder — is preferred over indwelling catheterisation for residents with urinary retention, carrying a lower infection risk and maintaining more normal bladder function over time.

External (Condom) Catheters

For male residents, external catheters may be used as a less invasive alternative to indwelling catheterisation. Regular skin checks beneath the device are essential to prevent maceration and skin breakdown in the surrounding tissue.

Bowel Management Products and Strategies

Faecal incontinence requires a different approach to urinary incontinence. A structured bowel management programme — typically developed with input from a dietitian, continence nurse, and GP — addresses the underlying causes alongside appropriate containment. Strategies include dietary modifications, management of constipation (a surprisingly common cause of overflow faecal incontinence), scheduled toileting after meals to take advantage of the gastrocolic reflex, and appropriate use of laxatives or bowel stimulants under medical supervision.

For residents with severe faecal incontinence, specialised bowel management systems may be used in consultation with medical staff — particularly in high-dependency or end-of-life care situations where comfort and skin protection are the primary clinical priorities.

Skin Protection in Continence Care: Why It Matters So Much

One of the most serious — and most preventable — consequences of poorly managed continence care in aged care is skin breakdown. The combination of moisture, warmth, friction, and the chemical irritants in urine and faeces creates a hostile environment for already-fragile older skin. The results can range from uncomfortable redness and rash to painful open wounds that significantly increase the risk of infection and pressure injury.

Understanding Incontinence-Associated Dermatitis (IAD)

Incontinence-associated dermatitis (IAD) is an irritant contact dermatitis caused by prolonged or repeated exposure of the skin to urine and/or faeces. It is characterised by redness, pain, itching, maceration (waterlogging of the skin), erosion, and scaling — and is very commonly associated with secondary fungal or bacterial infection. Research shows that IAD affects up to 41% of residents in long-term care facilities, making it one of the most prevalent and most under-identified skin conditions in aged care.

IAD is not a cosmetic issue. Residents with IAD are up to four times more likely to develop a sacral pressure injury than those without it. Because IAD and pressure injuries can look similar, they are sometimes confused — leading to incorrect management that worsens both conditions. The Aged Care Quality and Safety Commission continues to flag IAD as a priority area of concern in 2026, with regulatory action taken against providers for failure to identify, document, and appropriately manage IAD.

The Three-Step Skin Protection Approach

Best practice skin protection in continence care in aged care follows a structured three-step approach that should be applied consistently after every episode of incontinence.

Step 1 — Cleanse

Skin should be cleansed gently after every episode of incontinence using a pH-balanced no-rinse cleanser, rather than soap and water. Regular soap disrupts the skin’s natural slightly acidic pH, compromising its protective barrier. No-rinse cleansers remove contaminants effectively without rubbing or rinsing — minimising friction on already-vulnerable skin. Disposable soft washcloths are preferable to reusable cloths, which can harbour bacteria.

Step 2 — Moisturise

After gentle cleansing and careful drying (patting, not rubbing), a moisturiser appropriate for perineal skin should be applied to restore and maintain skin hydration. Older skin is naturally drier and less resilient — regular moisturising helps maintain the skin’s barrier integrity between incontinence episodes.

Step 3 — Protect

A leave-on barrier product — typically a barrier cream, barrier film, or three-in-one cleanser-moisturiser-barrier product — is applied to form a protective layer between the skin and the next exposure to urine or faeces. Barrier creams containing zinc oxide or dimethicone are the most widely used in Australian aged care. They should be applied as a thin, even layer — too thick interferes with the absorbency of continence products.

Skin Monitoring and Documentation

Skin condition should be formally assessed and documented at admission, at each continence product change where possible, and whenever a change is observed. Photography of skin lesions (with consent) provides an objective record of progression or resolution and is considered best practice by the Aged Care Quality and Safety Commission.

If IAD is identified and does not improve with standard skin care, or if the condition is worsening, this should be escalated promptly to the facility’s clinical team, the resident’s GP, and if necessary a wound care specialist.

Dignity in Continence Care: What It Really Means

Of all the topics in aged care, continence care most directly touches a person’s sense of dignity, privacy, and self-worth. It involves intimate parts of the body, requires assistance with functions most of us manage entirely privately throughout adult life, and carries a social stigma that can make residents feel embarrassed or diminished — even when the care provided is clinically excellent.

Privacy and Discretion

Every aspect of continence care should be carried out with the resident’s privacy fully protected. Curtains or doors should always be closed during personal care. Continence products should be stored and accessed discreetly. Conversations about a resident’s continence should never take place in shared spaces or within earshot of other residents. Care staff should use respectful, non-infantilising language — referring to a continence “pad” or “brief” rather than a “nappy” is a small but meaningful distinction.

