Silver Age Health | Nursing Methods for Elderly People with Urinary Incontinence

As the aging of our society becomes increasingly serious, the care of incontinent elderly people has attracted more and more public attention. Mastering some care skills for incontinent elderly people can not only save unnecessary expenses, but also better fulfill filial piety to parents. Urinary incontinence is a common health problem among the elderly, especially among women. The occurrence of this symptom is mostly related to weakened bladder stability and relaxed pelvic floor muscles, and may also be caused by the stimulation of acute urinary tract infection. Although it does not directly threaten the life of the elderly, it can cause the body to emit odor, skin erosion, and even cause recurrent urinary tract infections. These factors may cause the elderly to become withdrawn and depressed. Therefore, we should pay more attention and take effective measures to care for incontinent elderly people.

▏Psychological care for elderly people with urinary incontinence

Urinary incontinence often makes the elderly feel embarrassed, ashamed and helpless, thus generating psychological pressure. Nursing staff should give the elderly full understanding, respect and care, and avoid showing boredom or disgust.

1. Build a bridge of trust

First of all, establishing a trusting relationship with the elderly with urinary incontinence is the foundation. This requires us to listen to their feelings with great patience and empathy, whether it is physical discomfort or psychological distress. Respect their privacy and avoid discussing their condition in public, so that they feel respected and understood. By listening, we can not only understand their actual needs, but also provide them with a safe space to talk and relieve their psychological burden.

2. Popularize knowledge and eliminate misunderstandings

Many elderly people have misunderstandings about urinary incontinence, believing that it is a shameful thing to talk about, or a sign of their aging and uselessness. Therefore, it is very important to popularize the relevant knowledge of urinary incontinence, including its causes, treatment methods and prevention strategies. By conveying scientific knowledge, we can help the elderly to correctly understand urinary incontinence, understand that it is a problem that many elderly people will encounter, and it is not a sign of personal incompetence or shame, thus alleviating the emotion of self-denial.

3. Encourage active responses and build confidence

Encouraging the elderly to adopt a positive lifestyle and treatment attitude is an important part of psychological care. Guide them to participate in moderate physical exercise, such as walking, Tai Chi, etc., to strengthen the pelvic floor muscle strength; at the same time, guide them to learn correct urination habits, such as regular urination, avoid holding urine, etc. In addition, encourage the elderly to participate in social activities and maintain a positive attitude, so that they can feel the fun and meaning of life, and thus build confidence in overcoming the disease.

4. Family and Social Support

The family is the most solid support for the elderly. Family members should give the elderly full love and support, including emotional comfort, care in life and companionship when seeking medical treatment. At the same time, the society should also pay more attention to the elderly with urinary incontinence, provide convenient medical services, set up special consultation hotlines or support groups, so that the elderly can feel the warmth and strength from all walks of life. Build a support network with the participation of families, communities, medical institutions and other parties to provide comprehensive psychological care for the elderly with urinary incontinence.

5. Pay attention to emotional changes and intervene in time

Urinary incontinence may be accompanied by negative emotions such as anxiety and depression. Therefore, we should pay close attention to the emotional changes of the elderly and conduct psychological intervention in a timely manner once abnormalities are found. This includes providing professional psychological counseling, guiding the elderly to conduct relaxation training, and encouraging them to express their inner feelings. For the elderly with more serious emotional problems, they should be referred to professional psychological medical institutions for treatment in a timely manner.

▏Skin care for elderly people with urinary incontinence

Elderly people with urinary incontinence are prone to problems such as moist, red, and damaged skin, so good skin care is crucial.

1. Basic care measures: keep dry and clean

1. Change diapers or underwear in time

Once you find that the diaper or underwear is wet, you should change it immediately to avoid prolonged contact with urine. Choose products with good breathability to reduce skin irritation.

2. Gentle cleaning

Gently wash the affected area of ​​skin using warm water and a gentle cleanser (such as baby wash), avoiding scrubbing that can damage the delicate skin barrier.

3. Dry thoroughly

After washing, pat skin dry with a soft towel to ensure complete dryness. For hard-to-reach creases, use a hair dryer (on low heat) to aid drying.

2. Professional nursing advice: prevention is better than cure

1. Skin protectant

After cleaning and drying, you can apply an appropriate amount of skin protectant containing zinc oxide or vaseline to form a protective film to isolate direct contact between urine and skin and reduce irritation.

