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Urinary Incontinence Medication For Elderly

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Management Strategies For Ui Among The Elderly With Dementia

Treatment Options for Urinary Incontinence

It is often important to ask about UI in the presence of caregivers, as UI is frequently not reported voluntarily by the caregivers. Many of the elderly who are frail and demented have other comorbidities and the aetiologies for UI are often multiple. Even though UI cannot be cured, it can be managed and contained with appropriate continence aids to achieve a social/acceptable continence .

Figure 1: Summary of management of UI. View Figure 1

It is important to establish goals of treatment with the caregivers and the elderly with dementia. The goals include decrease in specific symptom burden, dryness or using less continence aids for protection, enable social activities to maintain/enhance quality of life, maintain the current place of residence and reduce caregiver burden .

From an elderly with dementias point of view, treatment options are rather limited because of the impaired cognitive function and pharmacological treatment may cause worsening of the cognitive function. Treatment options for UI consist of non-pharmacological means and pharmacological.

What Causes Urinary Incontinence

Urinary incontinence is not an inevitable result of aging, but it is particularly common in older people. It is often caused by specific changes in body function that may result from diseases, use of medications and/or the onset of an illness. Sometimes it is the first and only symptom of a urinary tract infection. Women are most likely to develop urinary incontinence during pregnancy and after childbirth, or after the hormonal changes of menopause.

Timed Voiding And Bladder Training

This technique can help your aging parent control their bladder by charting urination and leaking to determine the pattern. Once you see a pattern, help your parent to the bathroom at those times to empty the bladder before they might leak. When combined with biofeedback and pelvic muscle exercises, these methods may help your parent control urge and overflow incontinence.

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Basic Neurophysiology Of Micturition

The bladder is innervated by the autonomic nerves as well as the somatic nerves. The sympathetic innervation originates at T11-L2, supplying the bladder via the Hypogastric nerve. The parasympathetic nerves originate at S2-S4 and innervate the bladder via the Pelvic and Pudendal nerves.

The sensation of bladder fullness as it fills ascends via the spinal cord to be conveyed to the Pontine Micturition Centre, which promotes micturition via the parasympathetic supply to the urinary bladder. However, micturition may not be appropriate at all times. The central nervous system determines the correct timing of micturition, taking into account the social and behavioural part of micturition. Micturition is coordinated and triggered through simultaneous activities of the bladder contraction with relaxation of the urethral sphincters via the somatic and autonomic nerves.

In addition to the complex neuroanatomical and physiological reflexes to maintain continence, there are other faculties needed to maintain continence. An intact cognition is important to perceive the sensation of bladder fullness with the ability to postpone micturition after the first sensation, motivation and desire to pass urine, sufficient mobility and coordination to reach the toilet with hand dexterity to manipulate clothing items in order to do so. In addition, the ability to locate the toilet with clear direction and access also contribute to continence .

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What Causes Urinary Incontinence In The Elderly

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From not drinking enough water to childbirth to a health condition such as diabetes, there are many different reasons behind urinary incontinence.

The following health issues can cause urinary incontinence in both women and men:

  • Multiple sclerosis

For men, prostate problems are a common cause of urinary incontinence.

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Products To Help With Incontinence

Having the right products on hand will give you and your loved one peace of mind in an emergency and will make incontinence care less stressful. Typical items are:

  • Briefs that wick away moisture
  • Briefs made of water-resistant vinyl.
  • Booster pads and liners that absorb a lot of moisture
  • Washcloths and wipes that can be disposed
  • Bed pads that can be washed and are waterproof.
  • Bed pads with absorbency

Contact With Nurses In Primary Care

The nurses do come and see you from time to time because of your leg. Have they ever asked you whether or not you have any problems with urinary leakage?

No, they just come and dress me leg.

They’ve never asked you?

No. They’ve asked me what caused it, like, the ulcers.

“Has the nurse ever asked you about leakage of urine?

No. no. Until it came up on that survey of yours. Actually, to be honest I think they’ve got enough on their plate. When we go down there and look into the surgery you look at the people and there’s thousands of records, isn’t there? Well, I wonder how they get by. .

Embarrassment was considered to be the major reason why people did not present themselves for care. The perceptions of high standards of privacy and confidentiality were fundamental to use of any relevant services. This was especially true where people attended their local surgery and could be known both to surgery staff and to other patients.

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Prevalence And Type Of Urinary Incontinence

The prevalence of UI according to age is shown in . The overall prevalence of UI was 14.8%, increasing from 12.0% for the men aged 7074 years old to 26.3% among men 8589 years old but reduced to 16.3% for those aged 90 years old .

