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Incontinence management v. retraining

Long-Term Care Nursing Advisor, February 11, 2005

Many clinicians believe that toileting residents every two hours is the best means of keeping them dry, when in fact this is a dated and ineffective method. Effective urinary management is assessment based on and individualized to the resident. Incontinence management is a "catch" program that keeps residents dry. It is assessment based, but it does not involve retraining or relearning. It involves toileting the resident at times in which he or she is most likely to eliminate. Many residents will not be able to participate in active bowel and bladder retraining programs, but most will benefit from a regular, assessment-based toileting schedule.

Retraining is an active program that involves teaching the resident to identify sensations and relearn how to control the bladder. Residents relearn how to resist the urge to void and become used to emptying their bladder at progressively increasing intervals. This is also an assessment-based program that is done according to an individualized resident schedule. It does not involve toileting every two hours. Residents who have been recently admitted to the facility after an acute illness are often good candidates for active retraining. Most of these individuals have been living at home and have only recently lost bladder control. Beginning treatment early optimizes results. 

Editor's note: The above information is excerpted from the new HCPro book, The Long-Term Care Nursing Desk Reference. For more information about this book, click here: http://www.hcmarketplace.com/prod.cfm?id=3152

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