What Is Urinary Incontinence?
Many people cannot control
when or where they urinate. Many nursing home residents and residents in home
care have this problem. When residents wet themselves, it is called urinary
incontinence. A short way to say this is "UI." UI
is not the resident's fault. It is not a normal part of aging. The resident
is not bad or lazy. He or she has a health problem. And you can help.
This booklet will help you take care of and help residents with UI.
You Are the Key
UI can be cured and improved.
But residents need to get the right care. Many of the treatments in this booklet
can help. And you are an important part of the team that will make
the UI treatment work.
Causes of Urinary Incontinence
UI is most often caused by:
- Urinary tract infections (UTIs).
- Constipation or impaction.
- Reaction to medicine.
- Muscle weakness.
- Trouble getting to the bathroom.
Problems with clothing.
- Vaginal problems in women.
- Prostate problems in men.
You might be the first person to notice that a resident has UI.
How will you know? See the box below:
Does the resident have UI? If you can answer "yes" to one or more
of these questions, the resident may have UI.
Tell the nurse if you think a resident has UI.
- Do you ever find the resident wet?
- Do you ever find the bed wet?
- Does the bed have urine stains?
- Does the resident smell like urine?
- Does the resident leak urine on the way to the bathroom?
- Does the resident use pads, tissue paper, or cloth for protection?
Finding Out More About UI
with UI should be checked by a doctor or nurse. They may be able to find the
cause of the problem. This will help decide the best way to treat or even cure
Here is how you can help:
1. Watch the resident to see what kind of UI he or she might have.
- Watch the resident to see what kind of UI he or she might have.
- Keep a bladder record.
- Tell the doctor or nurse what you know about the resident's health and medicines.
The types of UI are listed below. There are different
kinds of UI:
- Urge incontinence.
- Stress incontinence.
- Overflow incontinence.
People with urge incontinence may
- As soon as they feel they have to go to the bathroom.
- On their way to the bathroom.
- After they drink just a little bit of liquid.
Sometimes they will feel like they have to
urinate if they touch or hear running water. They may need to go to the bathroom
many times during the day and night.
People with stress incontinence
leak urine when they:
- Move or exercise in a certain way.
Sneeze, cough, or laugh.
They may also lose urine when they:
Women often have stress incontinence.
- Get up from a chair.
- Get out of bed.
- Exercise, walk, or lift something.
People with overflow incontinence:
In men, this may be a sign of prostate problems.
2. Keep a bladder record.
- Feel as though they never empty their bladder all the way.
- Pass a little bit of urine, without feeling the need to go.
- Pass urine again after they just went.
A bladder record
can help you keep track of a person's daily urinating habits.
This record also shows when the person has an accident.
The bladder record can also help you and the nurse or doctor to find
the best treatment for the UI.
3. Tell the doctor or nurse what you know about the resident's health and medicines.
The doctor or nurse
will check the resident to try to find the cause of the UI. You know important
information about the resident that will help.
There are three treatments for UI. These are:
- Behavioral treatments that help the resident control his or her urine and use the toilet at the right
Many residents have problems getting to the bathroom. Some residents
are not able to tell you when they have to go. Most of these people will need
one of three behavioral (or "toileting") treatments. These are:
- Scheduled toileting.
- Prompted voiding.
- Habit training.
The steps for each of the behavioral treatments are
in the following boxes. If you have any questions, be sure to ask the doctor
You can help the doctor or nurse choose the right toileting
treatment by watching the resident and keeping a bladder record
You may also be able to answer some questions to help pick the right
Does the resident need help getting to the bathroom?
Residents who cannot get out of bed or cannot get to the bathroom
alone can use scheduled toileting.
Take the resident to the bathroom every 2-4 hours.
Does the resident know if his or her bladder is full? Some people know they
have a full bladder, but do not ask to go to the bathroom. These people may
be able to use prompted voiding.
- Check the resident often to see if he or she is wet or dry.
- Ask the resident "Do you want to use the toilet?"
- Help the
resident to the toilet if he or she needs to use the toilet.
- Praise the
resident for being dry and trying to use the toilet.
- Tell the resident
when you will come back to take him or her to the toilet again.
Does the resident go to the bathroom at the same time every day?
If the answer is yes, habit training may be best for them.
- Watch the resident to find what times he
or she urinates.
- Take the resident to the bathroom at those times
- Praise the resident for being dry and using the toilet.
Most of the time, the toileting treatment will be written
out for you in a care plan. The care plan shows when to take the person to
the bathroom. It is important to follow the care plan.
Be patient. Toileting treatments take time to work.
Treat the resident as an adult
with dignity. Residents may feel bad about being wet. They may not like
having someone see them undressed. It may help you to remember a few things:
You are the key to making behavioral treatments work.
- Answer call bell as soon as possible.
- Do not rush the resident.
- Give the resident enough time to empty his or her bladder.
Try to give the resident some privacy. Pull the curtain or close the door,
even if you must stay in the bathroom.
- Never yell at the resident if
he or she is wet. Tell the resident that he or she can try again the next
Medicine and Surgery
If residents need medicine
or surgery to treat their UI, you will probably be asked to help with their
care during or after treatment. But your most important job will be to work
with the resident on the behavioral toileting treatments.