What do you think of when you think of someone who has bladder leaks? Is it an elderly woman sitting in a nursing home? An older gentleman experiencing prostate issues? Those are the common images that come to mind for most people. But I have suffered from bladder leaks for 5 years, and they started when I was just 27.
That was when I had my first child. About 6 weeks after I delivered, I was diagnosed with a prolapsed bladder. That’s when your pelvic floor muscles are so weak that your bladder caves in to your pelvic region. It causes a lot of discomfort – heaviness and even pain after long days on my feet. My doctor said it would get better as I healed, and it did, but not nearly as much as I had hoped.
To make matters worse, because my pelvic floor was so compromised, I started having bladder leaks almost immediately after the birth of my son. They were embarrassing, and hard to deal with, especially as I was learning to care for a baby. I felt like I was too young, that this shouldn’t be happening to me.
Finally, after years of suffering, I started physical therapy. I had no idea there were PTs who treated these specific types of condition. PT has done me a world of good, although I still experience some leaks. But I am brave enough now to seek treatment and know, from researching the condition and learning more about it, that there are many treatments out there that I can try.
Don’t let bladder leaks hold you back. And don’t think they can’t happen to you if you’re young. Incontinence is a condition that too few of us talk about it. Maybe if more of us did, it wouldn’t be so hard to find the courage to seek help. It took me 3.5 years to finally talk to someone. Don’t be like me. Get educated. Seek treatment. Get your life back.
Sierra P., Orlando, FL
At 70 years old, you’d think that I’d have come to terms with having incontinence. But time has a way of making you see that some things you thought were normal actually weren’t at all.
The leaks started in my 50’s and at the time, I chalked it up to just growing older. I started wearing absorbent pads for protection and just went on living my life. My leaks started to get worse as I got older, and in my late 60’s I finally talked to my doctor about it. He asked me during a routine check up about my bladder habits and I told him I’d been having leaks for years. I tried to brush it off like it was no big deal (it was a bit embarrassing to talk about), but he kept pressing me, asking me more details and taking notes.
Finally, he told me that he wished I had told him about the leaks sooner, since there is so much that can be done to treat bladder leaks. He said no one should have to live with bladder control issues and that it absolutely is NOT a normal part of aging.
I felt so foolish for having believed all those years that it was just my body breaking down, getting older. Turns out that I was able to start a medication that really helped eliminate (mostly) my accidents. And there are even more treatments besides medications that I can try if I decide to.
Now that I’ve treated my incontinence, I feel freer at 70 years old than I did when I was in my late 50’s. I only wish I had opened up about it sooner to my doctor.
Don’t wait to talk about it. Don’t let the years pass you by living with incontinence. It’s just not worth it when so much can be done.
The Purpose of the Written Care Plan
• Care plans provide direction for individualized care of the client. A care plan flows from each patient’s unique list of diagnoses and should be organized by the individual’s specific needs.
• Continuity of care. The care plan is a means of communicating and organizing the actions of a constantly changing nursing staff. As the patient’s needs are attended to, the updated plan is passed on to the nursing staff at shift change and during nursing rounds.
• Care plans help teach documentation. The care plan should specifically outline which observations to make, what nursing actions to carry out, and what instructions the client or family members require.
• They serve as a guide for assigning staff to care for the client. There may be aspects of the patient’s care that need to be assigned to team members with specific skills.
• Care plans serve as a guide for reimbursement. Medicare and Medicaid originally set the plan in action, and other third-party insurers followed suit. The medical record is used by the insurance companies to determine what they will pay in relation to the hospital care received by the client. If nursing care is not documented precisely in the care plan, there is no proof the care was provided. Insurers will not pay for what is not documented.
The goal as established in a nursing care plan — in terms of observable client responses — is what the nurse hopes to achieve by implementing nursing orders. It is a desired outcome or change in the client’s condition. The terms goal and outcome are often used interchangeably, but in some nursing literature, a goal is thought of as a more general statement while the outcome is more specific. For example, a goal might be that a patient’s nutritional status will improve overall, while the outcome would be that the patient will gain five pounds by a certain date.
