Can be a major problem in the care of the elderly. It is an illness or symptom that may not be curable but can usually be managed satisfactorily. 6.5% of men and 11.6% of women over the age of 65 are incontinent of urine.
Age is associated with changes in the body which affect bladder tone and function and the elderly person may find it harder to control the reflex which postpones micturition or the urge to pass urine. The effect can be that some elderly people can only delay for a few minutes and this can be a problem if mobility is poor or the toilet is up stairs or along a passage, or that they are unable to remove their clothing. This condition can be short or long term.

SHORT TERM

Can be part of an acute illness such as Toxic Confusion State or Cardiovascular Accident. Infections of Cystitis or Urethritis or Bladder Stones or Tumours can cause it. Drugs can cause incontinence i.e. Diuretics or Sedatives and if the elderly person is constipated this could also lead to incontinence of urine, as a full rectum can impair the sensory nerves leading from the bladder to the brain.

LONG TERM

Disorders of the pathways to the brain due to Dementia or Strokes can result in the loss of the ability to stop the bladder contracting, although the elderly person could still have the sensation of retention.
Urge incontinence, where the elderly person desires to pass urine is immediately followed by micturation. Stress incontinence where small amounts of urine leak due to coughing or laughing. This is more common in women, especially if they have had children and can be caused by Prolapse of the womb.

MANAGEMENT OF INCONTINENCE OF URINE

Often very degrading to the elderly person to be constantly wet and often smelling or  stale urine, so the problem needs careful, sensitive handling.

Due to inflammation of the lungs. This can be caused directly by a bacteria or by some irritant. Can be an acute illness, but often in the elderly person, especially those who smoke, it is masked at first by a chronic lung condition and when finally diagnosed can be fatal.

This is when the deep body temperature is less than 35 degrees. This occurs when heat production, which is generated by food being converted into energy, is less than the heat loss from the skin and expelled air from the lungs. Can be precipitated by illness or a fall and generally occurs in those elderly people who have not been in good health. It is found in 3.6% of elderly people admitted to hospital and in 10% of elderly people living alone during the winter months.
Hypothermia is caused by cold, body heat regulation problems, infections, poor mobility, falls, fractures, diabetes, dementia, depression. The ageing process causes a reduction in efficiency of the heat regulating system and the shivering action is reduced. There is a reduction in the awareness of temperature change, therefore inadequate clothing may be worn.

The body needs glucose for every cell but can't use it unless insulin is produced to convert it. With Diabetes the person either does not produce any level of insulin, or they don't produce enough to cope with the level of glucose the body is receiving.
Obesity can cause the problem and the weight should be reduced by a controlled diet. Care will be needed with the feet because disruption of the peripheral circulation occurs often leading to Ulceration and sometimes Gangrene.
Diabetes can be controlled by diet, tablets or insulin injection, or a combination of these.

It has been estimated that 65% of people over 65 have some form of hearing loss. There are three main categories:

  1. Deaf without speech.
  2. Deaf with speech.
  3. Hard of hearing.
The majority of elderly people with hearing loss fall into category 3.
It has been proved that shouting at deaf people does not help hearing and that speaking clearly, whilst looking at the person is more appropriate.

There are an estimated 91,000 elderly people registered blind in the UK and there are more women than men who have a visual disability. The registering of a person with a visual disability is voluntary and can be done through the local Council Social Services department. The most common causes of visual disability are Glaucoma, Diabetic complication, Cataract or degeneration of the eye and some of these causes can be treated if detected soon enough.