Incontinence management
::
::
::
::
::
::
::
::
::
::
::
::
::
::
|
|
Modules - Incontinence Management
WHO RESPONDS TO PROMPTED VOIDING? MYTHS AND REALITIES
Prompted voiding has been touted in nursing homes for more than a decade, yet misconceptions still abound about which residents respond best to this highly effective intervention. It's time for a reality check.
- Myth: Only the most cognitively intact incontinent residents respond well to prompted voiding.
Reality: Many incontinent residents with severe cognitive impairments have proven responsive to prompted voiding, with significant reductions in their wet episodes. Indeed, in a study designed to identify predictors of successful prompted voiding, we found no significant differences on Mini-Mental State scores between responders and non-responders (1). In short, cognitive status is not a reliable predictor of responsiveness to prompted voiding.
- Myth: Able-bodied incontinent residents are the best candidates for prompted voiding.
Reality: Ability to ambulate and other measures of a resident's functional status are not good predictors of responsiveness to prompted voiding (1). The reason the most physically fit residents are usually the most likely to receive prompted is that it is less time consuming for the staff to assist these residents to the toilet. More impaired residents often respond just as well but are not given the chance.
- Myth: There is no reliable and feasible protocol that accurately predicts a resident's responsiveness to prompted voiding.
Reality: There is such a protocol (1), and it works like this: Provide prompted voiding to incontinent residents for a few days, and then analyze the results. Those who use the toilet appropriately at least two-thirds of the time are "responsive" to the intervention; those who don't are "unresponsive." The rationale behind this "run-in" approach is simple common sense: Residents either respond to prompted voiding, or they don't, and there is no reason to expect different results unless there is a significant change-for better or worse-in the resident's condition.
(prev | next)
|
|
|