Nursing orders are instructions for the specific activities that will perform to help the patient achieve the health care goal. How detailed the order is depends on the health personnel who will carry out the order. Nursing orders will all contain:
• The date
• An action verb like “monitor,” “instruct,” “palpate,” or something equally descriptive
• A content area that is the where and the what of the order, for example, placing a “spiral bandage on the left leg from ankle to just below the knee”
• A time element will define how long or how often the nursing action will occur
• The signature of the prescribing nurse, since orders are legal documents.
Finally, in the evaluation, the client’s health care professionals will determine the progress towards the goal achievement and the effectiveness of the nursing care plan. The evaluation is extremely important because it determines if the nursing interventions should be terminated, continued or changed.
I’ve been incontinent for 1 year now, and my wife has no idea. (At least I don’t think she does). You see I’ve gone to great lengths to hide it from her. It’s not like I leak all the time, but a few times a week I find myself unable to make it to the bathroom in time and I have an accident. It horrifies me, since this has never happened before.
My doctor tells me I have an enlarged prostate. This, my wife knows. I’m sure she also knows some of the symptoms, since she’s the type to do research on this stuff. But I haven’t told her I suffer from bladder leaks.
I keep spare underwear hidden in the car. I limit my fluids when I know we’re going to be out. I always scout out the nearest restroom in case I need to make a beeline to it. I even decline certain events if I think there’s a risk I may have an accident. I feel like I’m living as a secret agent with this condition – always trying to stay 1 step ahead.
You’re probably wondering why I haven’t told her. Talking with your spouse about something that embarrasses you is never easy. But for me, this is devastating. I’ve always been her “tough guy”. The one who fixes up old cars, goes bowling with the guys on Tuesdays, can handle pretty much anything anyone throws my way. But this is different. It’s made me feel like less of a man. And I feel embarrassed that I can’t control something as simple as my bladder.
I know it’s more complicated than that, but I just can’t help thinking “What will she think of me?” “Will she still find me attractive?” “Will she think less of me?”
We’ve always been so spontaneous. Running out at a moments notice to meet up with friends at a pub. Jumping on those last minute flights to somewhere tropical. Going to shows and concerts and ball games. I still want to be that person. That guy who does all the fun stuff. But these bladder leaks are getting in the way of that.
I know we’re getting older, but I still just want her to look at me like she always has, and I’m so scared this will change that.
I’m planning to tell her soon. I know that it’s probably better to just get it out there, Knowing my wife, she’ll probably jump right in and try to help. She’s awesome like that.
And, I’m sure her knowing will probably be good for me. We’ll find ways to deal with it together. We’ll find solutions for this condition that I know are out there but I’ve been too stubborn or embarrassed to seek out. It will be better. She will help me make it better.
But the thought of having that conversation with her is still scary as hell. The telling is really the hardest part of all of this. Wish me luck.
PATIENT PERSPECTIVE: INCONTINENCE LED TO MY DEPRESSION
Many people know the symptoms of incontinence – leaky bladders, the need to wear protection or take medications, etc. But few people know about how incontinence can make a person feel.
I’ve suffered with incontinence for the past 10 years, and over that time, I have become severely depressed. Incontinence is not just a condition that causes you to wet your pants. It fundamentally changes who you are. It’s like this dark cloud that constantly hangs over your head, following you all the time, and threatening to break open at any given moment.
When I first started experiencing the leaks, it was not that often and I was able to dismiss them, thinking they were just flukes. But as they became more common, I found that I was always terrified of having an accident in public. I was ashamed, and kept my secret from my family and friends, which led to a divide in our relationships that I could never bridge.
I started not doing many of the things I had done before – bowling with the guys, taking trips with my family. I felt embarrassed and ashamed of my condition. To be honest, I still do.
I wish I could say that I’ve found the courage to talk to someone, but I haven’t. My wife does know now (it was hard to hide it), and she is supportive, but it’s a humiliating thing to have to talk about to the one you love. She’s urging me to go to the doctor, which I guess I will. Hopefully there I will finally find relief.
Anyone who thinks that incontinence is only about wetting yourself is dead wrong. It’s so much more than that. It’s limited my life in more ways than I could have ever imagined and caused me so much anxiety and anguish that sometimes it’s alI I can think about. I’m hopeful that one day I’ll be able to say differently.
Providence, RI Henry M., 62