Involving the Resident in Decisions

Good continence care in aged care involves the resident as an active participant in decisions about their own management. Under the Aged Care Act 2024, residents have explicit rights to be involved in care decisions, have their preferences documented and respected, and be given choices where choices exist. If a resident would prefer a particular product, a specific timing for toileting assistance, or a specific staff member to assist them, these preferences should be honoured wherever operationally possible.

Prompt Response to Continence Needs

One of the most common and damaging failures in continence care is a slow response to a resident’s needs. Leaving a resident in a wet or soiled product for extended periods is not just a skin protection failure — it is a profound dignity failure. Call bells and verbal requests for toileting assistance should be responded to promptly. Scheduled continence rounds — regular, proactive checks — are considered best practice, particularly for residents who cannot independently communicate their needs.

Night-Time Continence Care

Night-time continence care deserves specific attention. Australian research found that overnight continence checks were often driven by staff routine rather than individual clinical assessment. Best practice night-time continence care should be based on each resident’s individual preferences, skin health, sleep pattern, and the actual frequency and severity of their overnight incontinence — not a blanket facility-wide routine.

Maintaining Independence Where Possible

Wherever a resident retains any capacity for independent continence management — whether that means independent toileting with grab rail support, self-managing product changes, or simply indicating when assistance is needed — that independence should be actively supported and preserved. The goal of continence care in aged care is never to create dependency where it does not need to exist.

Continence Care and the Aged Care Quality Standards 2025–2026

Under the strengthened Aged Care Quality Standards — which took full effect on 1 November 2025 under the Aged Care Act 2024 — continence care in aged care is addressed explicitly within Standard 5 (Clinical Care) and Standard 1 (The Person). Providers are required to:

• Conduct an individualised continence assessment for every resident
• Develop and document a continence management plan as part of the resident’s care plan
• Use evidence-based assessment tools and validated frameworks such as Continence SMART Care
• Provide appropriate continence products matched to each resident’s assessed needs
• Implement structured skin protection protocols for incontinent residents
• Review continence management plans regularly and in response to any change in condition
• Deliver care that upholds the resident’s dignity, privacy, and right to be involved in decisions

These obligations are assessed through unannounced audits, resident interviews, and clinical file reviews. If you have concerns, contact the Aged Care Quality and Safety Commission on 1800 951 822, or the National Aged Care Advocacy Program (NACAP) on 1800 700 600.

📋  QUESTIONS TO ASK ABOUT CONTINENCE CARE IN AGED CARE ✔  Has my loved one received a full continence assessment with a documented continence management plan? ✔  What continence products does the facility use, and how are they selected to match individual need? ✔  How frequently are continence products checked and changed — including overnight? ✔  What skin care routine is used for incontinent residents? ✔  Does the facility follow a structured cleanse-moisturise-protect skin care protocol? ✔  How are skin changes in the perineal area monitored and documented? ✔  What is the process for identifying and managing incontinence-associated dermatitis (IAD)? ✔  How does the facility support residents to maintain independent toileting where possible? ✔  How does the care team respond to call bells or requests for toileting assistance? ✔  Are continence management plans reviewed regularly and updated when needs change?

Frequently Asked Questions: Continence Care in Aged Care Australia 2026

What continence products are provided in Australian aged care?

Most residential aged care facilities in Australia provide continence products as part of the standard care offering, funded through the Basic Daily Fee. Products typically include absorbent briefs or pads matched to the resident’s assessed level of incontinence, bed and chair protection, and skin care products including no-rinse cleansers and barrier creams. Products should be selected based on individual assessment — not a facility-wide default applied to all residents regardless of need.

Is incontinence care covered by aged care funding in Australia?

Yes, for residential aged care. The cost of continence products and nursing care associated with continence management are covered within the residential funding framework, and residents should not need to purchase their own products for standard care. For those receiving home care under the new Support at Home program, the position is more complex — a February 2026 Senate inquiry heard that some older Australians under the co-contribution model can no longer afford their continence pads. Families with loved ones on home care should confirm how continence products are funded under their current Support at Home classification.

What is incontinence-associated dermatitis and how is it prevented in aged care?

Incontinence-associated dermatitis (IAD) is a skin condition caused by prolonged exposure to urine and/or faeces. It presents as redness, pain, maceration, and sometimes skin breakdown in the perineal and surrounding areas. It is prevented through prompt product changes, gentle pH-balanced cleansing after each episode, regular skin moisturising, and consistent application of a barrier cream or film. Residents with faecal incontinence, reduced mobility, or already-fragile skin require more frequent monitoring and more rigorous skin care protocols.

How does aged care support residents to maintain dignity during continence care?

