Urinary Incontinence: Let’s Talk
By Jeannine Thompson BSN RN CWOCN, Senior Select Home Care, Collin LIVING WELL Magazine
Of the 13 million Americans who have experienced urinary incontinence (UI), about 55% are over the age of 60. Women are three times more likely to experience incontinence than men. Each year about $18 billion is spent on disposable incontinent products, hospital stays, office visits and incontinence-related care.
Continence is voluntary bladder control. It is a “learned” social behavior requiring mental awareness. Generally a bladder holds about 2 ¼ cups of urine and empties that urine every three to four hours during the day and once at night.
Urinary incontinence (UI) is not being able to control when and where you urinate and is not a normal part of aging. It is a condition that that can be treated. Even though incontinence can be improved in eight out of 10 cases, fewer than half the people with bladder control problems ever discuss the condition with their healthcare provider. Talking about incontinence can be embarrassing. Having the courage to discuss the problem is the first step toward improving or curing the incontinence.
In addition to a urologist, there are approximately 6,500 certified wound ostomy continence nurses (CWOCN) in the U.S. These nurses are trained beyond the basics in incontinence care. A WOC nurse is board certified, ensuring that she has specialized skills, knowledgeable and expertise in her field. The CWOCN is required to remain current in her knowledge and is qualified to provide you with evidence-based care.
One of the most important things you can do to help your healthcare provider determine the best treatment plan is to keep a record of your intake and output (a bladder diary). This diary describes your day-to-day bladder habits and patterns related to your incontinence. Record the time, the type and the amount of fluid you drink along with a record of each time you urinate, have an accident and also the volume of urine loss. You may feel keeping the diary is time consuming, but don’t give up. Keep the bladder diary for at least three to five days. This will give your healthcare provider the best picture of your bladder health. It is not unusual to have more than one type of incontinence.
Stress Incontinence: If you have stress incontinence, you lose urine when you exercise, laugh, cough, sneeze or strain in a certain way.
Urge Incontinence: If you have urge incontinence, you start losing urine as you rush to the bathroom, hear or touch water or even put the key in the front door lock. Your bladder may be over active or even have spasms.
Overflow incontinence: If you have overflow incontinence, you may feel that you never completely empty your bladder. You may lose small amounts of urine often during the day and night. You may spend a long time at the toilet, but only make a weak, dribbling stream of urine.
Your healthcare provider will design a plan of care that bests fits your type and cause of the incontinence. It could be as easy as taking some active steps toward lifestyle changes that will improve or manage the incontinence. Lifestyle modifications can involve drinking your six to eight glasses of fluid before 6 p.m., reducing your consumption of caffeine and alcohol, avoiding and treating constipation, giving up smoking, and getting adequate physical activity. If you are overweight, work on losing those extra pounds. If your pelvic floor muscles are weak, learn Kegel exercises and perform them three times a day. Your provider may even recommend adding or stopping a medication and sometimes surgery.
Pelvic floor exercises (Kegels) are used to strengthen weak muscles around the bladder by squeezing and relaxing muscles in the pelvic and genital area. The exercise involves squeezing the pelvic muscle, holding for 10 seconds followed by 10 seconds of rest and repeated three to four times a day. Sometimes biofeedback and electrical stimulation are used to supplement Kegel exercises.
Medications such as water pills, high blood pressure meds, heart medications, muscle relaxants, cold remedies and antidepressants can contribute to urinary incontinence. Medications can also be used to help relieve urinary incontinent symptoms. Your healthcare provider will determine if medications are needed to ease the incontinence.
Urinary incontinence is a common and treatable condition where simple intervention can dramatically improve quality of life. Be informed and tell your healthcare provider if you have this problem.
Jeannine Thompson BSN, RN, CWOCN is with Senior Select Home Health and received her BSN from Upper Iowa University. She has been a registered nurse for 36 years and working in home care for 17 years. Jeannine has been a Board Certified Wound Ostomy Continence nurse for 21 years. You can contact Senior Select Home Health by calling 972-569-8157.
