jueves, 2 de mayo de 2013



URINARY INCONTINENCE IN THE ELDERLY


Urinary incontinence is the involuntary loss of urine in sufficient amount or frequency to be a social or hygiene problem. Urinary incontinence is not a normal part of aging but is a major problem in the aging population. Women are twice as likely tu experience urinary incontinence as men.
Incontinence has medical, emotional, social and economic consequences for older adults. It can result in skin irritation or breakdown and can contribute to pressure ulcers.



Reversible causes of incontinence:
  • Delirium
  • Infections
  • Atrophic vaginitis
  • Psychological causes (depression)
  • Pharmaceutical agents
  • Endocrine conditions (DM)
  • Restricted mobility
  • Stool impaction




Incontinence can be reduces if there is a commitment to success rather than a defeatist attitude. Stressing the benefits to the patient and identifying the benefits to caregivers can help motivate the process. All member of the health care team are essential to reduce incontinence.


Treatment:
General:
  • The nurse should assess and apply analytical and urine culture.
  • Correct precipitating factors favoring and incontinence
  • One should look for proper voiding habit
  • Constipation should be corrected 

Residual urine <100 ml:
  • Pelvic floor exercises (Kegel)



Residual urine> 100ml:
  • Overflow: probe or reconstructive surgery
  • Acontractile: modification techniques such as catheterization or incontinence pads.


The nurse must assess elimination pattern, assess fluid intake patterns, explain measures that help improve tone of the sphincter muscles, modify clothing to make toileting easier, answer call signals promptly, initiate actions to maintain skin integrity, insert catheter as prescribed by physician, discuss methods for coping with incontinence…

In short, I think that a nurse is very important to help the patient with urinary incontinence. We must inform and explain to the patient the problems and how to prevent it.
The incontinence could produce pressure ulcers and we should clean the skin carefully to prevent it.
A good nurse must provide all necessary care to the patient for a better life.





1.     Gloria Hoffmann Wold. Basic Geriatric Nursing. 5th ed. Milwaukee, Wisconsin:Elsevier; 2012

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