Hi my name is Lore Bertuch and I work with Shield HealthCare, specializing in
Incontinence, Ostomy, Enteral, Urology, and Wound Care products for patients at home.
Today we're going to talk about incontinence.
We're going to talk about what causes it, how to avoid it, things to mitigate it,
and lastly what products are available for incontinence at home.
Contrary to popular belief, incontinence is not caused by old age.
Rather, it is caused by disease factors such as Parkinson's, Dementia, Alzheimer's,
Stroke, and even Diabetes with Neuropathy.
For women, it's more common due to childbearing and the weight on the pelvic floor,
and sometimes for obese patients as well. For men, they can run into prostate issues and that causes leakage.
There are two primary types of incontinence we see:
"urge incontinence" and "stress incontinence."
"Stress incontinence" is when coughing, laughing, jumping, or sneezing causes leakage of urine.
With "urge incontinence", what happens is you have a burning desire to go to the restroom right now and you can't wait.
A good example is my mother. She drives home from work. On her way home she
realizes she has to go, gets to the door, puts her key in the door and loses urine before she makes it to the restroom.
The doctor will do an exam and discover whether there's any physical
abnormalities, such as pelvic floor prolapsing, or prostate issues in men, as well as look at the medications.
There are some diuretics that can actually cause incontinence and that can be changed.
Also, there are medications that can be used to actually stop incontinence --
but of course with all medications there can be side effects to that as well.
What are some of the solutions for incontinence?
Well, medication can be reviewed to see if there can be improvements in the
medication intake. As well as possibly surgery -- some people are candidates for
surgery. And there's also behavior therapy. Behavior therapy is used when a client
wants to improve their pelvic floor, and they do Kegel exercises where
they're squeezing the pelvic floor and releasing. Another thing that can be used
for incontinence is watching your intake. You want to make sure that you're not
drinking or eating things that are irritating the bladder, such as coffee,
tea, alcohol even spicy foods. However, we don't want to eliminate water. Water is very important and the client
needs to stay hydrated. I actually had a situation where my mother-in-law told me,
"Oh I'm not drinking any water today. I have a weak bladder." And I reminded her that
that is not a safe idea. If you have less fluid in the bladder you're not flushing
the toxins out of your system, and it's more opportunity for a urinary tract infection.
So it's best to continue to drink water regardless. Next, we're going to review our products that are
available. I like to call this my Victoria's Secret paper line, and I'm
going to tell you all about it today.
For light incontinence, you may want to consider using the cotton underwear
that's provided by the insurance, that has the waterproof pad inside. This makes
it convenient for you to use the disposable pads that you attach here,
and when you're done with the pad throw it away and you can reuse the underwear all day.
Medical (Medicaid) will cover two of these per month and these are 100-percent cotton.
This is the female version, we also have them in male and unisex version. Now, we
have a variety of pads you can use with that. For females, these small pads are perfect and actually these will hold
quite a bit of weight. If I were to pour a half a cup of liquid on it and twist
it, not a drop will come out of this pad, which is very important because you
don't want to sit on it and lose some urine. Now, for men this is not going to
work it's too low in the underwear. We need something with a little better geography that's going to cover the
geography. So this has a wide front and it kind of tucks in under the pelvis here.
Now, males can also use some of the larger pads because they are larger and
get up into the geography so this is the next size pad going up. Now depending on
how incontinent you are, you may go up in size to, let's say, the next size and then
we get into as far as our jumbo pad which is right here. So this is another
option. The nice thing about pads is when you put them in the underwear you have
the adhesive strip right there in the underwear.
You can pull them out, put a new one on, put your pants back on. That's not the
case with the pull-ups. Pull-ups you would have to remove your pants to put a new one on.
So these pads can be very convenient for ambulatory patients that are going
out a fair amount. Now, in addition to these hourglass shapes, we also have some
that are rectangular and there are different levels of incontinence, and for some people they like this better.
