What can I do to manage my incontinence while I try to get it under control?

When pharmacological and/or behavioral methods fail to manage urinary incontinence, various products are beneficial to contain urine, protect skin, and reduce odor.  The following are the most common products used in hospitals, long-term care facilities, and home.

Catheters:
Indwelling (Foley), Straight (Intermittent), and External (condom) catheters have a place in the management of urinary incontinence. A flexible tube (indwelling catheter) can be put into the urethra (the canal that carries the urine from the bladder) to collect urine in a container. Long term catheterization although sometimes necessary creates many problems, including urinary infections. Men have the choice of an external collecting device (condom catheter). This is fitted over the penis and connected to a drainage bag.

Adult Diapers and Briefs:
These absorbent products are designed to hold large volumes of urine and are for individuals who are incontinent of urine and stool. Adult Briefs are designed and used similarly to diapers placed on infants. Briefs made of absorbent material similar to underwear may be preferred due to psycho-social reasons.

2-Piece Pants and Liners:
This product includes a pair of reusable cotton pants or disposable mesh type pants into which an absorbent liner is placed and secured. When soiled, the liner is discarded and the pant is laundered. The 2-piece pant and liner can be used for both urinary and fecal incontinence and may be preferred by the ambulatory patient.

Underpads:
This product is an absorbable pad which is placed on the bed beneath the patient’s mid-section. The underpad protects the linens and is commonly used for the incontinent bed bound patient and to protect the bedding. Underpads are available in disposable or reusable types.

Skin Cleanser:
These are non-soap products which contain a surfactant to loosen or emulsify urine/feces without irritation to the skin. Most available cleansers DO NOT need to be rinsed which is a desirable feature for the caregiver.

Washcloths and Wipes:
These are reusable or disposable cloths used to cleanse the patient’s skin after an incontinent episode. Cloths which minimize the amount of friction injury to the skin during cleansing are most desirable.

Moisture Barrier Ointments:
These topical skin products contain petrolatum or a similar substance which forms a protective, moisture resistant barrier on the skin. Application of a moisture barrier ointment after cleansing is recommended as a preventative skin care measure for the patient with incontinence.

Call us with any questions about the products we offer and if we do not have it and you want it, we will get it for you.

There are numerous treatments for the management of urinary incontinence.  The first and most important step in treating incontinence is to see a doctor for a complete medical exam.  The doctor will ask for a detailed history of your health and give you a physical examination.  The doctor may want to check urine samples and you may be referred to a urologist, a doctor who specializes in diseases of the urinary tract, or to a gynecologist, a specialist in the female reproductive system.  Proper assessment and diagnosis is crucial to the selection of an appropriate treatment plan and, subsequently, a favorable outcome.

The following is a summary of some of the more common methods to manage urinary incontinence: Treatment of urinary incontinence should be designed to meet your needs.  As a general rule, the least dangerous procedures should be tried first.  The many options include:

Kegal’s Exercises (Pelvic Muscle Exercises):
Stress incontinence responds very well to exercises which strengthen the pelvic muscles (Kegal’s Exercises).  These exercises can be done alone or in conjunction with biofeedback therapy.  These techniques can help you sense your bladder filling and help delay voiding until you can reach a toilet.

Bladder Irritants/Infection:
Elimination of bladder irritants and treatment of bladder infections can eliminate the bladder contraction associated with urge Incontinence.

Prompted Voiding/Bladder Drill:
Prompted voiding and bladder drill programs teach individuals to urinate “By the clock”.  Frequent, scheduled voiding helps to prevent or significantly reduces leakage for individuals with urge incontinence.

Medications:
Pharmacological manipulation or in conjunction with other methods of management can relieve symptoms.  There are drugs given to relax the bladder, contract the bladder, relax the bladder neck, and contract the bladder neck.  These drugs are prescribed according to symptoms and urinary tract pathology and medications are useful adjuncts in several types of incontinence.  A doctor can prescribe medicines to treat incontinence.  However, these drugs may cause side effects such as dry mouth, eye problems, or urine buildup.

