Research Priorities (Not
in order of priority)
- Does
identification of co-morbidity lead to improvement?
- What
are clinically (as opposed to statistically) relevant
outcomes for this group?
- Measurement
and modification of caregiver attitudes/knowledge/expectations and
how to change them, with what clinical effect?
- Why
some individuals with increased risk become incontinent while others
maintain continence.
- Catheter
management.
- Retention
and its relevance.
- Minimizing
impact on quality of life for intractable incontinence.
Clinical Evidence (Indicates
what is known about preventing incontinence)
The prevention model outlined in section B. is not appropriate for
many frail older adults who are dependent on caregivers for toileting
and maintaining continence. Therefore the concept of "Dependent
Continence" is most applicable.
Investigated associations include:
- Immobility
- Impaired
cognition, especially spatial
- Drugs,
particularly sedatives and diuretics
- Complexity
of physical environment and barriers (e.g. the number of points
where the individual must make a decision on the way to the toilet)
- Impaired
activities of daily living, particularly dressing dependence
- Caregiver
attitudes/beliefs/knowledge
- Disease
e.g. Parkinson's, CVA, diabetes, fractured neck or femur
- Retention
of urine or an elevated post-micturition residual: urologic causes
or post-operative.
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