Article illustration by Gingermoth. All rights reserved.
By Maureen Shawn Kennedy, MA, RN, AJN editor-in-chief
Urinary and fecal incontinence are not the kinds of health topics widely discussed—people may compare notes about knee or hip replacements or their cholesterol levels, but you’ll find few people talking about leaking urine or feces. Even at medical and nursing conferences—unless one happens to be at a conference specifically dealing with those issues—you might be hard-pressed to find the topic on a program agenda.
But these are common problems—a 1995 report in the CDC’s MMWR estimated that 15%–30% of adults over age 60 suffer from urinary incontinence. (And that was 10 years ago. No doubt that number is higher by now, given the higher numbers of people who are over 60.) Fecal incontinence occurs in about one in 12 adults—in a 2009 report, that was 18 million people.
It’s the kind of problem that can drastically change the quality of life for those who have it, due to their fear of having an “accident” in public. Think about it: no extended excursions unless there are facilities all along the way (this can rule out many outdoor activities like golf, trips to the beach, or hiking); timed meals and beverages to reduce the chance of leaking, or even foregoing them altogether. It isolates people unnecessarily, and may contribute to further decline.
Our CE article this month, “Self-Management of Urinary and Fecal Incontinence,” examines self-management concepts and provides strategies to enable nurses to to help people self-manage their incontinence. Here’s the article overview:
Widely used by patients to control symptoms of chronic conditions such as diabetes, asthma, and arthritis, self-management can also help patients with urinary or fecal incontinence. The authors discuss the principles of self-management, the behaviors and skills self-managing patients need to acquire, and the nurse’s role in reinforcing their use. They then describe strategies that can be incorporated within the framework of self-management to control urinary, fecal, or dual incontinence.
The strategies are detailed and practical—perhaps the most important thing you can do is just to start the conversation. You can earn 2.3 hours of CE credit. Moreover, you’ll learn how to help patients increase their quality of life.
Dear Maureen,
Your blog is very interesting being that I feel this is a hidden topic in health care. Working in the hospital, urinary and fecal incontinence in patients is a frequent problem encountered by all health care personal. However, because it is so common it is not looked at as an issue and therefore usually not discussed. The only solutions given for this population of patients is to provide them with diapers and additional padding in case of an accident while in the hospital, or other invasive interventions. These types of solutions leave patients feeling powerless and embarrassed when it comes to controlling their bowel and bladder so, the issue never resolve because its often not diagnosed. If nurses and other hospital staff were provided additional education and given additional resources on how to help this population of men and women, it will increase the patients’ way of life tremendously. If hospital staff work together in a uniform way to implement self managing strategies like continence diary logs these patients will have a better outcome.
Sincerely ,
Sarice
Certainly, the best place to start is by talking to your doctor about what’s causing your incontinence. The sooner you seek medical help, the more successful treatment is likely to be.