Continence aids in the management of urinary incontinence

2012 ◽  
Vol 22 (2) ◽  
pp. 85-98 ◽  
Author(s):  
J Browning ◽  
Z Zaheer ◽  
A Orzechowska ◽  
A Mistri
Keyword(s):  
Urinary Incontinence ◽  
Nursing Homes ◽  
Older People ◽  
Urge Incontinence ◽  
Individual Characteristics ◽  
First Line ◽  
Anticholinergic Medications ◽  
Surgical Measures ◽  
The Right

SummaryUrinary incontinence is a common problem, more so in older people and those in residential or nursing homes. Guidelines promote a structure to the management of incontinence, recommending non-pharmacological measures (including continence aids) as first-line options. Anticholinergic medications are used widely for urge incontinence, and surgical measures employed in selective cases.Whilst other treatments are being tried, or where incontinence is refractory to treatment (about 30% of cases), it is important to promote continence or contain incontinence with continence aids in order to minimize psychological complications. What can be a bewildering array of aids is available and choosing the right type of aid requires knowledge of these. Here, we suggest a classification of continence aids, describing individual characteristics and appropriate situations for use.

scholarly journals The Management of Urinary Incontinence in Residential and Nursing Homes for Older People

1996 ◽  
Vol 25 (2) ◽  
pp. 139-143 ◽  
Author(s):  
S. M. PEET ◽  
C. M. CASTLEDEN ◽  
C. W. MCGROTHER ◽  
H. M. DUFFIN
Keyword(s):  
Urinary Incontinence ◽  
Nursing Homes ◽  
Older People

Sarcopenia and Associated Factors According to the EWGSOP2 Criteria in Older People Living in Nursing Homes: A Cross-Sectional Study

2021 ◽  
Author(s):  
Anna Escribà-Salvans ◽  
Javier Jerez-Roig ◽  
Miriam Molas-Tuneu ◽  
Pau Farrés-Godayol ◽  
Pau Moreno-Martin ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Nursing Homes ◽  
Older People ◽  
Sedentary Behavior ◽  
Associated Factors ◽  
Protective Factor ◽  
Cross Sectional ◽  
European Working ◽  
Original Definition ◽  
Associate Factor

Abstract Background: In 2018, the European Working Group on Sarcopenia in Older People (EWGSOP2) updated the original definition of sarcopenia, establishing new criteria to be used globally. To our knowledge, this is the first study considering it for the diagnosis of sarcopenia in older people living in Nursing Homes.Aim: Verify the prevalence and the degree of severity of sarcopenia according to the new EWSGOP2 criteria and to analyse its associated factors in residents living in nursing homes from Central Catalonia (Spain).Design: A cross-sectional multicenter study was conducted in 4 nursing homes. SARC-F test was applied as the initial screening, muscle strength was measured by a dynamometer, skeletal muscle mass by bioimpedance analysis and physical performance by Gait Speed. Four categories were used: total probable sarcopenia, probable sarcopenia, confirmed sarcopenia and severe sarcopenia.Results: Among the total sample of 104 nursing home residents (mean age 84.6, ± 7.8), and 84.6% women), 85 (81.7%) (95% confidence interval [CI], 73.0-88.0) had total probable sarcopenia, 63 (60.5%) had probable sarcopenia, 19 (18.3%) confirmed sarcopenia and 7 (6.7%) severe sarcopenia. In the bivariate analysis, obesity was negatively associated and total time in sedentary behavior positively associated with all sarcopenia categories. In addition, malnutrition was positively associated with total and probable sarcopenia. Urinary incontinence was a positive associated factor of total and probable sarcopenia. In the multivariate analysis, obesity represented a negative associate factor: OR=0.13 (0.03 - 0.57), p=0.007 and OR=0.14 (0.03 - 0.60), p=0.008 with total and probable sarcopenia, respectively, adjusted by urinary incontinence. For confirmed sarcopenia, obesity also represented a negative associate factor OR=0.06 (0.01 - 0.99), p=0.049 and the total time in sedentary behavior a positive associate factor OR=1.10 (1.00- 1.20), p=0.040. Conclusions: According the EWGSOP2 criteria, high prevalence of sarcopenia was found in institutionalized older people, ranging from 6.7% to 81.7% depending on the category. Malnutrition, urinary incontinence and total time in sedentary behavior were associated with sarcopenia whilst obesity represented a protective factor in this population.

