How to live confidently and independently with incontinence
Incontinence, or the inability to control the passing of urine, affects between an estimated 3 and 6 million people in the UK. Generally speaking, the condition is found in more women than men and is commonly associated with those who are older as it is often age-related.
At NRS Healthcare we have a friendly team of OT professionals who work in-house to provide sound advice through our online and telephone services, so you can always talk to someone about the issues you're experiencing, whether it's related to continence or something else entirely. Here is some information provided by our OT team on the issue of incontinence and also some advice on which products can help you continue to lead a confident and independent life.
Common types of incontinence
9 out of 10 cases are identified as stress or urge incontinence – but what do these terms mean?
- Stress incontinence – this is when the pelvic floor muscles or the urethral sphincter, are too weak or damaged to prevent urination: the pressure within the bladder, as it fills, is greater than the strength of the sphincter to stay closed. This causes urine to leak when the bladder is under pressure, or if sudden pressure is applied for example when you cough, sneeze, laugh, exercise or lift heavy items. It's not related to stress.
- Urge incontinence – this is when a sudden and very intense need to pass urine is felt, and is combined with an inability to delay going to the toilet. There is often only a few seconds between the need to urinate and the passing of urine. It is caused by an increase in the contractions of the detrusor muscles that control the flow of urine from the bladder (they relax to allow urine in and contract to allow urine out.)
What can cause incontinence?
Certain things can increase the chances of developing urinary incontinence, including:
- Child birth – can cause nerve damage or muscle weakness
- Obesity – causes increased pressure on the muscles
- Family history of incontinence – there can be a genetic link
- Increasing age – most common in women over 70
- Hormonal changes – reduced oestrogen levels after menopause
- Neurological conditions – e.g. Parkinson's disease, multiple sclerosis
- Other conditions – UTI, tumour, enlarged prostate
- Alcohol and caffeine intake – can irritate the bladder or cause the kidneys to produce more urine
- Dementia – an indirect cause affected by a persons ability to recognize the need to go to the toilet as well as an ability follow up with appropriate action
Emotional and physical effects
The effects of continence issues can be emotional as well as physical and can affect the individual concerned as well as their family or carers.
- Anxiety: about going out/access to toilets/having 'accidents'
- Social isolation: avoid going out in case of 'accidents', deter visitors to their own home (commodes/smells)
- Depression: negative impact on lifestyle
- Dehydration: reduction in fluid intake can lead to secondary conditions e.g. confusion, constipation
- Less active: a more sedentary lifestyle can lead to weight gain
- Financial: employability/additional cost of incontinence pads etc
- Increased work load for individual or their carers: washing of bedding/clothing
- Skin care: incontinence can damage skin/become sore/inhibit healing
- Lack of sleep: regular interruptions to sleep can lead to irregular sleeping habits affecting daytime routines
Possible interventions to help you live independently
- Commodes – to provide easier and quicker access to toileting facilities, particularly at night when it can be more hazardous to access main facilities, or if the toilet is difficult to access on a regular basis due to location/mobility issues (toilet outside or upstairs)
- Night lights – to improve safety when accessing a toilet at night
- Urinals – as above but also use of uri bags for use when away from the house
- Pads and Pants – to assist with the management of incontinence
- Bed and chair pads – to assist with the management of incontinence
- Waterproof duvets and pillows
- Monitoring kits (EnuSens)
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- May 13th 2020