Urgency incontinence was the most frequent type of urinary incontinence, with 20% of men reporting leaking urine before getting to the toilet . About 10% of men experienced post-micturition dribbling and 5% of men reported leaking urine for no obvious reason. Three percent of men reported using pads or other incontinence aids.

Analysis of the data from the ICIQ showed that the frequency of urine leakage was strongly correlated with the quantity of urine leaked . Both frequency and quantity of urine leakage were strongly correlated with the self-perceived impact on daily life rating in the ICIQ. Among those defined with UI, 12.6% reported a score over 5 on the self-perceived impact on life scale . The overall ICIQ summed score in all men in CHAMP ranged from 0 to 18 , with a median score of zero, the first quantile was zero and the third quantile was three.

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Is Urinary Incontinence A Natural Aspect Of Growing Older

Treatment for Urinary Incontinence

What is urine incontinence, and how does it affect your life? According to the National Association for Continence , involuntary urine loss is what it is. Incontinence can strike anyone at any age, but it is more common among the elderly.

Urinary incontinence in the elderly is more common as the body changes with age. According to the Urology Care Foundation, one out of every two women over 65 had bladder leakage at some point. It might be brought on by normal aging, lifestyle decisions, or a variety of health issues.

Urinary incontinence in the elderly can take several forms:

  • Some people only leak urine once in a while.
  • Others may leak pee on a regular basis.
  • Some people have total bladder and bowel control issues.

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Treating And Managing Urinary Incontinence

Today, there are more treatments and ways to manage urinary incontinence than ever before. The choice of treatment depends on the type of bladder control problem you have, how serious it is, and what best fits your lifestyle. As a general rule, the simplest and safest treatments should be tried first.

A combination of treatments may help you get better control of your bladder. Your doctor may suggest you try the following:

Resignation And Minimization Of Symptoms

I get caught out many a time. Yes. But I don’t have an active enough life not to keep it under control.

I haven’t ever been to the doctor about it at all. I belong to the school where you think you can’t keep worrying the doctor for every small thing.

It’s like anything, I’ll have to put up with it, won’t I? It’s a hindrance sometimes I suppose, but a lot of people is a lot worse off.

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Why Does Pregnancy Cause Incontinence

During pregnancy, your body goes through a lot of physical changes. As your uterus stretches to hold the growing baby, a few things happen. Your bladder can be squished by the expanding baby, making your bladder hold less than before. You might experience an increased urgency to pee during pregnancy because your bladder cannot hold as much as before. This might become even more challenging towards the end of pregnancy when the baby is at its largest.

Another reason for incontinence during pregnancy is the weakening of your pelvic floor muscles. These muscles are the support structures for all of the organs in your pelvis. During pregnancy, they can be stretched and weakened as your uterus expands.

Behavioral Therapy: The Initial Treatment For Urine Incontinence In The Elderly

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Behavioral therapy is often the first urinary incontinence treatment for the elderly after a diagnosis is made. This could entail:

Delaying urinating

This can be accomplished by progressively increasing the time between restroom visits. Double voiding, which is when a person urinates, waits a few minutes, and then urinates again, is another option. This educates the user to completely empty their bladder.

Bathroom visits on a regular basis

For persons with movement challenges or neurological illnesses, this is typically successful, even if it involves having someone else take you to the potty.

Exercises for the muscles of the pelvic floor

These exercises, known as Kegels, strengthen the muscles that help regulate urine. Typically, these should be practiced a few times a day, every day. It can be difficult to figure out which muscles to contract, but your doctor or this step-by-step instruction to completing Kegel exercises can assist.

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Urinary Incontinence In Women: What You Need To Know

  • Urinary incontinence is the accidental loss of urine.

  • Over 25 million adult Americans experience temporary or chronic urinary incontinence.

  • This condition can occur at any age, but it is more common in women over the age of 50.

  • There are four types of urinary incontinence: urgency, stress, functional and overflow incontinence.

  • Behavioral therapies, medications, nerve stimulation and surgery are some of the treatments available for managing urinary incontinence.

Symptoms Of Parkinsons Disease

Parkinsons has four main symptoms:

  • Tremor in hands, arms, legs, jaw, or head
  • Muscle stiffness, where muscle remains contracted for a long time
  • Slowness of movement
  • Impaired balance and coordination, sometimes leading to falls

Other symptoms may include:

The symptoms of Parkinsons and the rate of progression differ among individuals. Early symptoms of this disease are subtle and occur gradually. For example, people may feel mild tremors or have difficulty getting out of a chair. They may notice that they speak too softly, or that their handwriting is slow and looks cramped or small. Friends or family members may be the first to notice changes in someone with early Parkinsons. They may see that the persons face lacks expression and animation, or that the person does not move an arm or leg normally.

