Incontinence is not an inevitable part of aging, nor is it untreatable once it develops. Thoroughly revised and updated, this new edition of a trusted resource teaches diverse and effective strategies for assessing, managing, and even eliminating urinary incontinence in all care settings.
Managing and Treating Urinary Incontinence presents a full range of treatment options, explaining how each method works and who benefits most from its use. In pragmatic, easy-to-understand language, readers will learn essential information about
- the anatomy and physiology of the lower urinary tract and pelvic floor
- the types and causes of incontinence and overactive bladder
- the impact of bowel dysfunction on incontinence
- the value of incontinence education and self-care techniques
- the efficacy of behavioral treatments, such as bladder retraining and toileting programs
- the role of drug therapy and surgery in managing incontinence
The second edition provides expanded content on surgical interventions and pelvic organ prolapse, the latest information on available overactive and incontinence drug therapy, and a glossary of clinical terminology. Plus, a comprehensive review of incontinence containment products with illustrations and their availability is included. An accompanying CD-ROM contains new patient teaching tools, detailed assessment forms, and useful care plans for 12 common incontinence scenarios.
With the knowledge in this comprehensive guidebook, nursing staff will measurably improve the health and independence of residents or patients, and managers will reduce facility costs and staff burden. This book is a must-have for nurses, medical directors and nursing home administrators, incontinence specialists, occupational therapists, physical therapists, primary care physicians, social workers, and other health care professionals who work with older adults.
About the Authors
Foreword Diana J. Mason, Ph.D., R.N., F.A.A.N.
Foreword Joseph G. Ouslander, M.D.
Preface
Acknowledgments
- Introduction
- The Problem of Incontinence
- Understanding Bladder and Pelvic Floor Function
- Causes of Incontinence and Identification of Risk Factors
- Bowel Dysfunction and Its Relationship to Urinary Incontinence
- Clinical Assessment and Evaluation
- Self-Care Practices and Lifestyle Changes to Reduce Urinary Symptoms
- Behavioral Treatments: Implementing Toileting, Bladder Training, and Pelvic Floor Muscle Rehabilitation Programs
- Drug Therapy for Incontinence and Overactive Bladder
- Urinary Collection and Management Products
- Evaluation and Management of Pelvic Organ Prolapse
- Overview of Surgical Intervention for Incontinence
- Continence Nurse Specialists and Service Models
Appendix A: Glossary
Appendix B: Resources
Index
Diane Kaschak Newman, R.N.C., M.S.N., C.R.N.P., F.A.A.N., is an adult nurse practitioner and a recognized expert in the field of nonsurgical management and treatment of urinary incontinence and related disorders. She is Co-Director of the Penn Center for Continence and Pelvic Health in the Division of Urology University of Pennsylvania Health System in Philadelphia. Her clinical practice is dedicated to the evaluation, treatment, and management of urinary incontinence and related problems. She treats clients in long-term care, home care, and office practice environments. Ms. Newman participated in several research projects on the effects of behavioral treatment for urinary incontinence.
Ms. Newman received her master of science in nursing from the University of Pennsylvania. She was appointed the Chair of the Committee on Promotion, Organization, and Education in Continence for the 2001 World Health Organization’s International Consultation on Incontinence. She was also a member of the Project Task Force for the National association for Continence, Blueprint of Continence Care Guidelines for Assisted Living Facilities, and Co-Chair of the 1996 Update Panel for the Clinical Practice Guidelines called “Urinary Continence in Adults,” published by the Agency for Health Care Policy and Research, U.S. Department of Health and Human Services. In 1998, the Federal Drug Administration (FDA) appointed Ms. Newman to the Gastroenterology and Urology Device Panel. She is a member of the Centers for Medicare & Medicaid Services’ Scope and Severity of Nursing Care Deficiencies guideline panel of experts on long-term care.
