Changes in Physical Condition: Incontinence

ncontinence is the inability to control one's own urinary functions. People who are incontinent urinate on themselves before they get to a toilet. Nationally, more than 60% of all nursing home residents are incontinent. Unfortunately, incontinence is often ignored because it is considered a normal consequence of aging. But it isn't. Most incontinence can be managed or treated.

Many treatable problems contribute to incontinence. Some residents have several coexisting problems that contribute to the problem. Both must be treated, or the incontinence will persist. Untreated incontinence also increases the risk of pressure sores.

Recognizing the need to urinate is one of the last neurological sensations to be lost in mentally confused residents. More often than not, incontinence is really a problem of communication. Mentally confused residents may not be able to convey the need to use the bathroom except through extreme behavior, such as screaming, pulling at clothing, and disrobing. The resident will likely calm down after he or she has urinated or after any wet clothing has been changed.

There are several types of urinary incontinence, caused by mental or medical conditions. Stress incontinence is most common in women. The urethral sphincter fails to hold urine because of increased pressure, caused by having multiple children, muscle weakness, and aging. Residents with stress incontinence inadvertently leak when they laugh, cough, sneeze, change position, stand, lift or engage in some other physical activity.

Overflow incontinence is commonly seen in males with prostrate problems and all residents with neurological problems.

Functional incontinence results from the physical or mental inability to urinate. Restraints or the inability to get a toilet affect the physical ability, while lack of communication skills affect the mental ability. The resident may show signs of urge incontinence.

Unconscious, or reflux, incontinence is a neurological dysfunction. The resident may not be aware of the need to urinate, depending on the cause of the problem. The resident is frequently or continuously incontinent, and may experience severe urgency and bladder hypersensitivity.

Staff members in long term care facilities are often not very sympathetic when dealing with a resident's incontinence problems, and they may feel it is futile to try to combat it. But they can. In some cases, problems may be corrected simply by treating the underlying problem, and possibly retraining or managing the resident's needs. This approach will usually work for incontinence caused by high blood sugar (hyperglycemia), excess fluid intake, inadequate fluid intake, volume overload, venous insufficiency with fluid retention, congestive heart failure, and delirium. Similarly, incontinence caused by psychological or physical impairments can be managed by treating the underlying problem and by making sure toilet facilities are accessible and usable.

Incontinence that is caused by urinary tract infection usually responds to antibiotic treatment, though retraining may still be necessary after the infection is cleared up. If fecal impaction is leading to incontinence, remove the impaction. Then regularly use stool softeners and bulk forming agents, increase the fluids and fiber in the resident's diet, and encourage or assist him or her to get adequate exercise.

If a loved is in a nursing home and you feel that have been abused or neglected, please contact The Rasansky Law Firm immediately to discuss your legal rights and options regarding your loved one in a nursing home.

For more information about Nursing Home Claims, you can also visit www.nursinghomelawyer.com, a Rasansky Law Firm speciality site devoted exclusively to Nursing Home Claims, Nursing Home Abuse, Nursing Home Neglect, and Nursing Home Rights.

Signs that a Loved One In A Nursing Home could be in trouble include Behavioral Problems, Changes In Physical Conditions, Dehydration, and Immobility to name a few.