Addressing and acting on individual ideas on continence care

Technological Solutions for Urinary Continence Care Delivery for Older Adults: A Scoping Review

PURPOSE

The aim of this scoping review was to examine available evidence regarding use of technology-based continence care delivery for older adults and to identify gaps in knowledge.

METHODS

Scoping review.

SEARCH STRATEGY

With the help of a medical librarian, CINAHL, Cochrane Library, EMBASE, MEDLINE, ProQuest, PubMed, SCOPUS, Web of Science, and websites were searched. Search terms included technology, sensors, older adults, urinary incontinence, continence care, nursing homes, long-term care, and continence management. All literature elements except for opinion pieces and case reports written in English within the last 15 years were included. Articles not written in the English language were excluded; our search indicated that less than 6% of returned elements were written in other languages.

FINDINGS

After duplications were removed, 2146 potential sources were identified. After exclusions, 19 results were included in the review. Review findings suggest positive effects of technology-based continence care on older adults and those involved in their care such as enhanced delivery of a successful toileting program. Information on potential harms, from either the perspective of care provider or recipient, is limited. It is important that needs of older adults and collaborative efforts are considered in the implementation of technology-based continence care. A paucity of guidelines on the use and adoption of technology-based continence care was found; additional research into uptake and sustainability is needed.

CLINICAL IMPLICATIONS

Technological solutions, such as sensors, need to be accurate in the measurement of urine saturation levels and timely in notifying caregivers for effective delivery of continence care. Adverse consequences of incontinence, such as incontinence-associated dermatitis or urinary tract infection, may potentially be reduced or avoided with technology-based continence care delivery.

Incontinence in palliative care: assessment to promote dignity

This article will explore the district nurse (DN) role in caring for palliative service users and their responsibility to prepare them and their family members to understand the trajectory of their prognosis and the possible decline in urinary function and incontinence. Educating DNs to advise service users in appropriate management options and collaborating with the wider multidisciplinary team (MDT) to ensure service users' individual goals and aims are followed as closely as possible. Urinary incontinence (UI) is not a natural part of the ageing process, although the prevalence of UI is increased as people age, through multi-morbidities, polypharmacy, cognitive decline, mobility limitations or life-limiting conditions. UI affects an individual's dignity and can cause a negative impact on self-esteem, and it is often accompanied by a perceived stigma that can lead to anxiety, depression and a reluctance to ask for help and advice.