Management of urinary incontinence

2020 ◽  
Vol 26 (2) ◽  
pp. 63-70
Author(s):  
Gemma Nightingale
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Botulinum Toxin A ◽  
Urge Urinary Incontinence ◽  
Anticholinergic Medications ◽  
Surgical Measures ◽  
Predominant Symptom ◽  
Bladder Retraining ◽  
Huge Impact ◽  
Managing Stress

Urinary incontinence is a common problem affecting 25–45% women. Effective management can have a huge impact on a patient’s quality of life and many treatments are available. Management should be dictated by the degree of bother the symptoms are having, and vary depending on the type on incontinence. Conservative measures should always be initiated, including optimisation of body mass index and smoking cessation. Overactive bladder and urge urinary incontinence can be improved with bladder retraining and avoidance of bladder stimulants. Medical treatment then includes anticholinergic medications or Mirabegron. More invasive options include Botulinum Toxin A (Botox®) injections, sacral nerve stimulation or urological surgery. Stress urinary incontinence should be managed initially with pelvic floor exercises, and input from a specialist nurse or physiotherapist is beneficial. The surgical options for managing stress incontinence have changed considerably over the years, but include bladder neck injections, mid-urethral slings, colposuspension or autologous fascial slings. Mixed urinary incontinence is more challenging to manage, but all conservative measures should be started. Further treatment is directed towards the predominant symptom, but overactivity should be controlled before surgical measures for stress urinary incontinence are performed.

Palliative care during the final week of life of older people in nursing homes: A register-based study

2017 ◽  
Vol 15 (4) ◽  
pp. 417-424 ◽  
Author(s):  
Jonas Smedbäck ◽  
Joakim Öhlén ◽  
Kristofer Årestedt ◽  
Anette Alvariza ◽  
Carl-Johan Fürst ◽  
...  
Keyword(s):  
Palliative Care ◽  
Nursing Home ◽  
Nursing Homes ◽  
Older People ◽  
End Of Life ◽  
Pain Treatment ◽  
Symptom Relief ◽  
Individual Characteristics ◽  
Shortness Of Breath ◽  
Prevalent Symptom

ABSTRACTObjective:Our aim was to explore the presence of symptoms, symptom relief, and other key aspects of palliative care during the final week of life among older people residing in nursing homes.Method:Our study employed data from the Swedish Palliative Care Register on all registered individuals aged 60 and older who had died in nursing homes during the years 2011 and 2012. Variables pertaining to monitoring and treatment of symptoms, end-of-life discussions, circumstances around the death, and the individual characteristics of deceased individuals were explored using descriptive statistics.Results:The most common underlying causes of death among the 49,172 deceased nursing home residents were circulatory diseases (42.2%) and dementia (22.7%). The most prevalent symptom was pain (58.7%), followed by rattles (42.4%), anxiety (33.0%), confusion (21.8%), shortness of breath (14.0%), and nausea (11.1%). Pain was the symptom with the highest degree of total relief (46.3%), whereas shortness of breath and confusion were totally relieved in 6.1 and 4.3% of all individuals, respectively. The use of valid instruments for symptom assessment was reported for pain in 12.3% and for other symptoms in 7.8% of subjects. The most prevalent individual prescriptions for injection PRN (pro re nata, according to circumstances) were for pain treatment (79.5%) and rattles (72.8%). End-of-life discussions were performed with 27.3% of all the deceased individuals and with 53.9% of their relatives. Of all individuals, 82.1% had someone present at death, and 15.8% died alone. Of all the nursing home resident deaths recorded, 45.3% died in their preferred place.Significance of results:There were large variations in degree of relief from different symptoms during the final week of life. Pain was the most prevalent symptom, and it was also the symptom with the highest proportion of total/partial relief. Other symptoms were less prevalent but also less well-relieved. Our results indicate a need for improvement of palliative care in nursing home settings, focusing on management of distressing symptoms and promotion of end-of-life discussions.

Discussing advance care planning: insights from older people living in nursing homes and from family members

2017 ◽  
Vol 30 (4) ◽  
pp. 569-579 ◽  
Author(s):  
Francesca Ingravallo ◽  
Veronica Mignani ◽  
Elena Mariani ◽  
Giovanni Ottoboni ◽  
Marie Christine Melon ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Older People ◽  
Advance Care Planning ◽  
Family Members ◽  
Nursing Home Residents ◽  
Care Planning ◽  
People With Dementia ◽  
Advance Care ◽  
The Right ◽  
Age Range

ABSTRACTBackground:Evidence concerning when and in which manner older people living in nursing homes (NHs) would prefer to discuss advance care planning (ACP) is still scarce. This study explored the attitudes of NH residents and family members toward ACP and their opinions as to the right time to broach the subject, the manner in which it should be approached, and the content of ACP.Methods:This was a qualitative study using face-to-face interviews with 30 residents (age range 66–94), and 10 family members from 4 Italian NHs. The interviews were analyzed using content analysis.Results:Three main themes were identified: (1) life in the NH, including thoughts about life in a nursing home, residents’ concerns, wishes and fears, and communication barriers; (2) future plans and attitudes toward ACP, including attitudes toward planning for the future and plans already made, and attitudes toward and barriers against ACP; (3) contents and manner of ACP, including contents of ACP discussions, the right moment to introduce ACP, with whom it is better to discuss ACP, and attitudes toward advance directives.Conclusions:ACP was a welcome intervention for the majority of participants, but an individualized assessment of the person's readiness to be involved in ACP is needed. For people with dementia, it is essential to identify the right time to introduce ACP before NH admission. Participants in our study suggested that ACP should include palliative care and practical issues, and that in the NH setting all staff and family members may have a valuable role in ACP.