Clean Intermittent Catheterization:
Clean intermittent catheterization can be performed by the individual to prevent urinary retention and/or to empty the bladder at scheduled time before leakage occurs.  This is particularly helpful for the individual with reflex incontinence.

Environmental Modification:
Easy access to toileting facilities through proximity, clothing alteration, and large, visible signs are helpful for the individual with functional incontinence.  Timed or scheduled voiding may also be used in conjunction with easing toilet access.  Caregivers actually escort the individual to the bathroom at designated intervals, usually chosen by assessing the person’s usual voiding routine.

Surgery:
This should be a last resort approach.  Sometimes surgery can improve or cure incontinence if it is caused by a structural problem such as an abnormally positioned bladder or blockage due to an enlarged prostate.  Implanting devices that replace or aid the muscles controlling urine flow has been tried in people with incontinence.

Urinary incontinence can run the gamut from light drainage of urine that moistens ones under- clothes to thorough saturation where large volumes of urine is expelled. The Agency For Health Care Policy and Research and the American Urological Association have determined six distinct “types” of urinary incontinence. Of utmost importance is the understanding that more than one “type” of incontinence can occur simultaneously in the same individual. Therefore, diagnosis and treatment of so called “mixed” incontinence is somewhat more challenging.

Stress Incontinence:
Stress incontinence occurs when some physical exertion such as exercise, coughing, sneezing, laughing, lifting heavy objects, or other body movements that put pressure on the bladder and produces leakage of urine. The cause of stress incontinence is the weakening of the pelvic musculature which commonly occurs in women after having children and in post- menopausal women. It is the most common type of incontinence and can almost always be cured.

Urge Instability Incontinence:
In this type of incontinence, the bladder contracts spontaneously WITHOUT the control of the individual. This uncontrolled bladder contraction results in the leakage of urine. With urge incontinence, however, the individual has the sensation to urinate, but cannot reach the bathroom in time. Sensation is usually followed by immediate release of urine. Although healthy people can have urge incontinence, it is often found in people who have diabetes, stroke, dementia, Parkinson’s disease, or multiple sclerosis. It can also be a warning sign of early bladder cancer. In men, it is often a sign of an enlarged prostate.

Reflex Instability Incontinence:
In reflex incontinence, the bladder empties itself at unpredictable times causing gross leakage of urine. In this instance, however, the individual does NOT have sensation or urgency. Neurological disorders and injuries to the upper spinal cord are the most common reasons for reflex incontinence.

Overflow Incontinence:
Leakage or wetness occurs because the bladder is unable to empty effectively. This type of incontinence is associated with high residual volumes of urine after voiding. Individuals may also complain of nocturnia (urination at night) and the feeling that the bladder does not feel empty after urination. Some causes of overflow incontinence are chronic retention of urine and bladder outlet obstruction. In older men, this can occur when the flow of urine from the bladder is blocked.

Continuous Incontinence:
This type of incontinence is associated with leakage of urine proximal to the lower urinary tract. Continuous incontinence occurs with urinary fistula, birth defects of the urinary tract, and urinary diversion such as urostomy.

Functional Incontinence:
This type of incontinence is the one most commonly associated with the elderly. It may be caused by obstacles in the environment which make it difficult for the elderly person to make it to the bathroom on time as well as by cognitive and physical functional degeneration as seen in Alzheimer’s Disease. There is no associated pathophysiology of the urinary tract in an individual with functional incontinence.

The process of producing urine, storing urine, and eliminating urine is amazingly complex. It involves the function and co-ordination of the brain and the spinal cord, intact nerves and muscles, a functioning bladder, and the unobstructed flow of urine through the lower urinary tract.

Urinary incontinence is a devastating problem affecting some 10 million Americans. The major approaches to the management of urinary incontinence are long-term efforts through an interdisciplinary approach. A multitude of incontinence products play a vital role in the treatment and management of the various types of urinary incontinence. There are many modalities of treatment which depend upon the “type” of urinary incontinence as well as the individual attributes of the patient. Appropriate use of incontinence products are essential adjuncts to successful treatment and/or management of the incontinent person.