People with Parkinson’s disease often develop a parkinsonian gait that includes a tendency to lean forward take small, quick steps and reduce swinging their arms. They also may have trouble initiating or continuing movement.

Symptoms often begin on one side of the body or even in one limb on one side of the body. As the disease progresses, it eventually affects both sides. However, the symptoms may still be more severe on one side than on the other.

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How A Health Professional Can Help

The first health professional that youre likely to talk to about incontinence is your primary care provider, but they may refer you to another physician or professional who can better help. Urologists and gynecologists are surgeons who see men and women for incontinence, and nurse continence advisors can run specialized interprofessional clinics.

Diagnosing the cause of incontinence

What your doctor will ask about: The treatment of incontinence depends on the cause of the symptoms, which your doctor will evaluate by asking questions, doing a physical examination, and probably order a few preliminary investigations.

Your doctor will review your personal medical history, especially any history of prostate surgery for men, and for women, the history of any pregnancies and number and types of births. Lifestyle issues like smoking, alcohol intake, caffeine consumption, exercise , and body weight are likely to come up.

A careful review of the patterns of incontinence will help to determine the cause of urine loss.

To review, three common patterns of urinary incontinence are:

  • Stress: if you lose urine when doing certain activities,
  • Overflow: you lose urine all the time in a dribble,
  • Urge: feeling an urgent need to get to the toilet that you sometimes cant meet,

In older adults, its common for there to be a mixture of more than one pattern .

Your doctor will want to know:

The physical examination

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Management Of Urinary Incontinence In The Elderly

Urinary Incontinence (Stress, Urge, Overflow & Functional) | Causes, Symptoms, Diagnosis, Treatment

Management of urinary incontinence in the elderly is possible and can help seniors remain active.

While common in senior loved ones, urinary incontinence is a challenging condition to handle, impacting everyday life in a variety of ways and frequently leading to reduced self-confidence and assurance in addition to the limiting of enjoyable activities.

However, it is important to realize that urinary incontinence is not something that has to simply be accepted as an ordinary part of aging. Figuring out the root cause of the problem can result in a highly effective treatment option. Contributing factors to bladder control problems include:

  • A urinary tract or vaginal infection
  • Weakened or overactive bladder muscles
  • Pelvic organ prolapse or weakened pelvic floor muscles
  • Nerve damage from conditions such as Parkinsons disease, diabetes, or MS
  • Enlarged prostate
  • Health conditions which make it harder to get to the restroom in time, such as arthritis

An older adult going through difficulties with incontinence should visit with the doctor to talk about symptoms, medications, and medical background. She or he may recommend blood and urine tests as well as testing to figure out how effectively the bladder is emptying. Keeping a daily journal prior to the appointment may help, observing the times of day when urinating and when leaking urine.

When the reason behind the incontinence has been confirmed, treatment plans can include:

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Elderly Incontinence Treatment Options

Under a doctor’s care, incontinence can be treated and often cured. Today there are more treatments for urinary incontinence than ever before. The choice of treatment depends on the type of bladder control problem an older adult has, how serious it is, and what best fits their lifestyle. As a general rule, the simplest and safest treatments should be tried first.

Behavioral Therapy: The First Treatment For Urinary Incontinence In The Elderly

After a diagnosis is made, behavioral therapy is often the first urinary incontinence treatment for the elderly. This may involve:

Learning to delay urination

You can do this by gradually lengthening the time between bathroom trips. One can also practice double voiding, which is when a person urinates, waits for a few minutes, and then urinates again. This teaches the person to drain their bladder more thoroughly.

Scheduled bathroom visits

This is often effective for people with mobility issues or neurological disorders, even if this means someone else is in charge of taking you to the restroom.

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Incontinence And Alzheimers Disease

People in the later stages of Alzheimers disease often have problems with urinary incontinence. This can be a result of not realizing they need to urinate, forgetting to go to the bathroom, or not being able to find the toilet. To minimize the chance of accidents, the caregiver can:

  • Avoid giving drinks like caffeinated coffee, tea, and sodas, which may increase urination. But dont limit water.
  • Keep pathways clear and the bathroom clutter-free, with a light on at all times.
  • Make sure you provide regular bathroom breaks.
  • Supply underwear that is easy to get on and off.
  • Use absorbent underclothes for trips away from home.

For more ways to deal with incontinence and other common medical problems in someone with Alzheimers, visit Alzheimers Disease: Common Medical Problems.

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