Care Plan

Problem-Based Care Plan: Urinary Incontinence

Urinary incontinence is prevalent in older adults and includes an interference with social, emotional and physical life. Weakened pelvic floor muscles, neurological disease or (long-standing disease such as diabetes) can cause it. This care plan will ensure the maximization of urinary continence of a 77-year-old female client; also, infection and skin breakdown complications will be prevented: Care Plan.

Broad Goal

The aim is to achieve maximum continence through best-practice interventions that maximize bladder control, minimize incontinence, and maximize general life quality. The plan will also allow for incontinence management with dignity and avoid complications such as infection, skin breakdown, and trauma.

SMART Outcomes

Notably, the significant change the client will have had is a 30% reduction in incontinence in just two weeks. At least 80% of the time, the client must have a timed toilet routine to prevent accidents and urgency after they begin to develop regular toilet habits within a month. In six weeks, the client will have unblemished skin integrity, with no sign of irritation and breakdown, as documented in a week-by-week skin examination conducted by medical professionals.

Interventions

Consequently, bladder training and timed toilet will be implemented, encouraging the client to pass urine at 2-3 hourly intervals to maximize bladder capacity and reduce leakage, as noted by Alouini et al. (2022). Urinary continence will be increased through training of the pelvic floor muscles, with daily practice of Kegel exercises for continence gain. Hydration and nutrition will involve observation of intake and restriction of bladder irritants such as caffeine and alcohol intake.

Hygiene and skin care will include washing the perineum with mild soap and applying barrier creams to prevent breakage of the skin. According to Ostaszkiewicz et al. (2020), psychosocial care will involve incontinence care training for both carers and the client, minimizing embarrassment and improving independence. All interventions will maximize the client’s bladder control, comfort, and overall life quality.

References

Alouini, S., Memic, S., & Couillandre, A. (2022). Pelvic Floor Muscle Training for Urinary Incontinence with or without Biofeedback or Electrostimulation in Women: A Systematic Review. International Journal of Environmental Research and Public Health, 19(5), 2789. https://doi.org/10.3390/ijerph19052789

Ostaszkiewicz, J., Dickson-Swift, V., Hutchinson, A., & Wagg, A. (2020). A Concept Analysis of dignity-protective Continence Care for Care Dependent Older People in long-term Care Settings. BMC Geriatrics, 20(1). https://doi.org/10.1186/s12877-020-01673-x

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