Pathological Attributes to Urinary Incontinence
Urinary incontinence could be caused by a number of reasons for example, micturition occurs when the muscular wall of the bladder contracts and the internal and external sphincters open. The muscles of the internal sphincter are smooth fibres and are not under the control of the will; those of the external sphincter are striated muscle and one under voluntary control.
Micturition is controlled by the nervous system. The accumulation of urine in the bladder stimulates stretch receptors in the bladder wall. Impulses pass along sensory fibres of pelvic nerves to the spinal cord and all transmitted back the muscle of the bladder via the parasympathetic fibers. This is the micturition reflex, which causes contraction of the muscle. With this muscular contraction, the internal sphincter is pulled open.
In babies, this reflex will result micturition. In an adult however, the reflex can be inhibited by high centres in the cortex until it is convenient to pass urine. Incontinence means passing urine at the wrong time in the wrong places and this exhibition attracts stigma, isolation and exclusions to both the care for person and the family members. Here are some types of urinary incontinence:
Urinary incontinence during end of life care could be aggravated by the following themes:
Personalisation of services (DoH 2005, 2008) has provided the platform through which family members can be involved with their older relatives' end of life care; by apply for either "Cash for Care, Direct Payments, Individual Budgets" as to provide adequate care for their older relative. Family involvement has the propensity to reduce stress, anxiety and problems of getting undressed in front of strangers. Their participation, working with relevant health and social care authorities would minimize care breakdown, abuse and bewilderment associated to longevity of care.
Urinary incontinence could be caused by a number of reasons for example, micturition occurs when the muscular wall of the bladder contracts and the internal and external sphincters open. The muscles of the internal sphincter are smooth fibres and are not under the control of the will; those of the external sphincter are striated muscle and one under voluntary control.
Micturition is controlled by the nervous system. The accumulation of urine in the bladder stimulates stretch receptors in the bladder wall. Impulses pass along sensory fibres of pelvic nerves to the spinal cord and all transmitted back the muscle of the bladder via the parasympathetic fibers. This is the micturition reflex, which causes contraction of the muscle. With this muscular contraction, the internal sphincter is pulled open.
In babies, this reflex will result micturition. In an adult however, the reflex can be inhibited by high centres in the cortex until it is convenient to pass urine. Incontinence means passing urine at the wrong time in the wrong places and this exhibition attracts stigma, isolation and exclusions to both the care for person and the family members. Here are some types of urinary incontinence:
- True/total incontinence could be caused by injury or neurogenic disease, leading to changes in nervous innovation.
- Stress incontinence could be caused by inefficient pelvic muscles.
- Urge inconvenience has various causes including infection, bladder tumors, upper motor neurone lesion and psychological problems.
- Overflow incontinence is caused by obstructive disorders of the bladder, kidney retention following surgery and or, injury to the spine at the sacral level.
Urinary incontinence during end of life care could be aggravated by the following themes:
- Physical factors; this could be because of possible urinary track infection, the effect of ageing, visual disability, painful feet or reduced mobility.
- Environmental factors: the location of the toilet, lack of mobility aids/equipment in the house/flat and or, sitting on a low level chair may prevent older person from getting up quickly enough to use the toilet.
- Confusion: depression of the mental state to recognize bladder distension and or, the urge to empty bladder.
- Psychological/emotional factors: depression, reaction of society towards incontinence, loneliness and or, abuse by the caregiver.
- Diet/fluids intake: obesity, constipation and dehydration all could precipitate incontinence.
Personalisation of services (DoH 2005, 2008) has provided the platform through which family members can be involved with their older relatives' end of life care; by apply for either "Cash for Care, Direct Payments, Individual Budgets" as to provide adequate care for their older relative. Family involvement has the propensity to reduce stress, anxiety and problems of getting undressed in front of strangers. Their participation, working with relevant health and social care authorities would minimize care breakdown, abuse and bewilderment associated to longevity of care.
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