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Incontinence and Intellectual Impairment.doc

3 Pages

Health Sciences
Course Code
Health Sciences 2711A/B
Aleksandra Zecevic

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Incontinence and Intellectual Impairment The 4 Giants of Geriatrics: - Clusters of chronic diseases with diminished possibility for recovery, afflicting most very old people 1. Incontinence - The involuntary and inappropriate passage of urine and/or feces or a loss of bladder control 2. Immobility 3. Instability 4. Intellectual Impairment: • Delirium • Dementia • Brain failure (malfunction of all or nearly all of the brain) Normal Bladder Function • Normal average amount of urine secreted - 100 ml per hour • Sensations of bladder states: – Fullness – 300 ml, 3 hours after fluid intake; easily suppressed – Discomfort of full bladder – 600 ml, after 6 hours – Desperation – 750 ml or more; irresistible desire to urinate, leaking starts Incontinence • Symptoms: – Leakage of urine during exercise, laughing, coughing, sneezing or lifting – Inability to hold urine until you get to a toilet – Urine dribbles after urinating – Smell of urine on clothes or in the house – Lifetime option for some is diapers (lucrative industry) Prevalence • Up to 25 million adult Americans • 1 in 3 persons over the age of 60 • Twice as common in women than in men • Frustrating, embarrassing, debilitating condition (wakes you up, restricts activities, irritates skin, affects quality of life) • Only 25% seek help usually after 4 (men) – 6 (women) years • 1 in 8 people over the age of 65 suffer from it • 14% of women and 9% of men age 65 and over suffer from it • 22% of women and 19% of men age 85 and over suffer from it Incontinence occurs when: - muscles of the bladder suddenly contract and the sphincter suddenly relaxes - due to weakening of the pelvic floor muscles because of pregnancy, childbirth, menopause, overweight, enlarged or removed prostate - muscles of the pelvic floor stretch during pregnancy and childbirth; if the muscles don’t shrink back afterwards, they become weaker and can eventually lead to incontinence - prolapse – when the vaginal wall collapses, or weakens with age, so that the bladder can no longer be supported by it and as a result the bladder begins to fall into the vagina 6 Types of Incontinence: SUFTOM 1.) Stress - most common. Urine leaks during lifting, coughing, sneezing, laughing, exercise. - Caused by overstretched pelvic muscles due to child bearing. 2.) Urge - Nerves controlling the bladder are overactive and involuntary action of bladder muscle occurs. Happens in sleep, after drinking water, when hearing running water… 3.) Functional - Untimely urination due to other medical conditions that impair thinking, moving or communicating such as Alzheimer's disease or severe arthritis that prevents a person from reaching a toilet. 4.) Transient - temporarily leakage occurs due to an acute infection or medication. 5.) Overflow - Enlarged prostate constricts the urethra preventing complete bladder emptying. - Rare in women. Bladder overflows has urine leaks out 6.) Mixed - usually stress and urge incontinence together Treatments include: • Kegel Exercise • Electrical stimulation to pelvic muscles • Biofeedback to track bladder
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