GERIATRIC SYNDROMES: URINARY INCONTINENCE

URINARY INCONTINENCE is the involuntary loss of urine in sufficient amount or frequency to be a social or hygiene problem. 

A large percentage of the geriatric people suffers from problems with urinary elimination (nearly 30-50% of independent-living elderly and 50-75% of institutionalized elderly). This problem occur from changes in he function of the urinary system, or in the other body systems such as musculoeskeletal or nervous system. 

I think that urinary incontinence is a problem which cause emotional and social problems for persons because it can lead to guilt and frustation and social isolation.In addition, it can be costly, because the person need to purchase expensive undergarments and replace or launder clothing more frequently. For this reason, nursing should teach to the patient some strategies to control urinary incontinence and offer emotional support.

There are a lot of types of urinary incontinence:

• Stress incontinence: leakage of urine during conditions that increase intraabdominal pressure such as exercise, laughing, coughing, sneezing...
• Urge incontinence: It's the most frequent, and is caused by involuntary contraction of the detrusor muscle of the bradder. The person who has this incontinence are often unable to hold back the orine long enough to reach a toilet.
• Overflow incontinence: it's usually due to chronic bladder ouflow obstruccion such as prostatic disease, obstructive nephropathy or acute/chronic urinary retention. 
• Functional incontinence: situations which the patient is unable to reach the toilet in time for such reasons as poor mobility or poor relationship between the aging person's abilities and his or her environment.
• Total or mixed incontinence:it's caused by neurologic changes, bladder muscle spasms, trauma or diseases affecting the bladder or sphincter muscles which cause a continuous and unpredictable loss of urine.

Some nursing interventions to contol urinary incontinence are:

• LIFESTYLE CHANGES: losing weight, quitting smoking, not drinking alcohol and caffeine,preventing constipation...
• TIMED VOIDING: Urinate on a set schedule, for example, every hour. The patient can slowly extend the time between bathroom trips.
• Stress the importance of GOOD SKIN CARA AND HYGIENE after episodes of incontinence.
• BLADDER CONTROL TRAINING: Urinary incontinence is more frequent in women as in men, for this reason, I talk about KEGEL EXERCISES, because I consider that they are very effective to strengthen the pelvic floor muscles and helps back the flow urine of women.
• EMOTIONAL SUPPORT.

Bibliografia

• NIH
• MEDLINE PLUS
• NHS