Quality aged care providers embed dignity into every aspect of continence care — from using respectful, non-infantilising language, to ensuring privacy during personal care, to responding promptly to continence needs. Under the Aged Care Act 2024, residents have explicit, enforceable rights to be involved in decisions about their continence management, to have their preferences respected, and to be supported to maintain whatever level of continence independence they retain.

Can incontinence improve after moving into aged care?

In many cases, yes. Continence promotion strategies — regular toileting schedules, pelvic floor physiotherapy, medication review, fluid management, and environmental modifications — can meaningfully improve continence function in many residents. Even where full continence is not achievable, reducing the frequency or severity of episodes improves comfort, reduces skin exposure, and supports a better quality of life.

What is Continence Health Australia and how can they help?

Continence Health Australia — formerly the Continence Foundation of Australia — is the national peak body for incontinence prevention, management, education, and awareness. They operate the National Continence Helpline, provide a directory of continence nurse specialists, and publish evidence-based resources for consumers and healthcare professionals. Contact the National Continence Helpline on 1800 33 00 66 for free, confidential guidance.

Conclusion: Continence Care Is the Quiet Measure of Quality in Aged Care

Continence care is not a glamorous subject. It does not attract the same public attention as clinical safety incidents or food quality. But for the 70% or more of aged care residents who live with some form of incontinence, the quality of continence care they receive shapes their daily experience of aged care in the most direct and immediate way. It determines whether they feel comfortable or uncomfortable, respected or humiliated, cared for or managed. It determines whether their skin is protected or damaged. And it determines, to a significant degree, whether aged care feels like somewhere they can live well — or merely somewhere they are housed.

In 2026, the context for continence care in Australia is sharper than ever. The strengthened Aged Care Quality Standards have raised the legal bar for what providers must deliver. A 53% increase in Australians living with incontinence since 2010 makes clear the scale and urgency of the challenge. And the February 2026 Senate inquiry revelation that some Australians on home care can no longer afford their continence products has put the issue squarely into the public and political consciousness in a way it has rarely been before.

Good continence care in aged care requires clinical rigour — thorough assessment, individualised management plans, appropriate product selection, evidence-based skin protection protocols, and regular review. It requires investment in training and workforce capability, so that every member of the care team understands not just the mechanics of continence product management, but the clinical significance of skin monitoring, the importance of IAD identification and escalation, and the role of continence promotion in maintaining residents’ function and independence.

And it requires something that cannot be mandated by regulation — a care culture in which every staff member understands that continence care, done with skill and genuine compassion, is one of the most meaningful contributions they make to a resident’s quality of life. A culture where dignity is not a policy aspiration but a daily practice. Where a resident’s comfort, privacy, and self-worth are treated as non-negotiable — not just when an auditor is present, but in every shift, every personal care moment, and every response to a call bell.

If you are looking for aged care in Queensland that meets this standard, Superior Care Group is one of Queensland’s leading aged care providers, with renowned residences in Redland City and on the Gold Coast.

Superior Care Group is family-owned and operated — a distinction that matters profoundly in aged care. Family ownership means that the values underpinning every care decision come not from a corporate governance framework, but from a genuine, personal commitment to the wellbeing of every resident. Superior Care Group has been living that commitment since 1979, when they opened Wellington Park Private Care in Redland City — their founding residence and the beginning of more than four decades of dedicated aged care. In 2011, they extended that commitment to the Gold Coast with the opening of Merrimac Park Private Care, bringing the same founding philosophy of warmth, attentiveness, and genuinely personalised care to a new community.

At Superior Care Group, continence care is understood not as a clinical task to be completed but as an expression of the care relationship — an opportunity to uphold a resident’s dignity, protect their health, and demonstrate the kind of compassionate, attentive care that defines genuine quality in aged care. Their management team, equipped with decades of aged care industry experience, provides the clinical leadership and governance oversight that ensures care plans are not just documented but actively followed and regularly reviewed.

Superior Care Group offers a wide range of aged care services, built on personalised, tailored care plans that respond to each resident’s specific needs, preferences, and circumstances. Our compassionate team ensures the highest standards of support — helping every resident live as comfortably, independently, and with as much dignity as possible.

To learn more about life at Wellington Park Private Care or Merrimac Park Private Care, visit www.superiorcare.com.au or contact their team directly. They are ready to answer your questions — including the ones that can feel difficult to ask.

Compassionate Aged Care in Queensland — Superior Care GroupFamily-owned and operated since 1979. Renowned residences in Redland City and on the Gold Coast. Personalised, tailored care plans. A compassionate team committed to the highest standards of comfort, dignity, and clinical care.Visit www.superiorcare.com.au