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Managing Incontinence: Advice from a Nurse

We interviewed a full-time nurse to get the best advice on handling incontinence. Patients with incontinence cannot control their urination or defecation. Patients with incontinence usually require caregivers to take care of them at home. To prevent pressure ulcers and infections and maintain one’s quality of life and dignity, it’s essential to have a proper nursing care plan.

We prepared this article to reinforce the basics of incontinence management, basic usage of a diaper for adults and share caregiving tips from a nurse.

What Are the Different Types of Incontinence?
Stress Incontinence: Occurs when the bladder experiences pressure, causing urine leakage. It usually happens when one laughs, sneezes or exercises.
Urge Incontinence: Occurs when there’s a sudden and intense urge to urinate, leading to urine leakage. It’s common among the elderly, especially those with urinary tract infections and diabetes.
Overflow Incontinence: Occurs when the bladder doesn’t empty completely, leading to dribbling of urine.
Functional Incontinence: Occurs when physical or mental impairment causes difficulty in urinating at the appropriate time.
This commonly happens post-stroke. Stool Incontinence: Occurs when stool leaks from the rectum due to the inability to control the urge to defecate.

How Often Should You Change Diapers for Adults?
Changing adult diapers frequently is crucial to prevent skin infections and rashes. The frequency depends on one’s lifestyle, health, and budget. Typically, adults with incontinence require 5 to 8 diaper changes daily. This means an average person with incontinence requires at least 150 diapers a month.

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Caregivers should frequently check the diapers of patients who are less mobile to change them immediately when soiled. Since diapers are bulky, we recommend ordering them online to be delivered to your home.

How Can You Prevent Pressure Ulcers?
Pressure ulcers are localized skin and tissue injuries caused by prolonged pressure on a particular spot. Patients who are incontinent, have limited mobility, underlying medical conditions, and poor nutrition are prone to pressure ulcers.

Follow these tips to prevent pressure ulcers:

  • Use barrier cream: Apply a thin layer of barrier cream after each diaper change, and wipe it off gently and thoroughly during every change.
  • Turning: Turn your loved one every two hours gently, even while they’re asleep. Use a schedule to maintain consistency. For instance, at 8 am – back, 10 am – left, 12 pm – right, 2 pm – back, 4 pm – left, and 6 pm – right.
  • Nutrition: A well-balanced diet and adequate hydration prevent pressure ulcers.
  • Activity: Encourage your loved one to move frequently to prevent pressure ulcers from forming. Patients who are completely bed-bound should exercise with assistance. Simple exercises such as squeezing a stress ball or lifting arms and legs encourage blood flow and help maintain muscle strength.
  • Keeping skin clean and dry: To prevent sweat formation, keep your loved one cool by ensuring good air ventilation, using a fan, or cooling mattress. After a shower or diaper change, always dry your loved one thoroughly. Pay close attention to areas that are commonly missed, such as between fingers and toes, skin folds at the groin and below the breasts. Wear light and airy clothing.
  • Cushioning: Use cotton pads to elevate prominent bony parts of the body, such as the heels. For patients who are bed-bound, use alternating-pressure mattresses to reduce pressure ulcers from forming.
  • Moving: When moving your loved one along the bed, don’t drag them by force, as it can cause skin tears. Instead, use a drawsheet or bedsheet

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