2. Regular inspection

Family members or caregivers should regularly check the skin condition of the elderly, especially those areas that are easily damaged. If any signs of redness, swelling, or ulceration are found, seek medical attention immediately.

3. Nutritional support

A balanced diet is essential for maintaining skin health. Encourage the elderly to consume foods rich in protein, vitamins C and E, which help skin repair and enhance resistance.

4. Turn over regularly

For elderly people who have been bedridden for a long time, they should be turned over regularly to avoid prolonged pressure on local skin and prevent the occurrence of pressure sores.

▏Life care for the elderly with urinary incontinence

1. Adjust your lifestyle

Regular work and rest, regular toileting: Establishing a regular work and rest schedule for elderly people with urinary incontinence, including regular drinking and toileting, can help establish bladder rhythm. By recording the time and amount of each urination, you can gradually train your bladder control ability and reduce the occurrence of accidental urine leakage.

2. Healthy diet

1. Drink water in moderation and distribute it scientifically

Although drinking less water may seem to reduce urine leakage, doing so in the long run can lead to dehydration and other health problems. Elderly people should be encouraged to drink water in moderation according to their body's needs and try to distribute water to different times of the day to avoid drinking large amounts of water in a short period of time.

2. Eat a balanced diet and avoid stimulation

The diet should contain enough protein, vitamins and minerals to support the normal function of the body. At the same time, avoid consuming too much caffeine, alcohol and spicy foods, which may irritate the bladder and aggravate the symptoms of urinary incontinence.

3. Eat more fiber to prevent constipation

Constipation increases abdominal pressure, which in turn affects bladder control. Therefore, fiber-rich foods such as vegetables, fruits, and whole grains should be added to the diet to promote intestinal peristalsis and prevent constipation.

3. Exercise appropriately to enhance physical fitness

The elderly can practice under the guidance of doctors or professionals. Doing moderate aerobic exercise: such as walking, Tai Chi, yoga and other low-intensity aerobic exercise can not only improve cardiopulmonary function and physical fitness, but also promote blood circulation, improve the blood circulation of the bladder and urethra, and help relieve urinary incontinence symptoms.

Avoid strenuous exercise. Although exercise is beneficial, you should avoid overly strenuous activities to avoid increasing abdominal pressure and affecting bladder control. Choose an exercise method that suits you, proceed step by step, and persevere.

▏Rehabilitation training for elderly people with urinary incontinence

1. Pelvic floor muscle training

The pelvic floor muscles, which are located at the bottom of the pelvis and support the bladder, uterus (or prostate) and rectum, are vividly called "invisible belts". As people age, the pelvic floor muscles gradually relax, which is one of the important causes of urinary incontinence. Therefore, strengthening pelvic floor muscle training has become the primary task of rehabilitation training.

1. Kegel exercises

This is the simplest and most feasible way to exercise the pelvic floor muscles. By consciously contracting and relaxing the pelvic floor muscles, like the anal lifting exercise, several times a day, each time lasting from a few seconds to tens of seconds, you can effectively enhance the strength and endurance of the pelvic floor muscles.

2. Professional guidance

It is best for the elderly to train under the guidance of a physical therapist or professional nurse to ensure correct movements and avoid injuries caused by excessive force.

2. Bladder training

Bladder training is designed to help older adults re-establish regular urination habits and reduce the incidence of urinary incontinence.

1. Regular urination

Set a reasonable urination interval according to your own situation, such as once every 2-3 hours, and gradually extend the interval to train the bladder's urine storage capacity.

2. Keep a urination diary

Recording the time of each urination, urine volume, and whether there is a sense of urgency can help with self-monitoring and adjustment of training plans.

3. Avoid triggering factors

Reduce the intake of caffeine, alcohol and stimulating foods, and avoid excessive fatigue and emotional stress, as these factors may irritate the bladder and cause urinary incontinence.

Other helpful training and lifestyle adjustments

1. Weight management

Being overweight or obese can increase abdominal pressure and put extra strain on the pelvic floor muscles. Managing your weight through a healthy diet and regular exercise can help reduce symptoms of urinary incontinence.

2. Strength training

Whole-body strength training, especially exercises targeting the abdomen and thighs, can strengthen the core muscles and indirectly support the function of the pelvic floor muscles.