The influences of prompted voiding for urinary incontinence among older people in nursing homes

2020 ◽  
Author(s):  
Siswoyo ◽  
Cicik Lestari ◽  
Tantut Susanto ◽  
Hanny Rasni ◽  
Mulia Hakam ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Nursing Homes ◽  
Older People ◽  
Prompted Voiding

Awareness and Decision Making in Professional Ethics

2000 ◽  
Vol 5 (1) ◽  
pp. 19-27 ◽  
Author(s):  
Ronny Swain
Keyword(s):  
Decision Making ◽  
Professional Ethics ◽  
Ethical Decision Making ◽  
Code Of Ethics ◽  
Professional Autonomy ◽  
Ethical Awareness ◽  
Ethical Decisions ◽  
The Right ◽  
Aid Decision

The paper describes the development of the 1998 revision of the Psychological Society of Ireland's Code of Professional Ethics. The Code incorporates the European Meta-Code of Ethics and an ethical decision-making procedure borrowed from the Canadian Psychological Association. An example using the procedure is presented. To aid decision making, a classification of different kinds of stakeholder (i.e., interested party) affected by ethical decisions is offered. The author contends (1) that psychologists should assert the right, which is an important aspect of professional autonomy, to make discretionary judgments, (2) that to be justified in doing so they need to educate themselves in sound and deliberative judgment, and (3) that the process is facilitated by a code such as the Irish one, which emphasizes ethical awareness and decision making. The need for awareness and judgment is underlined by the variability in the ethical codes of different organizations and different European states: in such a context, codes should be used as broad yardsticks, rather than precise templates.

The Accuracy of ACR TI-RADS Classification of Neck Ultrasound as a First-Line Diagnostic Approach for Thyroid Neoplasms in Pediatric Patients: A Retrospective Study

2018 ◽  
Vol 5 (1) ◽  
pp. 13-23
Author(s):  
Nikolai S. Grachev ◽  
Elena V. Feoktistova ◽  
Igor N. Vorozhtsov ◽  
Natalia V. Babaskina ◽  
Ekaterina Yu. Iaremenko ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Predictive Value ◽  
Thyroid Nodules ◽  
Pediatric Patients ◽  
Thyroid Neoplasms ◽  
Diagnostic Methods ◽  
Diagnostic Approach ◽  
First Line ◽  
Neck Ultrasound

Background.Ultrasound (US)-guided fine-needle aspiration biopsy (FNAB) is the gold standard in diagnosing the pathological nature of undetermined thyroid nodules. However, in some instances limitations and shortcomings arise, making it insufficient for determining a specific diagnosis.Objective.Our aim was to evaluate the effectiveness of ACR TI-RADS classification of neck ultrasound as a first-line diagnostic approach for thyroid neoplasms in pediatric patients.Methods.A retrospective analysis was made of FNA and US protocols in 70 patients who underwent the examination and treatment at Dmitry Rogachev National Research Center between January 2012 and August 2017. In the retrospective series 70% (49/70) of patients undergone FNA and 43% (30/70) of them undergone repeated FNA. All US protocols were interpreted according to ACR TI-RADS system by the two independent experts. The clinical judgment was assessed using the concordance test and the reliability of preoperative diagnostic methods was analized.Results.According to histologic examination protocols, benign nodules reported greater multimorbidity 29% (20/70), compared with thyroid cancer 17% (12/70), complicating FNA procedure. A statistically significant predictor of thyroid cancer with a tumor size ACR TI-RADS showed a significant advantage of ACR TI-RADS due to higher sensitivity (97.6 vs 60%), specificity (78.6 vs 53.8%), positive predictive value (87.2 vs 71.4%), and negative predictive value (95.7 vs 41.2%). Concordance on the interpreted US protocols according to ACR TI-RADS classification between two experts was high, excluding accidental coincidence.Conclusion.The data support the feasibility of US corresponding to the ACR TI-RADS classification as a first-line diagnostic approach for thyroid neoplasm reducing the number of unnecessary biopsies for thyroid nodules.

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