1. Learning for Ageing Well
Eleanor van den Heuvel
Brunel University, London
The National Institute for Clinical Excellence (NICE) uses International Continence Society definition where UI is defined as ‘the complaint of any involuntary leakage of urine’. The Continence Foundation (UI) Urinary Incontinence 'is a condition in which involuntary urine loss is a social or hygienic problem and is objectively demonstrable'. Clearly these two definitions will describe completely different groups of people as “incontinent of urine” Consider the following scenarios
Wendy has a “sensitive” bladder she needs to urinate frequently and gets very little time between the urge to urinate and reaching the toilet. She wears sanitary protection in case some urine escapes before she reaches the toilet.
Incontinent according to NICE but not according to the Continence Foundation definition but she certainly does have continence difficulties. To feel comfortable travelling, working or generally participating in leisure activities, Wendy needs to be sure that toilet facilities will be available and accessible. Wendy will be a beneficiary from the research produced in WP2 and WP4
Susan is a bright and active woman who suffers from cerebral palsy. In earlier years her mother lifted her out of her wheelchair each time she needed to the toilet. Mum is now older and Susan is active in a drama and dance company. Susan has therefore chosen to wear continence pads during the day because there is no one who can transfer her to the toilet. Sometimes defined as “functionally incontinent” Susan’s urinary system functions perfectly but her mobility limitations prevent her from accesses the toilet. Susan would particularly benefit from the devices produced in WP4.
Alan has an enlarged prostate which is being treated conservatively. He needs to visit the toilet frequently and has little time to spare between knowing he needs to urinate and an irresistible urge to void. Alan is currently continent by both NICE and Continence Foundation definitions but he has particular continence needs both in clinical monitoring of his condition and in easy access to toilet facilities. WP2 and WP3 will both produce outcomes that will benefit Alan.
Faecal Incontinence (FI) is also subject to widely different definitions the most exacting being “Any leakage of gas, liquid or stool” (dictionary definition also used for some prevalence studies). Many studies include loss of control of gas as FI many other use solid or liquid stool leakage as the defining symptom of FI. Some studies state any loss of bowel control including “skid marks” some state faecal soiling three times within the last month. FI is a symptom not a diagnosis and often arises from a number on different underlying conditions working together. For older people with gastro intestinal problems (chronic or acute) sphincter problems due to muscle weakness or nervous system problems, those with limited mobility or any combination of the above the issue is not whether they are labelled continent incontinent. The most important issues (both of which our research program addresses) are getting appropriate treatment that promotes continence and being provided with sufficient good quality toilet facilities so that it is possible to remain active and continent.

2. Dare to Age Well
Background 1in 2 women over 65 have urine leakage Upto 85% have not sought help

4. Memory Problems

5. Taboo topics

6. Taboo Topic

7. Exercises for strengthening the pelvic floor muscles

8. Urge control techniques
Stop! Sit down! Contract!
Distract your brain

9. Empowerment is when YOU take charge of YOUR health
How well did it work?
What can I do?
YOU identify if there is a PROBLEM
Did it work?
Will I do it?
How will
I do it?
Are the target symptoms
better?

10. Bladder control problems are NOT a normal part of ageing

11. Make it happen

12. Dare to Age Well
Background 1in 2 women over 65 have urine leakage Upto 85% have not sought help

15. Dare to Age Well
Background 1in 2 women over 65 have urine leakage Upto 85% have not sought help