Ms. Newman is an internationally known speaker on urinary incontinence and the use of devices and products in the management of incontinence. A prolific writer, Ms. Newman has written and presented more than 75 scientific papers, chapters, and articles in major journals on the subject of assessment, behavioral treatment, and management of incontinence with an emphasis on the nurse’s role. She is the author of The Urinary Incontinence Sourcebook (Revised edition; 1999; McGraw-Hill).
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“. . . this book is a thorough and exhaustive resource . . . this comprehensive tome will embrace my academic shelves for years to come and be within reach should I need to know anything about UI.”
–Physical & Occupational Therapy in Geriatrics
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“an excellent resource for health care professionals when addressing bladder and bowel incontinence as well as for health care professionals caring for residents in assisted-living facilities, nursing homes, and rehabilitation centers. …the book provides a wealth of information to assist and empower patients and their family members about available treatment options in advance of seeking care.”
-Francie Bernier, Ph.D., R.N.C., Urologic Nursing
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“The authors, who are well-recognized experts in the non-surgical management of urinary incontinence, have again provided a spectacular reference for providers of all levels and disciplines who care for patients with invontinence…this book provides a comprehensive and up-to-date guide to help increase the knowledge of anyone who picks it up.”
-Susanne A. Quallich, APRN, BC, NP-C, CUNP, Andrology Nurse Practitioner, Division of Andrology and Microsurgery, Department of Urology, University of Michigan Medical Center, Ann Arbor, MI, Member of Urologic Nursing Editorial Board
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“This book, written by two of the world’s authorities on urinary disorders, is an excellent overview of the management of the disorders of the pelvic floor, using a collaborative, yet inclusive, approach. The authors have condensed a very broad field into a readable, yet authoritative, text, which is comprehensive in its inclusion of the spectrum of interventions for pelvic floor dysfunctions. The unique merging of nursing and medical care to create a broad strategy will benefit patients by emphasizing a step-wise, progressive group of interventions. This is a must for those seeking a text which is truly state of the art in its context.”
–Roger Dmochowski, M.D., Professor, Department of Urology, Vanderbilt University Medical Center
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“An outstanding piece written by two of the foremost world’s experts. This should form the foundation for a very much needed ‘core curriculum’ in incontinence for the primary care provider.”
–Matt T. Rosenberg, M.D., Director, Mid Michigan Health Centers and President, Urologic Health Foundation
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“This is an outstanding and comprehensive resource for both the new and experienced clinician involved in continence care.… This book is packed with practical information ranging from assessment instruments, care plans, patient education handouts, to lists of support groups, consumer organizations, and product manufacturers. It is highly recommended for nurses, physicians, physical therapists, and occupational therapists involved in establishing continence programs. It belongs in every long-term care facility and hospital.”
–Jean F. Wyman, Ph.D., A.P.R.N., GNP-BC, FAAN, Professor and Cora Meidl Siehl Chair in Nursing Research and Director, Minnesota Continence Associates, University of Minnesota School of Nursing
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“This second edition from two of the foremost thought leaders and innovators in the field is extremely well written, and, not unexpectedly, quite thorough.… Upon completion of this text, not only will the reader have a command of the diagnosis and management of urinary incontinence, but he will have an appreciation of how these skills and knowledge can improve the suffering and quality of life of those who are afflicted with this condition. Overall, I highly recommend this text to anyone with an interest in, or who is involved in the diagnosis and treatment of urinary incontinence including students, nurses, residents-in-training and other practitioners and allied healthcare personnel.”
-Eric S. Rovner, M.D., Professor of Urology, Medical University of South Carolina
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“This second edition is a much needed update and contains the many advances in the field of incontinence care. The authors address the subject with expertise and experience while providing a unique guideline for assessment, which can be applied to patients in any setting…. Treatment options from the most simple behavioral to complex surgical are all-inclusive and provide an excellent resource for providers, caregivers and students.… A ‘must have’ reference for anyone caring for the millions of people affected by urinary incontinence!”
-Cindy Monaghan, R.N.C., M.S., F.N.P., Director Seton Health Incontinence and Wound Services, Troy, NY