Incontinence - Assisting a family member

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Assisting a family member

Assisting a family member

Incontinence

The diaper Condom Anal plug Bladder catheterization Fecal catheterization Promote continence Examination of urine and feces
  • The diaper
    • Diapers
    • Shaped diapers
    • Pant diapers
    • Application
  • Condom
  • Anal plug
  • Bladder catheterization
  • Fecal catheterization
  • Promote continence
  • Urine and stool tests

Incontinence of urine and feces (urofecal) is a frequent event in a series of particular diseases and conditions: stroke, dementia, neurological diseases, third age, women after pregnancy and children in early childhood. This problem, so frequent, has significant psychosocial and economic implications.

Incontinence requires specific treatment to ensure comfort and an acceptable quality of life.

Incontinence, especially urinary incontinence, is estimated to be the second leading cause of hospitalization in long-term care facilities (institutionalization).

In addition to normal neurological control and the integrity of the intestinal and urinary tract, other aspects such as the ability to use the hands, coordination, facilitated access to the toilet, quickness in removing clothes and so on.

Before tackling the discussion on incontinent aids (diaper, catheter, etc.), it is necessary to evaluate the type of subject we face and the opportunity to carry out any rehabilitation therapies. There are some categories of people who need a deep analysis to determine the exact problem:

  • individuals who must be assisted in elimination for causes directly attributable to neurological damage;
  • individuals who need supports to facilitate or facilitate mobility;
  • individuals with neurological integrity who present cognitive disorders;
  • individuals with multiple disorders (neurological, motor, neurological).

This premise is fundamental because patients with motor problems must not use incontinence aids if they do not need it, as well as patients with cognitive deficits but with preserved urinary or faecal functions. The reason is easy to understand: the aids must not replace the act of evacuation.

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The diaper

The diaper is an aid adopted to manage urinary and faecal incontinence. It is designed to contain organic products without creating skin ailments, such as maceration and rashes, to check odors if possible and make the patient more autonomous. These absorbency systems are of different types and shapes depending on the use to be made of them. There are drop-proof diapers for men and women, pant diapers or strips with and without elastic. They have some disadvantages (leakage of organic material) and can create disturbances (maceration of the skin, on delicate skin they can cause wounds).

For urinary incontinence in the male particular forms are used which absorb only in the vicinity of the penis, while in the woman the absorbency must be in the central area (perineum).

Fecal incontinence must be treated by using pant diapers. Below is a brief overview of the types of diapers and diapers and their uses.

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Diapers

Diapers are designed for people who have mild urinary and faecal incontinence. They consist of pure cellulose with a "non-woven" filter film that comes into contact with the skin and are covered externally with a sheet of synthetic material which has the purpose of retaining the organic material and preventing it from leaking. They also have an adhesive that adheres to the underpants to avoid accidental dislocation. Their function is to absorb small quantities of urine or minor intestinal losses. Diapers are disposable aids (therefore they must be eliminated at every change) and can cause skin irritation or allergies to the components that make them up.

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Shaped diapers

The shaped diapers have a rectangular shape, that is "shaped", to adapt to the normal anatomical conformation. Inside they contain cellulose and outside they have a sheet of synthetic material to retain the residues. They are fixed with underpants preferably mesh and some have internal elastic bands to retain losses. The shaped diapers are disposable devices designed for medium to severe urofecal losses which, due to their size, can create groin injuries and allergies, if poorly positioned.

If the patient has bedsores, it is necessary to decide on their use after consulting with the doctor or nurse.

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Pant diapers

The pant diapers have, in fact, the shape of a pant and are equipped with adhesive side wings to keep them still. They do not require mesh underpants for their fixing. They are also equipped with absorbent, filtering substances and a synthetic external sheet for the containment of the organic material. The outer wings are equipped with adhesive and can be attached and detached several times. Their use is recommended in severe urofecal incontinence and they are also disposable devices.

There are different sizes: small (small), medium (medium), large (large), extra large (extra large).

These devices are capable of creating injuries at the groin level and are contraindicated in case of skin lesions, if not properly treated; In addition, the pant-diapers favor skin macerations in some cases, especially if the patient is not changed after the evacuations. Some individuals may be allergic.

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Application

The application of diapers and diapers requires a minimum of experience. Usually, after a short period of training, patients are able to wear them and remove them on their own. If they are lacking in strength or the cognitive level does not allow it, then this procedure is carried out by relatives or carers.

Autonomous patient If the patient manages to independently apply the diaper, he will have to pay particular attention to the part responsible for the absorption of urine and that of the stool, in fact the diapers have a narrower and a wider part. The narrowest area must be placed near the urine leakage area (front area), while the widest area must be placed near the anus (rear area). If it is a pant diaper, the stickers must be placed behind the back and must stick on the front wings: they have two on each side.

Non-autonomous patient The procedure for application by an operator proceeds as follows.

  • Prepare the material and put on gloves.
  • The operator can wear the diaper with the patient standing or in bed.
  • If the subject is able to stand up by grasping a handrail or other secure support, positioning will be carried out respecting the anatomical shape of the garrison.
  • Ask the patient to slightly spread the legs and insert the device with one hand and fix the adhesives with the other.

This practice is quite uncomfortable.

If, however, the subject is in bed, proceed as follows.

  • Prepare the material and put on gloves.
  • Check that the bed is equipped with a disposable crossbar.
  • Ask the patient to turn to the right side or help him to position himself on it.
  • Open the diaper completely so as to have the two wings with the adhesive facing the patient's head and those without the adhesive towards the feet.
  • Place half the diaper under the buttock resting on the bed, being careful to have the wings with the adhesive near the back.
  • Rotate the patient to the supine position, in this way the diaper will be halfway under the right side.
  • Ask or help the person turn slightly to the left side and spread the wing that was under the buttock.
  • Return the patient to the supine position, at this point the diaper is positioned.
  • Bring part of the diaper in front of the pubis.
  • Free the rear wings from the adhesive and glue them on the front wings.
  • Check that no creases have formed between the left and right groin and do not fasten the adhesives too tightly.

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