▏Environmental care for elderly people with urinary incontinence

1. Create a comfortable living environment

Keep the room well ventilated and at a suitable temperature. The bed should be soft and comfortable for the elderly to rest. The special needs of elderly people with urinary incontinence should be considered in the design of the living environment. For example, the bedroom and bathroom should be close to each other to reduce the distance they have to walk at night; handrails should be installed in the bathroom to ensure the safety of the elderly when using the toilet; the floor should be made of non-slip material to prevent falls; at the same time, easy-to-clean and absorbent floors and carpets should be installed to handle unexpected situations in a timely manner and keep the environment dry.

2. Install handrails and anti-slip facilities

Install handrails in places such as bathrooms and corridors to prevent the elderly from falling.

3. Place bedpans and urinals

Place bedpans and urinals next to the elderly's bed to facilitate them to urinate at any time. Bedpans and urinals should be cleaned and disinfected regularly.

4. Intelligent assistance and technological care

With the development of science and technology, smart devices have brought many conveniences to the lives of elderly people with urinary incontinence. Smart mattresses can monitor the physiological conditions of the elderly in real time, detect and remind family members or caregivers in time; smart toilets can automatically flush and dry, reducing the burden on the elderly. The application of these technological products not only improves the quality of life, but also allows the elderly to feel the warmth and care of society.

▏Medical care for elderly people with urinary incontinence

1. See a doctor regularly

For elderly people with urinary incontinence, regular medical treatment is an indispensable part. With age, physical conditions may change at any time, and the causes of urinary incontinence are also varied, including but not limited to weakened bladder muscle function, prostate hyperplasia, and nervous system diseases. Therefore, regular visits to the hospital for professional examinations, such as urine routine, urine flow rate measurement, bladder B-ultrasound, etc., can timely detect and evaluate changes in the condition and provide a basis for formulating personalized treatment plans. At the same time, doctors can also adjust medication plans according to the physical condition of the elderly, avoid interactions between drugs, and ensure the effectiveness and safety of treatment.

2. Take medication as directed by your doctor

Drug treatment is one of the important means of managing urinary incontinence. When using drugs, the elderly must strictly follow the doctor's orders and take them on time and in the right amount. Different drugs have different therapeutic effects on different types of urinary incontinence. For example, anticholinergic drugs are used to improve overactive bladder, and alpha-receptor blockers are often used to relieve urination disorders caused by prostatic hyperplasia. However, drugs are not omnipotent, and the elderly have a weakened ability to metabolize drugs, which makes them prone to adverse reactions. Therefore, caregivers need to closely observe the elderly's reactions after taking the drugs. If they feel uncomfortable, they should stop taking the drugs immediately and consult a doctor. In addition, adhering to long-term treatment and not arbitrarily changing or interrupting the treatment plan are the keys to effectively controlling urinary incontinence.

3. Timely treatment of complications

If urinary incontinence is not properly treated, it is often accompanied by a series of complications, such as urinary tract infection, skin inflammation (such as diaper rash), and increased psychological pressure. These complications not only increase the physical burden on the elderly, but also seriously affect their mental health and social activities. Therefore, caregivers need to have a high sense of responsibility, pay close attention to the physical condition of the elderly, and take immediate measures once signs of complications are found. For example, keep the perineum clean and dry, change diapers or underwear regularly to prevent urinary tract infection; use appropriate care products to reduce skin friction and prevent skin inflammation; at the same time, give the elderly sufficient psychological support, encourage them to participate in social activities, and reduce psychological pressure.

Nursing for elderly people with urinary incontinence requires comprehensive consideration of psychological, skin, life, rehabilitation training and medical factors. Scientific and effective nursing measures can improve the quality of life of the elderly and alleviate their pain and distress. At the same time, family members and society should also give more care and support to elderly people with urinary incontinence, so that they can feel warmth and dignity.

(Picture from the Internet)

Author | Han Mei is a practicing pharmacist who has worked in a well-known national tertiary hospital for more than 30 years and has rich medical care experience. She has represented the hospital on many occasions to go out for exchanges and study. She is an expert in food hygiene and nutrition, has a national nutritionist qualification, and is a science enthusiast.

Preliminary review | Chen Jiaqi

Review | Wei Xinghua

Final Review | Zhou Yang