Many people with incontinence pull away from their family and friends. They try to hide the problem from everyone, even their doctors. The good news is that in most cases urinary incontinence can be treated and controlled, if not cured. The bad news is that caregivers may not know that treatment is a choice. They may think that nursing home care is the only answer for an older person with incontinence.

Incontinence does not happen because of aging. It may be caused by changes in your body due to disease. For example, incontinence may be the first and only symptom of a urinary tract infection. Curing the infection may relieve or cure the problem. Some drugs may cause incontinence or make it worse.

If you are having trouble with incontinence, see your doctor. Even if it can’t be completely cured, modern products and ways of managing incontinence can ease its discomfort and inconvenience.

Swine flu pandemic has begun, 1st in 41 years:

Protect yourself…Protect your family!
Use GentleCare Non-Alcohol, Fragrance Free Hand and Skin Sanitizer in the battle against cold and flu this season!

The World Health Organization declared a swine flu pandemic Thursday – The first global flu epidemic in 41 years – as infections in the United States, Europe, Australia, South America and elsewhere climbed to nearly 30,000 cases.

The long-awaited pandemic announcement is scientific confirmation that a new flu virus has emerged and is quickly circling the globe. WHO will now ask drugmakers to speed up production of a swine flu vaccine. The declaration will also prompt governments to devote more money toward efforts to contain the virus.

Read more…

As the Owner and President of Paragon Marketing Group, you can feel confident in knowing that since GentleCare was created, my wife and I have used all of our products ourselves and with our 6 and 5 year old son’s. We have shared them with our family and friends and have been promoting healthy skin integrity and infection control hygiene for many years.

I have been involved in this technology for the past 10 years and have seen the tremendous benefits of our GentleCare Alcohol Free Hand Sanitizer over all alcohol based hand sanitizers.  Do not be fooled by the alcohol lobby efforts in Washington.  Alcohol Free is here to stay and provides residual protection after each application where alcohol fails.

It is your choice, make it the right one!

Call me direct with any questions: (508)845-9915

Sincerely,
Kevin DuBois

There is nothing in our breathable adult diapers or disposable chux underpads which would cause the potential for skin irritation. They have a spun lace cloth type backing which allows for airflow, breathability and excellent wetness protection related to urinary or fecal incontinence.

All of our adult diapers and select underpads contain S.A.P. (Super Absorbent Polymer), which is basically a cornstarch derivative which is found in many of the foods that we enjoy.  S.A.P. (Super Absorbent Polymer), will absorb 300 times it’s weight in fluid and is alkaline in pH.  SAP will keep the patient / user dry and work to neutralize the acidity found in urine and excessive moisture or other symptoms related to incontinence.

Over the years there has been much debate over which is better, reusable, washable cloth adult diapers or disposable adult diapers?

Coming from someone who started out as a wound care specialist 18 years ago and a professional with over 16 years of incontinence product experience, the answer is simple.  Disposable incontinence adult diapers are better.

Let’s take a look at some of the pro’s, con’s and major differences of both.

First, some will argue that reusable, washable, cloth diapers are better for the environment because they do not clog the landfills and we use less of them.  Maybe, maybe not.  Have you ever seen the amount of slug water waste as well as the amount of electricity needed to wash these types of products?

Second and most important, disposable diapers contain SAP or “Super Absorbent Polymer”.  These are the tiny crystals that gel when they become wet.  They will absorb 3oo times their weight in fluid and will work to keep the user dry.  The SAP is also extremely alkaline in pH and will work to neutralize the acidity found in urine and fecal material which will prevent urine burns, diaper rash and potential skin damage.

Cloth diapers do not contain SAP and are not a pH neutralizer.  For this reason these are not recommended.  Unless the user is able to change themselves the minute they void, they will run the risk of skin damage and possible breakdown.

Please feel free to post a comment with your thoughts and ideas related to this topic.

Sincerely,

Kevin DuBois
HomeHealthDelivery.com
A division of:
Paragon Marketing Group, LLC

Roughly 41% of adults at home and in long-term care facilities experience some type of skin damage associated with urinary and/or fecal incontinence.  Exposure to urine and/or feces can lead to perineal skin damage.  Perineal skin damage secondary to incontinence ranges in severity and may include erythema (redness); swelling; oozing; vesiculation (blistering); and crusting and scaling in the groin, perineum, and buttocks region.

