CRITICALLY DISCUSS THE ROLE OF THE NURSE IN THE PROMOTION CONTINENCE I Essay

CRITICALLY DISCUSS THE ROLE OF THE NURSE IN THE PROMOTION CONTINENCE I OLDER PEOPLE - Essay Example This paper will discuss the management and rehabilitation of continence and the role nurses can play in assessment and rehabilitation. Burgio et al., (1994, cited by Shirazi et al.,) recognize four types of UI which include urge incontinence (bladder contractions are not inhibited), stress incontinence (urethra is not effectively closed during transient increases in pressure), overflow incontinence (bladder does not contract), and functional incontinence (inability or unwillingness of the person with normal bladder to reach the toilet in time). Urge incontinence occurs due to overactive detrusor muscle contacting and sending an urgent message to the brain to eliminate (Carr, 2004). Overflow incontinence is associated with storage due to an obstruction or a nervous system problem. Functional incontinence is found in people whose mobility or cognition is impaired. Stress incontinence occurs due to the deficiency in the urethral closure mechanism during episodes of raised intra-abdominal pressure such as coughing, sneezing, laughing (Dolman, 2003 cited by RNAO, 2006). While people of any age can be affected with incontinence, it becomes prominent in the elderly people as detrusor contractile function, bladder capacity, and urinary flow rates all decline with age (Wagg, n.d.). Prostrate enlarges with age in men and this tends to dominate the behaviour of the urinary outflow tract. The bladder requires a greater contractile effort as obstructions increases. The detrusor muscle and the urethral sphincter are essential for urinary continence and micturition (expulsion). These two act together for storage and expulsion of urine. Urine is stored when the detrusor muscle relaxes and the urethral sphincter closes while voiding occurs when detrusor contracts and sphincter relaxes (Yerkes, 1998). This process of storage and voiding depends on a