Elderly urinary incontinence

Middle-aged and elderly urinary incontinence is divided into temporary urinary incontinence and long-term urinary incontinence. The main cause of its occurrence is urinary tract infection and disease. The affected population is mainly middle-aged and elderly men.

Cause

The situation of secondary enuresis caused by middle-aged and elderly people is many kinds and complicated. What are the reasons for men’s spontaneous urinary incontinence and frequent urination and urgent enuresis?
1. Temporary urinary incontinence: urinary tract infection; acute insanity disease; medicine: sleeping pills and tranquilizers: psychological: depression
2. Long-term urinary incontinence: cerebral cortical disorders (stroke, dementia, etc.) surgery that damages the urethral sphincter or pelvic nerve; spinal cord disorders; overflow incontinence: diabetes, prostate disease, alcoholism, etc.; bladder skin disorders.
3. The peculiarities of female menopause and the elderly women with prolapse of the uterus caused by multiple childbirths, women with a history of genitourinary surgery, and women cannot restrain themselves from urinating after childbirth.

Training method
1. Intermittent urination training. That is, during each urination process, the patient controls to pause urination for 3-5 seconds before continuing to discharge urine;
2. Levator anus training. The patient takes a standing, sitting or lying position, which is coordinated with breathing exercises. When inhaling deeply, slowly contract the urethral opening and anus. At this time, the patient feels that the urethral opening and anus are tightly closed and the anus is lifted up. Then hold the breath for 5 seconds, and then slowly relax the urethral opening and anus when exhaling . In this way, 10 consecutive contraction and relaxation exercises each time, three times a day. The above two training methods are both contraction training of the pelvic floor muscles and urethral sphincter, thereby enhancing the contractility of the bladder and urethral sphincter, so that urinary incontinence will not occur as soon as the abdominal pressure increases. The patient must persevere in the above training, generally it takes 3-6 months of training to be effective.

Targeted care
Analyze the causes and problems of urinary incontinence with patients and their families to reach their consensus. For urinary incontinence caused by reduced self-care ability or communication difficulties, it is necessary to develop a time plan for assisting in urination, and help the patient to urinate in time. For incontinence that cannot be controlled at all, a more detailed plan should be developed, such as senile dementia. Analyze the causes of urinary incontinence according to nursing records, and choose corresponding methods, such as indwelling catheterization, induced urination, etc. For bedridden patients, we should try to relieve the patient’s inferiority complex and relieve the patient’s mental tension; pay attention to covering the exposed part, wash it in time after defecation, and keep the perineum clean and dry to prevent infection. For urinary incontinence caused by mental factors, time, and environmental factors, it is necessary to understand the cause in detail, do a patient and meticulous explanation work, eliminate the patient’s ideological anxiety and fear, properly arrange the surrounding living environment, and give the greatest spiritual value. The comfort of urinary incontinence may disappear.
Focus on psychological care
Urinary incontinence brings great pain and inconvenience to patients, and seriously affects the quality of life of patients. In particular, the elderly are slow to move, their mobility is weakened, their self-esteem is vulnerable to injury after illness, and they are prone to distrust and stubbornness in others. In severe cases, they are depressed, anxious, and feel lonely. In this regard, nursing staff must first be patient, kind and tireless, and use good nursing language and behavior to arouse patients’ confidence in recovery. It is necessary to teach patients how to use the toilet and adjust the environment that facilitates the activities of the patient. For example, the toilet should be placed in a place where the patient can easily access it. Help patients who have difficulty wearing undressing, try to wear simple and easy-to-detach clothes. Cautious catheterization, use sterile intermittent catheterization when necessary, and avoid indwelling catheterization as much as possible. Whenever the patient makes a small improvement, the patient should be given appropriate encouragement.