Beyond the bladder: holistic care when urinary incontinence develops

Incontinence in palliative care: assessment to promote dignity

This article will explore the district nurse (DN) role in caring for palliative service users and their responsibility to prepare them and their family members to understand the trajectory of their prognosis and the possible decline in urinary function and incontinence. Educating DNs to advise service users in appropriate management options and collaborating with the wider multidisciplinary team (MDT) to ensure service users' individual goals and aims are followed as closely as possible. Urinary incontinence (UI) is not a natural part of the ageing process, although the prevalence of UI is increased as people age, through multi-morbidities, polypharmacy, cognitive decline, mobility limitations or life-limiting conditions. UI affects an individual's dignity and can cause a negative impact on self-esteem, and it is often accompanied by a perceived stigma that can lead to anxiety, depression and a reluctance to ask for help and advice.

Registered nurse's experiences of continence care for older people: A qualitative descriptive study

AIM

This study aimed to illuminate nurses' experience of continence care for older people receiving home care, either in their own home or in an assisted living facility.

BACKGROUND

Registered Nurses (RNs) have a major role to play in identifying and establishing appropriate actions regarding continence care for older people. However, the crucial nursing care pathway for continence care is commonly described as poor.

METHODS

Interviews were conducted with 11 RNs providing home care, and the transcribed texts were analysed using inductive content analysis.

RESULT

The impressions of RNs were categorised according to four themes: perceptions of continence care, an open approach to continence care, the need for personalised aid fittings and the importance of teamwork in continence care. Key findings were the importance of teamwork; the need for nurses to embrace leadership at the point of care and be more visible in terms of the provision of direct care; substantiation that evidence-based interventions, such as scheduled toileting and prompted voiding, should constitute the norm in continence care within the context of home care; and the need for nurses to support the right of older persons to receive an assessment of their continence problems, deemed to be the minimum standard of quality care.

CONCLUSION

The provision of continence care that is based on key nursing standards, such as evidence-based and person-centred care, as well as individualised continence care that is based on evidenced-based guidelines, would ensure an improvement in the continence care that is presently on offer to older people.

IMPLICATIONS FOR PRACTICE

Nurses need to embrace leadership at the point of care and to be more visible with the provision of direct care in order to improve continence care for older people receiving home care.