Assessing Urinary Incontinence  

50% of long term care facility residents experience some degree of urinary incontinence. 2004 OSCAR data, derived from the results of long term care facility surveys, reveals that Bladder Care was cited in 10% of surveys. The data shows a high rate of incontinence for residents who are actually low risk for incontinence. Surveyors will be looking closer at how the facility assesses urinary function, identifies the type of incontinence, and implements individualized care plan interventions to address the resident’s particular needs.

The surveyor guidelines stress that identifying the nature of the incontinence is a key aspect of the assessment. Interventions and programs should be specific to the type of incontinence.

 Urge Incontinence

• The most common cause of urinary incontinence in elderly persons

• Urgency, frequency, and nocturia

• Resident can feel the need to void, but is unable to inhibit the urge long enough to reach the commode

• Causes are: age-related, neurological, bladder infection, urethral irritation

• Second most common type of urinary incontinence in elderly women

• Loss of small amount of urine with physical activity such as coughing, sneezing, laughing, walking stairs or lifting

• Occurs when the bladder is distended from urine retention

• Symptoms may include: weak stream, hesitancy, intermittency, dysuria, nocturia, incomplete voiding, frequent or constant dribbling

• May be caused by obstruction or neurological condition

• May mimic urge or stress incontinence, but is less common than those

• Secondary to factors other than inherently abnormal urinary tract function

• May be related to: physical weakness or poor mobility/dexterity (poor eyesight, arthritis, stroke, contracture, cognitive problems, medications, or environmental factors

• Related to a potentially improvable or reversible cause

• Temporary or occasional incontinence from variety of causes such as delirium, infection, medication, increased urine production

More information on urinary incontinence can be found in the book