Urinary incontinence may be managed with prompted voiding in nursing homes for elderly

By: Emily Lunardo | Bladder | Friday, September 16, 2016 - 12:00 PM

Urinary incontinence may be managed with prompted voiding in nursing homes for elderlyUrinary incontinence may be managed with prompted voiding in nursing homes for elderly. In Hong Kong, 10 to 15 percent of those over the age of 65 suffer from urinary incontinence and rates among those residing in nursing homes have increased dramatically.

Urinary incontinence is commonly addressed with the use of adult diapers, but this can negatively impact a person’s self-esteem and increase the risk of skin irritation and urinary tract infections. Behavioral strategies have also been found to be effective at treating urinary incontinence, such as time voiding, bladder training, and prompted voiding.

In prompted voiding, the caregiver regularly reminds the patient to go to the bathroom to empty their bladder.

To test if this method could work, the researchers took residents of five nursing homes in Hong Kong and selected 52 volunteers who met the criteria for the study. The participants were randomly assigned to receive either prompted voiding or normal care. Urinary incontinence rates dropped 13.9 percent in the prompted voiding group, whereas in the control group, rates actually went up.

Professor Claudia Lai explained, “When prompted by staff to regularly go to the washroom, the elderly went a long way towards managing their urinary incontinence problem and were able to enhance the quality of their life. Staff training and quality assurance are the keys to the success of the program. Staff at the participating nursing homes acknowledged the effectiveness of the PV [prompted voiding] strategy and regarded it as an alternative solution for managing urinary incontinence. The attitude of the staff towards urinary incontinence among the elderly also changed after the training.”

“The results and data collected in this study will definitely help to increase the public’s concern about urinary incontinence. To further promote the therapeutic value of a PV behavioral strategy, we have consolidated the findings and the key points into a practical manual under the sponsorship of The Hong Kong Jockey Club Charities Trust. Local social entities are welcome to request a copy for reference,” Professor Lai continued.

Behavioral strategy to manage incontinence in elderly patients

About 13 million Americans suffer from urinary frequency, and it is not just the older population. People of all ages can have urinary problems. Many young patients experience an abnormal opening or obstruction in the urinary tract, which is also called a functional bladder outlet obstruction. It can be treated. On the other end of the spectrum, a lot of elderly experience urinary incontinence – about 77 percent of nursing home residents.

Behavioral therapy has been shown to be a cost-effective way to help improve urinary incontinence. This can include biofeedback, bladder training, or pelvic floor muscle training.

Biofeedback is a technique that helps people control their bladders by recording activity of the bladder, rectal sphincter, and abdominal pressures which you are able to see. By watching this recorded information, you are able to learn to relax the bladder and abdominal muscles and contract your pelvic floor muscles in accordance with the video.

Bladder training involves increasing the time you are able to hold in urine and creating a urinating schedule. By waiting to void the bladder by the schedule, you can increase your bladder’s capabilities and thus improve urinary incontinence.

It does require plenty of motivation and work for behavioral strategies to be successful. Some people who do not wish to devote the time it may not be as beneficial. You may have to try a few different techniques to see which one works the best.

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