Abstract: Noninvasive Techniques to Manage Urinary Incontinence Among Care-Dependent Persons

Joyce Colling, RN, PhD, FAAN. "Noninvasive Techniques to Manage Urinary Incontinence Among Care-Dependent Persons." Journal of Wound, Ostomy and Continence Nursing 23 (November 1996) 6: 302-08.

Summary:
* Colling describes how nurses with no special expertise in or knowledge of urinary incontinence should assess and treat incontinence in persons who are cognitively or physically impaired, and who reside in nursing homes or retirement communities.

Key Points:
* Approximately 50% of nursing home residents in the United States are incontinent. Among the community-dwelling elderly, rates of incontinence have been estimated at 19% for men and 38% for women. These figures could be significantly reduced through proper assessment and treatment programs.
* Among persons residing in retirement centers, urinary incontinence is often hidden or ignored, because of fear of embarrassment or eviction from the retirement community, or the belief that incontinence is a normal part of aging which cannot be reversed.
* Urinary incontinence is a symptom, rather than a disease. "Many aspects, both internal and external, influence the cognitively or physically impaired person's continence status."
* Before considering a treatment or management program for a cognitively or physically impaired person suffering from incontinence, nursing staff should assess the patient's health history, medication and fluid intake profile, and incontinence history, and perform a focused physical examination which includes a cognitive and functional assessment, a urinalysis, and an environmental assessment.
* Colling recommends habit training and prompted voiding as the two treatment options most appropriate for persons with persistent urinary incontinence. She notes that although pelvic muscle exercises and bladder retraining can prove beneficial for some elderly incontinent patients, their applicability to the impaired population is limited, since these treatment methods require active participation from the patient.

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