Maintaining hygiene and preventing skin breakdown is ESSENTIAL TEACHING for the home health patient with urinary incontinence!

Urinary incontinence is described as the 'involuntary leakage of urine'. (1) The type of urinary incontinence is normally linked to the cause...including...

• • Stress incontinence: Urine leaks out while coughing, laughing, or doing some activity, such as running or jumping
  • Urge incontinence: There is a sudden and intense urge to urinate, and urine leaks at the same time or just after.
  • Overflow incontinence: The inability to empty the bladder completely can result in leaking
  • Total incontinence: The bladder cannot store urine
  • Functional incontinence: Urine escapes because a person cannot reach the bathroom in time, possibly due to a mobility issue.
  • Mixed incontinence: A combination of types

According to the American Urological Association, as many as one-quarter to one-third of men and women in the United States experience urinary incontinence. Urinary incontinence is more common among women than men. An estimated 30 percent of females aged 30-60 are thought to suffer from it, compared to 1.5-5 percent of men.

Patient Education for Managing Urinary Incontinence

1. Keep a log noting when you have incontinence and when you void deliberately. A pattern or trend may emerge that will help you plan ahead.
2. Perform Kegel exercises 2 times a day...
   1. As you begin urinating, try to stop the flow of urine without tensing the muscles of your legs. It is very important not to use these other muscles, because only the pelvic floor muscles help with bladder control.
   2. When you are able to slow or stop the stream of urine you have located the correct muscles. Feel the sensation of the muscles pulling inward and upward.
   3. Hold to a count of 3, working your way up to a count of 10.
   4. Helpful hint: If you squeeze the rectal area as if...not to pass gas, you will be using the correct muscles.
3. When voiding, practice “double voiding” (urinate, wait a few seconds, urinate again).
4. Urinate only every 3 to 6 hours to “re-train” your bladder.
5. Know that consumption of diuretics, antidepressants, antihistamines, and cough-cold preparations exacerbates urinary incontinence.
6. Eat fruits, vegetables, and whole grains daily to prevent constipation.
7. Stop smoking (nicotine irritates the bladder).
8. A number of protective devices are available to help manage accidental urination, including the following:
   1. bed pads,
   2. combination pad-pant systems
   3. disposable or reusable adult diapers,
   4. full-length absorbent undergarments,
   5. male incontinence drip collectors,
   6. underwear liners (pads, guards, shields, inserts) should be applied correctly and changed often to prevent skin irritation and urinary tract infection.

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