Question

2-- A 78 year-old male is losing bowel and bladder control. What are three effective and acceptable interventions, for each system, for this older adult?

Answer 1

Ans:) The effective acceptable interventions for 78 year old male who is losing bowel and bladder control or as follows:

FOR BOWEL INCONTINENCE:

• Provide a high fibre diet under the direction of a registered dietitian unless contraindicated as insoluble type of fibre promotes the movement of material through the digestive system and increases the stool bulk, so it can be of benefit to those who struggle with irregular stools.Bulk stool stimulates peristalsis and expulsion of stool from the bowel.
• Ensure a fluid consumption of at least 3000ml/day unless contra indicated as this prevents impaction because moist stool can move through the bowel more easily .If the patient has diarrhoea ,fluid therapy is vital for volume replacement.
• perform removal of fecal impaction manually if necessary because presence of fecal impaction can interfere with the establishment of a regular bowel routine.

FOR BLADDER INCONTINENCE:

• For blader incontinence ,behavioral therapy is often the first treatment which includes learning to delay urination by gradually lengthening the time between bathroom trips .it also includes double voiding which is "when a person urinates ,wait for few minutes and then urinates again ".This teaches the person to drain their bladder more thoroughly.
• pelvic floor muscle training .This technique strengthens the pelvic floor muscles and is an effective treatment for bladder movement.Besides it, bladder training is given to a person which involves learning techniques to increase the length of time between feeling the need to urinate and passing urine.
• ​​​​​​​in order to ease the symptoms of bladder incontinence some medications are given which includes
• oxybutynin
• solifenacin(anticholinergics which block the signals that trigger abnormal bladder contractions associated with overactive bladder).
• Desmopressin which reduces urine production at night.

​​​​​​​Catheter can also be inserted to drain the urine. it may be used intermittently or on long-term basis.