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What is one good way a nursing assistant can assist residence with normal changes of aging related to the urinary system?

4 min read

According to the American Association of Post-Acute Care Nursing, providing regular toilet assistance is a considerable nursing intervention for elderly residents to manage incontinence. One good way a nursing assistant can assist residence with normal changes of aging related to the urinary system is by offering frequent, scheduled trips to the bathroom. This proactive approach addresses decreased bladder capacity and weakened muscles while preserving resident dignity.

Quick Summary

Offering regular, scheduled toileting opportunities is a highly effective method for nursing assistants to help elderly residents cope with age-related urinary changes. This strategy helps manage incontinence and reduces the risk of urinary tract infections while preserving resident dignity and comfort.

Key Points

  • Implement a scheduled toileting routine: Offer frequent, scheduled trips to the bathroom, such as every two hours, to manage reduced bladder capacity and urge incontinence.

  • Ensure resident dignity: Maintain privacy and use respectful language when assisting with toileting to protect the resident's self-esteem.

  • Monitor fluid intake: Encourage consistent hydration throughout the day, as dehydration can worsen urinary issues and increase the risk of infections.

  • Practice proper hygiene: Assist with careful front-to-back perineal care to prevent urinary tract infections, a common risk for older adults.

  • Enhance bathroom safety: Use grab bars, raised toilet seats, and non-slip mats to ensure residents can access and use the toilet safely, especially if they have mobility issues.

  • Document and report observations: Consistently monitor and document voiding patterns, any signs of discomfort, or changes in urine to report to the nursing staff.

In This Article

Understanding Age-Related Urinary Changes

As individuals age, natural changes occur within the urinary system, which can significantly impact their quality of life. The bladder's capacity often decreases, and its muscles can weaken, leading to a more frequent and urgent need to urinate. These changes can make it difficult for residents to hold their urine for extended periods. In men, an enlarged prostate is common and can further obstruct urine flow. In addition, many elderly individuals experience reduced mobility or cognitive decline, making it harder to reach the toilet in time. A nursing assistant's role is to help manage these issues with competence and compassion, and implementing a schedule for bathroom trips is a fundamental strategy.

The Impact of a Scheduled Toileting Program

Prompted, or scheduled, toileting is a core strategy that empowers residents and helps prevent accidents. This involves the nursing assistant taking the resident to the bathroom at predetermined intervals, such as every two hours, regardless of whether they express the need to go. This strategy directly counteracts the effects of weakened bladder muscles and decreased sensation by ensuring the bladder is emptied regularly. By consistently adhering to a set schedule, a resident's body can begin to retrain itself to void at predictable times, which is a key component of bladder training.

Creating a Personalized Toileting Routine

Developing an effective routine requires communication and observation. The nursing assistant should first consult the resident and the nursing care plan to understand their individual needs and patterns. A "bladder diary" can be used to track fluid intake, voiding patterns, and any incontinent episodes, providing valuable data for tailoring the schedule. The routine should also be flexible, taking into account a resident's daily activities, meal times, and fluid intake. Offering a commode or urinal nearby can also be beneficial, especially at night, to make access easier and quicker.

Practical Steps for Implementing a Toileting Schedule

  • Explain the plan respectfully: Before starting, the CNA should explain the toileting schedule to the resident, emphasizing that it is a proactive measure to help them stay comfortable and dry.
  • Offer proactive assistance: Rather than waiting for a resident to ask, the CNA should offer assistance at the scheduled times, such as every two hours, in a matter-of-fact and discreet way.
  • Maintain dignity and privacy: When assisting, always ensure privacy by closing the door or pulling the curtain. Avoid using childish or embarrassing language, and treat the resident as a respected adult.
  • Ensure proper hygiene: After toileting, proper perineal care is essential. The CNA should assist with wiping from front to back, especially for women, to prevent urinary tract infections (UTIs).
  • Monitor and adjust: The CNA should consistently monitor for signs of incontinence between scheduled trips and report findings to the nurse. The schedule can be gradually extended as the resident's bladder function improves through retraining.
  • Encourage fluid intake: Ensure residents drink adequate fluids throughout the day, especially water. Dehydration can lead to concentrated urine and bladder irritation, which worsens urinary symptoms and increases the risk of UTIs.

Comparison of Toileting Methods

Feature Scheduled Toileting Reactive Toileting (Waiting for Request)
Effectiveness Proactive method for preventing incontinence. Promotes bladder health by ensuring regular emptying. Often leads to incontinence accidents, as resident may not recognize or communicate the need in time.
Resident Dignity Preserves dignity by preventing accidents and maintaining routine. Reduces embarrassment. Can be embarrassing and distressing for residents who have accidents. Can lead to social withdrawal.
Health Benefits Reduces risk of UTIs, skin irritation, and falls associated with rushing to the bathroom. Higher risk of UTIs due to incomplete bladder emptying. Increased risk of skin breakdown and falls.
CNA's Role Requires consistent prompting and adherence to a planned schedule. Focuses on prevention. Primarily reactive, responding to resident requests or accidents. Focuses on cleanup.
Autonomy Involves the resident in the process, and fosters a sense of predictability and control. May diminish autonomy by placing the resident in a dependent position after an accident occurs.

Promoting Hydration and Other Support

While a toileting schedule is crucial, a holistic approach is most effective. Nursing assistants should actively promote adequate fluid intake, especially for residents who might avoid drinking to prevent accidents. Creative methods can include offering a variety of fluids like juice, herbal tea, or broth, and making drinking a social activity. Making water readily available in a visually appealing cup can also increase intake.

For residents with mobility issues, assistive devices such as grab bars and raised toilet seats can be beneficial in making the bathroom more accessible. Ensuring a clear, well-lit path to the bathroom, especially at night, is also a simple but vital safety measure. By combining a structured toileting schedule with these additional supportive measures, nursing assistants can effectively and respectfully assist residents in managing the normal urinary changes of aging.

Conclusion

For a nursing assistant assisting residents with normal changes of aging related to the urinary system, the most effective strategy is to implement and consistently follow a proactive, scheduled toileting program. This approach directly addresses common issues like decreased bladder capacity and urgency while protecting resident dignity and promoting overall health. By understanding the physiological changes that occur with age, nursing assistants can provide compassionate, person-centered care that improves residents' independence and quality of life.

Frequently Asked Questions

The primary reason for a timed toileting schedule is to proactively address the age-related changes of a weakened bladder and decreased capacity, helping to prevent incontinence accidents and reduce resident anxiety about needing to get to the toilet in time.

A CNA can encourage higher fluid intake by offering a variety of drinks like fruit juices or tea, making drinking a social activity, and keeping a water bottle readily accessible.

A CNA should look for signs of a UTI, which can include increased confusion, pain or burning during urination, a change in urine color or odor, or increased frequency and urgency.

Maintaining dignity is crucial because incontinence can be embarrassing for residents and negatively affect their self-esteem. A sensitive, respectful approach helps residents feel secure and respected.

No, a nursing assistant should avoid using the word 'diaper'. Acceptable and more respectful terms include 'briefs', 'pads', or 'liners'.

To improve bathroom safety, a CNA can ensure pathways are clear, proper lighting is in place, and assistive devices like grab bars and raised toilet seats are available.

By consistently prompting urination at set intervals, the schedule helps retrain the bladder to delay voiding for longer periods and trains the body to follow a more predictable voiding pattern.

References

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Medical Disclaimer

This content is for informational purposes only and should not replace professional medical advice. Always consult a qualified healthcare provider regarding personal health decisions.