URINARY INCONTINENCE

SELF-MANAGEMENT

TECHNIQUESPresentation By:

Gina Kaczmarek, Student Nurse

URINARY INCONTINENCE Urinary incontinence (UI) defined as the

involuntary loss of urine Affects 1/3 of community-dwelling

elderly women and 1/5 of men Increases to 50% for elderly in nursing

homes, and is seen twice as often in women

At CCCW, roughly 40-45% of members (elderly & disabled), use incontinence products

URINARY INCONTINENCE COMPLICATIONS UI can lead to many problems that affect quality of life Physical complications

Increased risk of urinary tract infections Increased risk of falls

Rushing to the bathroom Skin breakdown

Prolonged skin contact with soiled items

Increased psychological distress Reports of increased depression, anxiety and

embarrassment Fear of having an accident Loss of independence, decreased self-esteem

Social problems Social isolation due to embarrassment and fear of having

an accident in public

URINARY INCONTINENCE There are many different types of UI

Stress Leakage of small amount of urine when laughing, sneezing, exercise, etc. Weakened external pelvic floor muscles, increased intra-abdominal

pressure Urge

Leakage of large amounts of urine due to overactive bladder Weakened internal muscles of urinary tract

Overflow Bladder muscles are overextended and have poor tone

Functional Physical or psychological factors hinder ability to make it to the

bathroom in time Mixed

Combination of any of the above

Treatment varies depending on the type of UI so a thorough assessment is necessary

However, there are self-management techniques that can be helpful for all types

URINARY INCONTINENCE SELF-MANAGEMENT TECHNIQUES Self-management techniques can be

helpful for members to feel in control of their healthLoss of independence and self-esteem are

major psychological distresses The interdisciplinary team at CCCW is at

a great position to give education, guidance and support

URINARY INCONTINENCE SELF-MANAGEMENT TECHNIQUES Bladder diaries

Help members to self-monitor, along with give health care providers a look into what is causing incontinence

Bladder Training Scheduled voiding (ex. 2 hour toileting) Biofeedback to resist urge to go in-between toileting

sessions Time between voids can slowly be lengthened

Pelvic floor exercises Contraction and relaxation of pelvic floor muscles, or

Kegels Contract for 5-10 seconds then relax for 10-20

Research suggests at least 32 contractions a day Can be split up between 3-5 sessions a day

Consistency is key as muscle tone will be lost once exercises are stopped

URINARY INCONTINENCE SELF-MANAGEMENT TECHNIQUES Lifestyle Modifications

Weight loss Decrease intra-abdominal pressure and pressure on pelvic floor

muscles Smoking cessation

Research shows people who smoke are more likely to report urinary incontinence

Caffeine reduction Can increase bladder contractibility

Alcohol reduction Diuretic effect

Appropriate fluid intake Increased fluid intake can have diuretic effect Can be controversial to decrease fluid intake as it can increase risk

for dehydration Restrict fluids before bedtime

Bowel management Avoid constipation and straining

URINARY INCONTINENCE SELF-MANAGEMENT TECHNIQUES Ensuring a safe and accessible environment

Mobility aids Higher toilet set, railings, etc.

Clothing that allows a timely removal Velcro rather than buttons

Knowing location of bathrooms Incontinence Products

Pads, briefs Ensuring correct product for needs

How much urine product needs to hold, comfort, individual preference

Prompt removal to decrease risk for UTIs and skin breakdown

CONCLUSION Urinary incontinence is a chronic

condition that can lead to many complications

It is important that this condition is addressed, especially since it affects so many.

Community-dwelling elderly are in a position where they can utilize self-management techniques in order to regain some independence and increase quality of life

REFERENCES Community Care of Central Wisconsin. (2011). End-of-year report.

Retrieved from http://www.communitycareofcentralwisconsin.org/images/stories/2011%20CCCW%20End-of-Year%20Report.pdf

Grandstaff, M., & Lyons, D. (2012). Impact of a continence training program on patient safety and quality. Rehabilitation Nursing, 37(4), 180-184. doi:10.1002/rnj.34

Imamura, M. (2010). Lifestyle interventions for the treatment of urinary incontinence in adults. Cochrane Database Of Systematic Reviews, (9)

Pellatt, G. (2012). Promoting male urinary continence. British Journal Of Nursing, S5-s11.

Tabloski, P. (2010). Gerontological Nursing (2nd ed.). Upper Saddle River, NJ: Pearson Education Inc.

U.S. Census Bureau (2010). Age and Sex Composition: 2010. Retrieved from http://www.census.gov/prod/cen2010/briefs/c2010br-03.pdf

Vries, H.F., Northington, G.M., Bogner, H.R. (2011). Urinary incontinence (UI) and new psychological distress among communit dwelling older adults. Archives of Gerontology and Geriatrics, 55, 49–54

Wallace, S., Roe, B., Williams, K., & Palmer, M. (2004). Bladder training for urinary incontinence in adults. Cochrane Database Of Systematic Reviews, (1)