Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
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Sexual function
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Stress incontinence
Urge incontinence
Over Active Bladder
Functional incontinence
Overflow
Other bladder problems
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Stress Incontinence
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Anal Incontinence
Flatus
Liquids
Solids
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Prolapse
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Pregnancy
Childbirth
Hormonal variations
Menopause
Gynaecological surgery
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Constipation
diet / fibre
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Nervous system
Bladder
Urethra
Oestrogen
Prostate
Co-morbidities
Parkinson's Disease
Dementia
COAD
Diabetes
Constipation/FI
SOURCE: Hunt (1993)
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Bladder/Urethra Changes
Structural
Functional
bladder collagen
Benign prostatic
hypertrophy
oestrogen
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bladder capacity
bladder sensation
post-void residual
volume
urine flow rate
urethral pressure
risk of urinary infection
concentration of urine
overnight
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Management of Incontinence in
Older Adults
Primary prevention
Childbirth trauma
PFM weakness
Detrusor overactivity
Impaired mobility or cognition
Secondary prevention
Reverse predisposing conditions OR
Prevent from progressing to incontinence
Tertiary prevention
Management strategies to reduce the impact of
incontinence
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Management of Incontinence in
Older Adults
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Condom drainage
Catheters
Skin care
Protective clothing
Pads and Pants
Bed-pads and chairpads
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Management of Incontinence in
Older Adults
Where to get help
GP
Medical specialists
Continence nurse advisors
Continence physiotherapists
Community health centre/service
ACAS/DNS
Interpreter services
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10 Things to Remember
1. Screening is essential
2. Incontinence is not
inevitable consequence
of ageing
3. Mx options for older
adults essentially the
same as for younger
adults
4. Special considerations
for Ax & Mx of older
adults
5. Baseline assessment
6. Significant
improvement in elderly
when focus away from
bladder
7. Ix & Mx options
8. Nocturia & Nocturnal
enuresis
9. Incontinence in frail
elderly not necessarily
caused by dementia
10. Every person should be
given the opportunity
to achieve continence
(Independent/ dependent/ social)
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Aging muscles
50% of total muscle mass loss between 20-90
Muscle weakening (atrophy) is worse with a
sedentary lifestyle
Changes in how muscles respond occur with
aging
But
Age related changes are often reversible
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CANT FIND
THEM?
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Self Examination
Stopping the flow
Coughing with confidence
Get a Grip or Pull Them In
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Types of Exercises
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When to Exercise?
Tighten Those Muscles with:
Sneezing
Coughing
Laughing
Whenever you leak
Functional activities
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Summary
Muscle weakness occurs with inactivity and
aging
Pelvic floor is a muscle as any other
Weakness causes incontinence
Exercising will make muscles stronger
Pelvic floor exercises reduce incontinence
Never too late to start exercising
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Any questions?
THANK YOU
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