Managing Urinary Incontinence

Urinary incontinence, or loss of bladder control, affects nearly 60% of all people living in nursing facilities (NF) in the U.S. Incontinence is not a normal part of the aging process but is often related to underlying issues including chronic medical conditions, dementia, mobility impairments and some medications.

There are several types of urinary incontinence:

  • Urge incontinence: The person experiences sudden, strong urges to urinate, with urine leakage if they are unable to get to the toilet in time.
  • Stress incontinence: The person will experience urine leakage with activities that increase the pressure in the pelvic region, such as coughing, sneezing or laughing.
  • Overflow incontinence: The person is unable to completely empty their bladder when urinating, leading to urine leakage.
  • Mixed incontinence: The person will experience both urge and stress incontinence symptoms.

Some people experience functional incontinence. This occurs when the person has no underlying disorder of the urinary tract, but due to physical or mental or cognitive issues is unable to get to the bathroom.

Incontinence is often one of the issues leading to NF admission and can increase the risk of falls, fractures and skin breakdown. People with incontinence are often reluctant to participate in activities, leading to social isolation.

Individualized, person-centered continence promotion plans can help reduce the number of incontinent episodes a person experiences, and in some cases can reverse incontinence completely. For a continence promotion plan to be successful, it must be based on the person’s specific needs and usual toileting habits.

NFs must also have processes in place for providing incontinent care. Staff should receive education on how to perform incontinent care, with return demonstrations and ongoing monitoring of competency.

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