Treatment of continence in people with learning disabilities: 2.

Continence is a complex skill predicated on an array of voluntary and involuntary processes that must occur synchronistically. It is a skill that takes the non-disabled child years to perfect. Within the array of skills that combine to achieve continence, there are many opportunities for events to go awry. In clients with learning disability, overall brain function is impaired and more localized damage may coexist. The care and management of continence needs in the adult with learning disabilities can be construed as challenging to service providers. Continence needs, over and above neurological damage and/or societal damage, may also be based within a psychological need. This article, the second in a series examining issues associated with continence care in clients with learning disabilities, considers the differentiation between and understanding of impairment, disability and handicap, both globally and partially. The nurse is asked to place the continence needs of his/her client within this matrix.