Management of Urinary
Mary M Lancaster
Take time to deliberate,
but when the time for action arrives,
stop thinking and go in.
Urinary incontinence is a disturbing and often distressing problem for both patients and caregivers. Its management can be costly and time consuming. The onset can result in the placement of the affected person in a long-term care facility. When magnified by the decreased mental ability of patients with dementia, the management can become a seemingly insurmountable task. Strategies currently exist that can help lessen the strain on patients and caregivers.
Urinary incontinence is a problem all too often left untreated out of embarrassment or lack of knowledge of available treatment options. However, its treatment and management are receiving greater attention from health care personnel and the general public than in the past. In March 1996 the Agency for Health Care Policy and Research (AHCPR) issued an updated Clinical Practice Guideline entitled "Urinary Incontinence in Adults: Acute and Chronic Management." This publication goes beyond the original guidelines published in 1992 to include management strategies for persons with chronic incontinence. Groups such as Help for Incontinent People (HIP) and the International Continence Society are making strides in assisting caregivers in the public and health care domains to be knowledgeable of treatment and management options.
When the patient has had a complete evaluation of the incontinence, as discussed in Chapter 15, and no "reversible" cause is identified, finding the most appropriate form of management is the first step. The management strategy