For those that are a little heavier incontinent we move into the pull-up.
The pull-up can hold up to a thousand CCs (cubic centimeters) of liquid.
This is probably our most popular product. It's like disposable underwear.
In fact, I'm going to tell you a story. My coworker, her mother became
incontinent after an incident. However, she was completely in denial, and many of
you will experience that with some of your seniors. So what my coworker did is, she took
all the underwear out of her mom's drawer, folded these up and had all the pull-ups
in there. When her mother came home and opened it and went to get her underwear
she said, "Where are all my underwear?"
So what did my coworker tell her? She said "Haven't you been reading the latest articles in
magazines? Victoria's Secret came out with a disposable model! Basically you
just wear these and then throw them away. We don't have to wash your underwear anymore."
So her mother-in-law agreed, and it worked out fine. So the pull-ups are
great. They come in several sizes up to a 2X, as well as our belted undergarment.
Our belted undergarment is kind of like a g-string on me, but you get the idea.
It has belts here, and you can add an extra belt so that it can get around the girth.
These are also good for men in boxer shorts, so that it will stay up high on the
thighs and the brief won't be hanging between the knees. So this is another
product. Once again, if you're not sure, you can order a sample from our company
when you call the 800 number.
Next I'll talk to you about some of the accessories that are covered by the insurance.
Some of your clients, they may need "chux." These are underpads that
can go either on the bed or on a chair. You put the plastic side down, and the
client can lay on top of this. This will ensure that if there's any leakage, it
will not destroy the furniture or the bedding. So this is an option, and you
receive one box of 90 per month.
The other product is our mattress protector.
Now, the mattress protector is a twin size. It fits on a twin size bed, and this
you would put on the bed and it's a waterproof sheet with a plastic interior,
so that any urine or feces will not get onto the mattress. This is a wonderful product, it's washable and reusable
and Medical (Medicaid) will pay for one every six months.
For your patients that are bedridden or are heavy incontinent, we recommend
using a full brief. The briefs have the advantage of wetness indicators so you
can tell when they're wet, these lines will turn a darker color. They also will
absorb up to 1800 mLs of fluid. If you have somebody who voids more than once in the middle of the night,
maybe in the morning before their change, you may want to consider using a "booster"
The "booster" goes inside of the pad here and just adds more absorbency.
Next, the first thing you want to do with your patient is make sure that they're laying on
their side. You don't want to try and lift them because you will hurt your
back by lifting the weight, so have the person help you if they can.
You're going to put the Velcro tab side at the top. All adult briefs have two Velcro
tabs, so we're going to put those up here and place the product slightly
underneath the buttocks and open it up. Next thing you want to do is make sure
you take care of any skin care if you have the proper products for that, as far as
cleaning the person before you put this brief on. Then we're going to go
ahead and roll the patient and you want to pull up the inside of the brief
between the legs and we want to get a snug fit. It's important if you notice
there are gathers around the brief here, elastic gathers. It's important that
these briefs fit tightly in the thigh. You don't have a opening here.
Otherwise, urine is going to run right down the leg, which is not very helpful.
Next, you're going to open each of the Velcro tabs, and snugly put this
around the patient's leg. So, you want to make sure you have the right size, and
our customer service can help you ensure that you're ordering the correct size for your client
based on height and weight.
Lastly, I'd like to explain to you how to receive these products for
your client. Please call the 800 number on your screen and you can speak to one
of our customer service agents, they are going to ask you for the client's
information, such as the doctor's name and phone number.
If you know the diagnosis of the patient, as well as what products you're interested in.
You will also need to know the insurance policy number. Also, we will ask you whether you
know what product you like, if you're not sure, let us know if the client is
light incontinent, medium incontinent or heavy incontinent
and we can send you some samples for your client to try.
I want to thank you for listening to this video and if you have any further questions
please call the 800 number on the screen and speak to our customer service department.