Background Mary was a fit 75 year old until a recent stroke left her with a dense right hemiparesis, dysphagia and depression. One of her main problems was urinary frequency and urgency. She was calling the nurses to her room hour to use the toilet and was worried they thought her a nuisance. Mary would not leave her room and declined invitations to her daughter’s home for fear of having an accident. On assessment Mary disclosed that whilst in hospital an indwelling catheter had been inserted for a while. Urinalysis showed a large presence of leucocytes. A MSU confirmed a UTI. Plan of Care The appropriate antibiotics were prescribed and within one week Mary’s urine was clear of infection and her symptoms had partially resolved. However she was still experiencing some urgency, frequency and nocturia. A bladder retraining programme was initiated and Mary was encouraged to drink more water and reduce her caffeine intake. A month later she had improved only slightly. After discussion with her GP, anticholinergic medication was prescribed. This was very effective in reducing the frequency and urgency. Mary was encouraged to continue bladder retraining. Follow Up After a three month period Mary was able to stop taking the anticholinergic medication and managed to maintain the improvement. Mary is a much happier individual as a result of this and now feels confident to visit her daughter’s house. (Case Studies 2 & 3 from ACA Continence Resource Pack for Care Homes) QUESTION How easy would it have been just to manage these issues with continence products and not deal with the underlying problems?
Background Mary was a fit 75 year old until a recent stroke left her with a dense right hemiparesis, dysphagia and depression. One of her main problems was urinary frequency and urgency. She was calling the nurses to her room hour to use the toilet and was worried they thought her a nuisance. Mary would not leave her room and declined invitations to her daughter’s home for fear of having an accident. On assessment Mary disclosed that whilst in hospital an indwelling catheter had been inserted for a while. Urinalysis showed a large presence of leucocytes. A MSU confirmed a UTI. Plan of Care The appropriate antibiotics were prescribed and within one week Mary’s urine was clear of infection and her symptoms had partially resolved. However she was still experiencing some urgency, frequency and nocturia. A bladder retraining programme was initiated and Mary was encouraged to drink more water and reduce her caffeine intake. A month later she had improved only slightly. After discussion with her GP, anticholinergic medication was prescribed. This was very effective in reducing the frequency and urgency. Mary was encouraged to continue bladder retraining. Follow Up After a three month period Mary was able to stop taking the anticholinergic medication and managed to maintain the improvement. Mary is a much happier individual as a result of this and now feels confident to visit her daughter’s house. (Case Studies 2 & 3 from ACA Continence Resource Pack for Care Homes) QUESTION How easy would it have been just to manage these issues with continence products and not deal with the underlying problems?