Multiple variables work together and can lead to perineal skin injury.  Moisture from incontinence can alters the skin’s protective pH and increases the permeability of the skin.  Urine and feces contain bacteria that can permeate and irritate the skin, allowing for secondary infections.  Damaged skin can lead to reduced blood flow or the loss of collagen or elastic fibrous connective tissues which affect skin nutrition, elasticity, and strength.  Perineal skin injury can lead to ulceration and bacterial (Staphylococcus) and yeast (Candida albicans) infections that lead to discomfort and increased treatment costs.  Additional problems associated with perineal skin damage include diminished quality of life, increased pain and costs, and possible pressure ulcer development.

The bad news is that perineal skin damage secondary to incontinence is painful, expensive, affects quality of life and can lead to depression and other emotional issues.  The good news is that with the right products and care it is preventable.  Here are some suggestions for managing incontinence and preventing skin breakdown or damage associated with urinary and/or fecal incontinence.

1. Establish a bowel and bladder toileting schedule for patients with incontinence.
2. Avoid excess friction on the skin by using high quality perineal products with soft wipes.
3. Cleanse skin gently at each time of soiling with pH-balanced cleanser.
4. Use incontinent skin barriers as needed to protect and maintain intact skin.
5. Select underpads, diapers or briefs that are absorbent to wick incontinence moisture away from the skin.
6. if needed, consider utilizing a pouching system or collection device.

Compliance with product usage is more likely to occur if the user of the product accepts or likes the product and that the products are easy to use.  There are many products available for use when dealing with urinary and/or fecal incontinence.  Types of products include: Pre-moistened washcloths or wet wipes, no-rinse perineal spray or foam cleansers, dry wipes or dry washcloths and numerous types of skin protectants, diaper rash ointments and protective barrier creams.

The single most important product that can be used in preventing skin damage associated with urinary or fecal incontinence is an effective skin protectant and barrier cream.  GentleCare Skin Care Products features a broad selection of skin care items specifically designed for patient skin care and caregiver skin care.  Two such products that stand out when it comes to incontinence management are the GentleCare No-Rinse Perineal Foam Skin Cleanser and the GentleCare Protective Ointment.

If you would like more information regarding perineal care management and product options available to you, please contact us and one of our knowledgeable staff will be more than happy to assist you in establishing a protocol for success.

Sizing adult diapers and incontinence products can sometimes be confusing. You see, most all adult diaper products come in 4 and sometimes 5 sizes.

There are small diapers for adults, medium size diapers, sometimes regular size adult diapers, large and x-large size adult diapers. Most manufacturers classify these by waist size. Unfortunately, this is not always the best way to determine your correct size. Body mass size and the shape of the body will directly impact the way the diapers fit.

The simplest and most accurate way to determine which size is best for the incontinent person is to measure from the middle of the hip bone across the front to the middle of the adjacent hip bone and then double the measurement. Then match this to the waist size to determine which size is best.

The hip bones and not the waist is the largest area and directly affects the fit of your adult diaper or other incontinent care garment. Utilizing this measurement will assure that you have made the best decision regarding the size of your diaper product.

I hope this helps. Please contact us if you have any additional questions by calling (800) 262-8670.

First let me start by thanking the many customers that we have had the pleasure of servicing for the past 9 years.  As we get ready to celebrate our 10 year anniversary I cannot express enough the gratitude that I have to all of you that have remained loyal.

HomeHealthDelivery.com has gone through many changes over the last decade and we have continually worked to improve all aspects of our business.  From the latest technology in online e-commerce software to consistent quality and selection of products.

Through this latest addition to our web site, we will try to provide useful and valuable information about adult diapers, incontinence care, skin care, aids to daily living and topics related to caring for yourself, a  loved one and health care in general.

Thank you for visiting our site and we hope that you will consider us for all of your home health care needs.

Sincerely,
Kevin DuBois
President / Owner
Paragon Marketing Group, LLC