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Incontinence Care
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Section 7 - Caregiver Resources
Patient Quality of Life: Should Doctors Guess It?
Incontinence Care
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Some Facts About Artificial Nutrition and Hydration
Things To Consider-Artificial Nutrition and Hydration
  Incontinence Care
Incontinence care requires patience and gentle care. Even if the incontinence cannot be cured, it can be controlled so that the person's quality of life can be improved. The emphasis should be on appropriate treatment rather than on palliative measures such as using catheters, sheaths unless the physician orders it.  Long term use of catheters can cause infections.
A warning: some products make wide-ranging claims with little or no scientific backing. If youre in doubt over the effectiveness of a product, consult with your doctor first.
Patient Choice
Enable the patient to make an informed choice when selecting incontinence products is important.  Provide them several options.  They're probably embarassed, talk to them in privacy.
Many people shy away from wearing protective undergarments because they dont want to wear a "diaper," or believe that the undergarment will be visible through their clothing. In fact, the diaper-style undergarment is only one of a selection of possible under-garments.  Care should be taken not to call these products "diapers"  as this may offend and embarass the person needing to wear them.  Chose another name such as  "protective wear".
Types of Products
Pull-ups undergarments pull on and off like regular underpants. They can handle mild to moderate leakage.

Belted Garments provide protection to the front and back, and attach by means of elastic belts. They allow a little more freedom of movement, but the belts can fit quite tightly. They are best used for mild to moderate incontinence.

Adhesive Pads come in a variety of designs. Specially designed male and female pads are available. The insert attaches to underwear with adhesive strips. Most pads handle mild incontinence well, and some can absorb moderate leakage.

"Diaper" Style Undergarments are designed for heavy incontinence, diaper style garments look like adult-sized diapers, a fact that puts many wearers off. They are, however, the best choice for handling heavy incontinence.

Cloth or Disposable                                     Protective undergarments are available in cloth and disposable forms.  Each type has its own advantages. Disposables cost more over time, but can generally handle greater amounts of leakage   than cloth. Cloth is generally more comfortable, and reduces the chances of developing skin rashes. Laundry is, of course, an issue. Cloth undergarments can absorb mild to moderate amounts of incontinence.

Fitting Undergarments
Whatever type of protective garment you choose, a correct fit is essential to prevent leakage and maximize comfort. The undergarment should fit snugly, but not so tightly that it causes discomfort. Too loose, and leaking will occur; too tight, and skin irritation is likely. If youre using adhesive pads, try to handle the adhesive as little as possible: hand lotions and deodorants can impair the adhesives ability to stick to your underwear.


Clinical Practice Guideline: Urinary Incontinence - a tool to guide care decisions. This guideline is a starting place that will guide the care team through a process of addressing urinary incontinence in the long term care facility resident. $12.00 non members. Excerpts:

Incontinence: The Caregiver's Role - There are a number of reasons your loved one may be experiencing incontinence. Caregiver.com article.

Incontinence Tips - Incontinence is a symptom of other problems such as nerve disorders, loss of sensation and weakening muscles. It can also occur due to medications or surgery and affects approximately 10-15% of seniors age 65 and over. There are four different types of incontinence!

How Incontinence Affects The Skin - Exposure to urine and feces is one of the most common causes of skin breakdown and makes the skin more susceptible to the following types of injuries:

Helping Residents Stay Dry - In this interview, Dr. Palmer shares her insights on what long-term care facilities can do to better manage incontinence, how to determine the best toileting schedule, and more.
 Resources continued
Managing Incontinence - Medicare and other major insurances will pay for most of these products in a limited monthly number. HMOs and managed care insurers do not routinely pay for these products. Absorbent products  found in drug stores are considered personal hygiene products and are not paid for by insurers. NOTE: If your loved one is with Hospice, incontinence products are, typically, provided.
NAFC's purpose is to be the leading source for public education and advocacy about the causes, prevention, diagnosis, treatments, and management alternatives for incontinence.
Urinary incontinence - When left untreated, urinary incontinence can be debilitating and can lead to social isolation, psychological distress, skin problems, and even premature admission to a nursing home.
Urinary Incontinence - National Institutes of Health; General/Overviews,  Specific Condition/
Aspects,  Diagnosis/Symptoms, Clinical Trials and more
Other Tips
  • Most types of incontinence  can be managed more effectively. Be sure to get an assessment by a qualified healthcare specialist.
  • Have your healthcare professional help you assess the person's clothes and environment to improve incontinence management. Develop a toileting plan if appropriate.
  • If using a padding system, check it regularly and change immediately when wet.
  • Obtain assistive devices, like urinals, bedside commodes and toilet seat elevators, to improve continence management.
  • Use disposable or reusable underpads to protect the bed and chairs.
  • After an episode of incontinence of urine or stool, use a pH-balanced incontinence wash for clean-ups. Avoid using soaps that can be harsh and that alter the skin pH with frequent use.
  • Use disposal wipes to clean up after incontinent episodes. If using washable washcloths, use them only for this purpose.
  • Use a room deodorizer, an odor eliminator or kitty litter in a pan under the bed to control odors from incontinence.
  • Evaluate the person's dietary habits to improve continence. Normal fluid intake - unless contraindicated for another medical reason - drink 6 to 8 eight-ounce glasses of liquid a day.
  • Avoid bladder irritants like caffeine (in chocolate, coffee, tea, colas), aspartame (Nutrasweet) in diet foods and sodas and alcohol.
  • Urinary incontinence can be made worse by fecal constipation. If the person suffers from constipation, increase dietary fiber and ask your healthcare professional to develop a management plan.
I'm not endorsing these, they've just been recommended by other families.
We used Depends.   Today's Caregiver magazine recently recognized Kimberly-Clark Corporation's Depend refastenable underwear with a 2003 Caregiver Friendly Award in the Product category.
Tena "Night Super" Pads  hold a whopping 50 ounces and, for day use,  Tena "Day Plus" holds an impressive 36.7 ounces.Available from several suppliers. 
HDIS Home Delivery Incontinence Supply   1-800-269-4663  delivers incontinence products discreetly to your door. Offers largest variety, secure on-line shopping, free catalog.  They will send some free samples, or you can buy sampler packs of most of their products.  You can also buy smaller packages than the cases listed, to try them out. 
Product is a company that is  owned by a person who actually uses the products sold. 
Product Information - Get information on 11 different products.  Click Here to Request Free Information
Email Webmaster~Jean E. Miller