Incontinence in elderly

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Incontinence in elderly

  1. 1. Bowel & Bladder Incontinence In ElderlySkin Management Perspective<br />Alex Khan RN BSN CWCN CFCN<br />www.woundcarenurses.org<br />
  2. 2. Objectives<br />Upon completion of this presentation, all participants will be able to:<br />Assess incontinence in patients<br />Identify potential issues related to incontinence<br />Identify skin conditions related to incontinence<br />Appropriately prevent and mange issues related to incontinence<br />
  3. 3. Definitions:<br />Urinary incontinence is defined as the involuntary leakage of urine.<br />Fecal incontinence is the inability to control bowel movements, causing stool (feces) to leak unexpectedly.<br />
  4. 4. Epidemiology<br />Community-dwelling older adults (>65) with bowel or bladder incontinence:<br />35% of women<br />20-30% of men<br />Assisted living environments<br />30-50% of women<br />30% of men<br />Long-term care (nursing home)<br />> 50-78% of men and women<br />
  5. 5. Effects of Incontinence<br />Bowel & Bladder incontinence has significant negative impact on both overall and health-related quality-of-life.<br />Social isolation, Depression, Psychological distress<br />Increased caregiver burden, Skin inflammation / breakdown<br />Sleep disturbance, Increased risk urinary tract infection (UTI), Cost related to management of incontinence<br />Increased risk of falls and fractures related to urgency / frequency, nocturia, impaired mobility and vision changes<br />Increased risk of mortality associated with falls, fractures and skin breakdown<br />
  6. 6. Issues Associated with Incontinence Management<br />Incontinence briefs hold moisture against the skin causing maceration and breakdown/excoriation.<br />Prolonged use of catheters increases the risk of bladder infections.<br />Increased cost associated with frequent diapers and incontinence pad changes.<br />Incidence of contact dermatitis / yeast infection associated with incontinence. <br />
  7. 7. Incontinence Associated Dermatitis<br />Skin condition commonly associated with incontinence. Skin irritation and inflammation related to exposure to urine and feces. Additional risk factors:<br /><ul><li> Diaper use
  8. 8. Bed bound / immobility</li></li></ul><li>Incontinence Associated Dermatitis<br />Incontinence associated dermatitis in dark skin patients is difficult to identify, it has the appearance of deep dark discoloration.<br />
  9. 9. Moisture Associated Skin Damage<br />Skin maceration is a sign of increased moisture exposure. Skin maceration leads to skin breakdown. This condition is also referred to as Moisture Associated Skin Damage (MASD).<br />
  10. 10. Shear & Friction<br />Erosion of the skin occurs frequently and probably attributable to friction created by moving moist or saturated pads or clothing over irritated skin; or to damage from digestive enzymes present in liquid or solid stool. <br />
  11. 11. Unstageable Pressure Ulcer<br />Incontinence, immobility, increased moisture, pressure and malnutrition causes serious skin conditions/wounds.<br />
  12. 12. Prevention & Management<br />Frequent checks for incontinence episodes<br />Turning and repositioning schedule<br />No-rinse skin cleansers are preferable to soap and water<br />Low air loss / pressure distribution surface<br />Change cloth pads frequently<br />Breathable pads must be utilized on air mattress<br />No diapers while in bed<br />Moisture barrier creams / Antifungal creams<br />Skin protectant sprays<br />
  13. 13. Skin Treatment Products<br />

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