incontinence in elderly
DESCRIPTION
Continence / Wound careTRANSCRIPT
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Bowel & Bladder Incontinence In ElderlySkin Management Perspective
Alex Khan RN BSN CWCN CFCNwww.woundcarenurses.org
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ObjectivesUpon completion of this presentation, all participants will be able to:
• Assess incontinence in patients• Identify potential issues related to incontinence• Identify skin conditions related to incontinence• Appropriately prevent and mange issues related to
incontinence
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Definitions:
• Urinary incontinence is defined as the involuntary leakage of urine.
• Fecal incontinence is the inability to control bowel movements, causing stool (feces) to leak unexpectedly.
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Epidemiology
• Community-dwelling older adults (>65) with bowel or bladder incontinence:– 35% of women– 20-30% of men
• Assisted living environments– 30-50% of women– 30% of men
• Long-term care (nursing home)– > 50-78% of men and women
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Effects of IncontinenceBowel & Bladder incontinence has significant negative impact on
both overall and health-related quality-of-life.– Social isolation, Depression, Psychological distress– Increased caregiver burden, Skin inflammation / breakdown– Sleep disturbance, Increased risk urinary tract infection
(UTI), Cost related to management of incontinence– Increased risk of falls and fractures related to urgency /
frequency, nocturia, impaired mobility and vision changes– Increased risk of mortality associated with falls, fractures
and skin breakdown
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Issues Associated with Incontinence Management• Incontinence briefs hold moisture against the skin causing
maceration and breakdown/excoriation.• Prolonged use of catheters increases the risk of bladder
infections.• Increased cost associated with frequent diapers and
incontinence pad changes.• Incidence of contact dermatitis / yeast infection
associated with incontinence.
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Incontinence Associated Dermatitis
Skin condition commonly associated with incontinence. Skin irritation and inflammation related to exposure to urine and feces. Additional risk factors:• Diaper use• Bed bound / immobility
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Incontinence Associated Dermatitis
Incontinence associated dermatitis in dark skin patients is difficult to identify, it has the appearance of deep dark discoloration.
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Moisture Associated Skin Damage
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).
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Shear & Friction
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.
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Unstageable Pressure Ulcer
Incontinence, immobility, increased moisture, pressure and malnutrition causes serious skin conditions/wounds.
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Prevention & Management
• Frequent checks for incontinence episodes• Turning and repositioning schedule• No-rinse skin cleansers are preferable to soap and water• Low air loss / pressure distribution surface• Change cloth pads frequently• Breathable pads must be utilized on air mattress• No diapers while in bed• Moisture barrier creams / Antifungal creams• Skin protectant sprays
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Skin Treatment Products