Incontinence and the Individual with Alzheimer’s Disease Virginia Alzheimer’s Commission AlzPossible Initiative
INCONTINENCEAND THE INDIVIDUAL WITH
ALZEIMER’S DISEASE
Featuring: Terri Decker, RN, CWOCN,Terri Decker, RN, CWOCN,
Deborah H. Perkins M.S., APRN, BC, GNP andmoderated by Ayn Welleford, PhD
WEBINAR
Nov 19, 2007
Incontinence and the Individual with Alzheimer’s Disease Virginia Alzheimer’s Commission AlzPossible Initiative
PROBLEM SCOPE
INCONTINENCE
FECALURINARY
Incontinence and the Individual with Alzheimer’s Disease Virginia Alzheimer’s Commission AlzPossible Initiative
URINARY INCONTINENCE - PREVALENCE
Incontinence and the Individual with Alzheimer’s Disease Virginia Alzheimer’s Commission AlzPossible Initiative
URINARY and FECAL INCONTINENCE STATISTICS
Incontinence and the Individual with Alzheimer’s Disease Virginia Alzheimer’s Commission AlzPossible Initiative
BLADDER CONTROL SYSTEM
Source: The National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC) - http://kidney.niddk.nih.gov/kudiseases/pubs/bodydesign_ez/index.htm
Incontinence and the Individual with Alzheimer’s Disease Virginia Alzheimer’s Commission AlzPossible Initiative
DIGESTIVE SYSTEM
Source: The The National Digestive Diseases Information Clearinghouse (NDDIC) - http://digestive.niddk.nih.gov/ddiseases/pubs/yrdd/
Anatomy of the rectum and anus
Incontinence and the Individual with Alzheimer’s Disease Virginia Alzheimer’s Commission AlzPossible Initiative
TYPES OF URINARY INCONTINENCE
STRESS Leakage of small amounts of urine during
physical movements such as coughing, laughing, sneezing.
URGE Leakage of large amounts of urine unexpectedly;
associated with strong urge to void.MIXED
Combination of Stress and Urge IncontinenceOVERFLOW
Unexpected leakage of small amounts of urine because of a full bladder; due to blockage or ineffective bladder contraction.
Incontinence and the Individual with Alzheimer’s Disease Virginia Alzheimer’s Commission AlzPossible Initiative
TYPES OF URINARY INCONTINENCE
Functional Untimely urination because of:
Physical disability External obstacles Problems in thinking or communicating
Incontinence and the Individual with Alzheimer’s Disease Virginia Alzheimer’s Commission AlzPossible Initiative
TRANSIENT CAUSES OF INCONTINENCE
Transient Urinary IncontinenceTransient Urinary Incontinence: Bladder Infections Medications Constipation Urethritis, Vaginitis Dietary Irritants
Transient Bowel Incontinence:Transient Bowel Incontinence: Fecal Impaction Dietary Irritants Bacterial/Viral Infections Medications
Incontinence and the Individual with Alzheimer’s Disease Virginia Alzheimer’s Commission AlzPossible Initiative
TYPES OF URINARY INCONTINENCE
Source: National Institute of Diabetes and Digestive and Kidney Diseases,NATIONAL INSTITUTES OF HEALTH
Types of Urinary
Incontinence
STRESS
TRANSIENT URGE
OVERFLOW
FUNCTIONAL
MIXED
OVERACTIVE BLADDER
Incontinence and the Individual with Alzheimer’s Disease Virginia Alzheimer’s Commission AlzPossible Initiative
Alzheimer’s Disease and INCONTINENCE
Avoid Constipation
CHECK WITH HEALTHCARE PROVIDER TO
RULE OUT TRANSIENT PROBLEMS
Bladder infection
Fecal impaction
Helps guide prompting
to toilet based onperson’s habits
Toileting Schedule
USE BOWEL AND
BLADDER DIARY
Ease of Use Clothing
HOUSE TIPS:
Use picture of toilet on bathroom door
Good lighting in the hallway and bathroom
Use of bedside commode or urinal
Stay Calm
APPROACH
Matter-of-Fact
Attitude
Sense of Humor
Assist with changing garments
from behind
Incontinence and the Individual with Alzheimer’s Disease Virginia Alzheimer’s Commission AlzPossible Initiative
ABSORBENT INCONTINENCE PRODUCTS
If your situation is: Best product options are:
Light Urinary IncontinenceOccasional leaks of urine--may occur with laugh, cough, or sneeze.Mentally alert, able to communicate
•Bladder Control Pads•Male Guards•Belted Undergarments
Moderate IncontinenceModerate amount of urine loss (more than a leak, less than a full void)Attempts to get to the bathroom, by self or with assistanceUsually every 2-3 hoursMentally alert or may have mild confusion at times
•Protective Underwear or •Adult Style Pull-On
Heavy IncontinenceFrequently Incontinent of bladder and/or bowel movementsLarge amount of urine loss/ night-time useImmobile or Bed-Bound individual
•Tape-Tab style Brief
Images courtesy of Attends Healthcare
Incontinence and the Individual with Alzheimer’s Disease Virginia Alzheimer’s Commission AlzPossible Initiative
SKIN CARE
Care of the skin after an incontinent episode is important since moisture, ammonia from the urine, as well as enzymes from the stool can all affect the skin and contribute to rashes, skin breakdown, and other complications.
Mild, pH-balanced skin cleansers are designed to gently cleanse the skin. Protective barrier products are also useful to protect the skin and prevent skin breakdown.
High quality absorbent incontinence products are also effective in preserving skin integrity as they effectively wick away wetness to help reduce trauma to the skin.
Incontinence and the Individual with Alzheimer’s Disease Virginia Alzheimer’s Commission AlzPossible Initiative
HELP AND RESOURCES
Contact healthcare provider
Reading materials on urinary incontinence: http://www.niapublications.org/agepages/urinary.asp
Reading materials on fecal incontinence: http://digestive.niddk.nih.gov/ddiseases/pubs/fecalincontinence/index.htm
Contact the Alzheimer’s Association in your area http://www.alz.org/apps/findus.asp?SearchState=VA&SearchByState=Search&FormSent=1#SearchStart
Medical Suppliers such as Home Care Delivered (800-565-5644 or www.homecaredelivered.com) offering an extensive line of quality, name-brand medical supplies delivered to the home.
