Managing incontinence in people with dementia

It is estimated that there are 850 000 people with dementia in the UK, and 53% of them have incontinence. Dementia adds an extra challenge to managing a patient's continence. This article discusses that challenge, looking at the nature and causes of incontinence, the effects that ageing has on continence and the associated complications. It then examines the nature of dementia and some of its causes and goes on to show how the symptoms of dementia can impact on a person's continence. The article highlights the important of conducting a thorough assessment of a person with dementia who experiences incontinence, including medical history, medications and symptom profile. Using a bladder diary, the importance of involving relatives and carers, physical examination and ‘red-flag’ symptoms to be aware of are also discussed. Lastly, this article talks about creating a strategy to manage a patient's incontinence, including prompted toileting, medication, using incontinence pads, catheterisation, care planning and supporting relatives and carers.

Safety and passivation of faecal contamination in waste

Absorbent hygiene wastes like nappies and incontinence pads are ubiquitous in municipal and healthcare waste streams around the world as they are convenient products used in child-care and adult incontinence management. Absorbent Hygiene Product (AHP) manufacturing is resource-intensive as the products are required to be of the highest value as they are in almost-constant contact with sensitive body parts. The potential for recovering such valuable resources such as cellulose-based fibres and super-absorbent polymers for reuse in non-food sectors like the construction and wastewater industries has been considered in this study. Appropriate decontamination via chemical methods have been examined using AHPs contaminated with human-associated bacteria. Findings suggest that for simulated AHP wastes inoculated with 108–109 CFU g-1 of human-associated bacteria like Escherichia coli, Staphylococcus aureus, Staphylococcus epidermidis, and Streptococcus pyogenes, a 1:1 ratio of 0.5% calcium hypochlorite/AHP waste is adequate to inactivate the bacteria particularly when combined with an inorganic salt for at least 60 min. Specifically, 4 to 5 log10 reductions were observed. Following such disinfection, material storage and temperatures above 25ºC minimise incidences of microbial regrowth. The disinfection protocol was not found to adversely affect the AHP quality. Overall, such findings suggest that AHP recycling is a potential alternative to current AHP waste disposal practices like incineration (with or without energy recovery) and landfilling.

Urinary Incontinence in Hospitalised Elderly Patients: Do Nurses Recognise and Manage the Problem?

This study examined to what extent nurses recognize urinary incontinence (UI) in elderly hospital patients, what UI interventions nurses realize, and if elderly inpatients are willing to raise the topic during their hospital stay. A convenience sample of 78 elderly inpatients in a Swiss hospital were screened for UI and asked if they were willing to be questioned about UI during hospitalisation. Nursing records were analysed as to whether UI had been recognized, and to collect data on interventions. Forty-one patients (51%) screened positive for UI, of whom 10 (24%) were identified as such in their nursing records. The single intervention documented was the use of incontinence pads. Only 5 patients preferred not to be asked about UI at hospital. Nurses in the study hospital should systematically ask elderly patients about UI and provide them with information on interventions.