Incontinence Case Studies

Jean Rogers is a 69 year old grandmother who has been married to husband Tom for 44 years. They both live in a bungalow with an adapted bathroom. Jean has been diagnosed with dementia which the patient began to show symptoms 3 years ago however, Jean’s dementia is progressing with time and has a short term memory loss. Tom is struggling to support her mentally and physically as well as himself and realises that the time is coming where he must accept more help. Jean takes medication for memory loss and blood pressure. The patient has their bowels open regularly however, is urinary incontinent and wears PAD’s. Jean was having recurrent urinary tract infection (UTI).

Difficulties with continence can affect an individual’s self-esteem, health and their day to day activities. Incontinence sufferers have been known to lose self-esteem and confidence and even withdraw from their usual circle of friends and family. The fear of being found out can make an individual feel ashamed of their condition. These feelings as a whole can impact negatively on an individual’s life. If the incontinence is due to a urinary infection, this could cause intimacy issues, leading to fear of rejection from a spouse. Family outings or sports activities may be affected due to fear of

This reflection case study will be discussing urinary continence management using Gibbs reflective framework (Gibbs,1988). This will include what is urinary incontinence management, the pathophysiology of urinary incontinence after stroke, how continence affect patient and current clinical practice and the role of the nurse and multi-disciplinary team within continence management. Also using the evidence based research and national guidelines.

Incontinence is one of the major problems faced by the elderly. Nurses can play a significant role in discovering continence problems (Lea R.et.al.2007). Urinary incontinence is the unintentional passing of urine. It is a very common problem and is thought to affect more than 50 million people in the developed world.(NHS.UK). To identify the problem and provide necessary treatment at the early stage, a thorough physical assessment is necessary.

Incontinence can affect individuals mentally as well as physically, it can have a negative effect

Urinary incontinence is very common following a stroke with 40-60% of hospitalised patients experiencing it in the acute phase, 25% on discharge and one third of survivors experiencing ongoing problems at one year (Barrett 2002, Kolominsky-Rabas et al.2003).Bladder and bowel problems are common following a stroke and can have a huge impact on physical and psychological aspects of quality of life, for both patients and carers. Health care professionals can do much to help improve and manage incontinence problems in stroke patients and this starts with a good understanding of key issues. Mobility and manual dexterity problems can compound bladder and bowel symptoms because they can make toileting access difficult, other problems such as visual disturbances, dysphagia and cognition also contribute indirectly to continence difficulties. There is evidence that professional input through structured assessment and management of care, together with the involvement of specialist continence nursing services, may reduce urinary incontinence and related symptoms after stroke. Bladder and bowel care requires active management –this includes a written personalised plan, taking into consideration required assistance, personal needs and goals. This essay is an overview on the importance of timely nursing assessment and management of urinary incontinence

First, neurological disorders can occur, as seen with Alzheimer’s disease and Parkinson’s disease, which can lead to neurogenic bladder (“Neurology/Neurogenic Bladder,” 2017). Next, physiological disorders can occur as seen with enlarged prostate in men or shortening of the urethra in women (Jaipaul, 2017). Anticipating the above changes appropriately will aid in understanding what leads to urinary retention in older adults, the resulting need of catheterizations, and the CAUTIs that can follow. Having a foundation to build on, it would be beneficial to explore what nurses can do prevent urinary tract infections in patients who require catheterization.

Urge incontinence is defined within the context of overactive bladder syndrome. The overactive bladder is characterized by bothersome urgency (a sudden and strong desire to urinate that is not easily deferred) (Abrams et al, 2002). Overactive bladder is typically associated with frequent daytime voiding and nocturia, and approximately 37% will experience urge urinary incontinence (Stewart et al, 2003).

The survey contained two sets of questions. The first set was designed to gain and understand of what the customers thought they were currently paying for urinary incontinence care. This included the actual cost of diaper and catheters, as well as secondary costs such as the cost of nurse/care giver time and the cost of infection/bedsore

On July 04 2017, at approximately 6:34PM I, Sgt. Bowring was investigating criminal mischief that had taken place at Lake Holbrook near the point. While myself and Deputy George where speaking to two individuals possibly involved in the criminal mischief an unknown female advised Deputy George that there was a fight in the Men’s Restroom that was located approximately 20 yrds away from our location.

There are many successful options for control of urinary incontinence which include nursing interventions in the form of behavioral therapy, pharmacological agents, and surgical treatment.

Furthermore, another factor creating a risk for pressure ulcer development is malnutrition. Wysocki (2002) observed that 10 to 50% of hospitalized patients are malnourished. Nurses should be alert to inadequate nutrition and its effects. Also, Cobb and Warner (2004) noted that when thirty percent of weight is lost, spontaneous pressure ulcers begin to develop, and prevention strategies might not work. In addition, urinary and fecal incontinence are also significant risk factors. Incontinence results in excess moisture, and irritation of the skin. The nurses and assistive personnel in XY hospital often do not assist their incontinent patients for long periods of time, and they do not utilize the available skin protectants. Studies confirmed the effectiveness of no-rinse cleansers and moisture barrier creams, and found that they were less likely to harm skin integrity than soap and water (Thompson, et al., 2005). The findings also advise that checking the patients for soiling every two hours adds to the effectiveness. Although not all pressure ulcers are preventable and curable, the literature provides supportive evidence that appropriate prevention protocols decrease the incidence of stage one and two

Fecal incontinence is the inability to control your bowels. When you feel the urge to have a bowel movement, you may not be able to wait until you can get to a restroom. This can cause you to have accidents.

Accessible multidisciplinary services including assessment (urodynamics investigation where appropriate), diagnosis and management for people with urinary incontinence and other bladder dysfunctions.

For many people, getting older can be difficult because of fear. They worry about what could happen to them or what type of diseases they might develop later on. To become a more mature adult is a stage of life that each individual will experience in a certain point. Statistics shows that eighty-eight percent of those of sixty-five years of age and older have at least one chronic health condition such as diabetes, dementia, Parkinson’s disease or cancer. (ezinearticles.com). This scholarly essay will focus mainly on urinary incontinence (UI) which is a common health problem that elderly may have.