Assessment interview: type of incontinence (leaks)
In this topic we will look at different types of leaks and:
- When they occur
- How often they occur
- How heavy they are (amount)
Start by asking the person to describe the difficulties they are having with their bladder and bowels, and how they are managing.
Ask: Can you describe what is happening?
Ask for urine and stool: when leaks occur:
- Day
- Night
Meet Dembe
Dembe is a 13 year old boy who loves playing football. Dembe occasionally wets the bed at night. He never knows when it will happen.
Dembe does not experience any leaks during the day, only at night.
Some people leak only during the day, or only at night. Some people may leak both night and day.
To contain night time leaks until the morning, a more absorbent product is usually needed.
Ask for urine and stool: how often leaks happen:
- Occasional
- Frequent
- Constant
Leaks are:
- Occasional when the leaks are not daily.
- Frequent when they happen every day or night.
- Constant when a person is constantly leaking (often described as dribbling).
Knowing how often a person leaks helps to decide how often they may need to change.
Question
How often (on average) does a person empty their bladder in the day?
c) Is correct. On average, people empty their bladder between six and eight times a day.
If you were not sure of the answer to this question, or you got this wrong, review the TAP Self care module, Continence topic.
Question
Remember Marina?
Every few days, Marina has leaks of urine when she coughs or exercises. Marina regularly feels a strong need to go to the toilet and has to rush to get there in time. This happens in the day and also when she wakes at night. She often cannot hold on and leaks urine before reaching the toilet.
Check the boxes below to describe when and how often Marina is having urine leaks.
When:
a) and b) are correct. Marina experiences urine leaks in the day and in the night.
How often:
b) frequent is correct.
Marina has leaks every day and every night. These may be light leaks when she coughs or exercises or heavier leaks when she feels a sudden strong need to go to the toilet and leaks urine.
Ask: For urine and stool leaks – Are the leaks mostly:
- Light
- Moderate
- Heavy
Leaks can be described as:
- Light
- Moderate
- Heavy.
As a general guide,
- Light leaks are less than 300ml
- Moderate leaks are about 300-600ml
- Heavy leaks are about 600 – 900ml.
The volume of leaks will vary during the day and children leak less than adults.
It is not always practical to measure leaks. Instead you can ask the person to describe their leaks.
Question
Read each of the following descriptions of leaks. Decide which ones would be ‘light’, ‘moderate’ or ‘heavy’.
1. Leak spreads through clothes, and spills onto chair, bed or floor. The person has to change their clothes.
This is:
- Heavy
2. Leak is mostly contained in underwear, with maybe some moisture spreading to clothes.
This is:
- Light
3. Leak leaves person feeling wet. It spreads to clothes, but no further.
This is:
- Moderate
Knowing how heavy leaks are helps identify how much the person’s absorbent product should contain.
It also helps to work out how often the person may need to change their product.
Matching absorbent products to volume of leaks
Different manufacturers describe the absorbency of their products in different ways.
Some say how much liquid the product should absorb, however how this is measured and described varies.
Getting feedback from people who have used the absorbent product is sometimes the best way to know how absorbent a product is.
Activity
Look at the product descriptions you completed earlier. How are the product absorbencies described?
Question
Remember Marina?
Marina has leaks of urine when she coughs or exercises. These leaks spread to her underwear.
She also leaks urine regularly in the day and night. The leaks wet her underwear and clothes.
1. Check the boxes below to describe how heavy Marina’s urine leaks are:
a) Light and b) Moderate are correct.
Marina has light leaks when she coughs or exercises and moderate leaks when she cannot get to the toilet in time.
- What absorbency of product would you recommend for Marina in the day?
b) Moderate is correct.
Marina has both light and moderate leaks. The moderate leaks are most frequent. Marina needs a product to absorb moderate leaks, to avoid accidents.
- What absorbency of product would you recommend for Marina at night?
b) and c) could both be correct.
- Moderate would be fine if Marina gets up to change after a leak.
- Heavy may suit Marina if it can contain enough to avoid her changing during the night.
Remember Dembe?
Dembe wets the bed at night once or twice a week. The leak wets his clothes and sheet.
Check the boxes below to describe Dembe’s urine leaks:
When:
b) Night is correct. Dembe only experiences leaks at night.
How often:
a) Occasional is correct. Dembe has leaks once or twice per week. He does not have leaks every day.
Is it:
a) Heavy is correct.
Dembe is describing heavy leaks that spread beyond his clothing to the bed. Look at the available products suitable for his age to match the absorbency.
Ask: For stool leaks – is the stool:
- Mostly liquid or
- Mostly solid?
Question
Which of the absorbent products below may be better at containing leaks of liquid stool?
(Select all that may apply)
Yes. This product wraps closely around the hips, thighs and waist and has good cover over the bottom.
No. This product does not wrap around the hips and has less cover over the bottom.
Yes, this product wraps closely around the hips, thighs and waist and has good cover over the bottom.
No, this product does not wrap around the hips and has less cover over the bottom.
If you are not sure, look back at the product descriptions in Lesson one.
It is also important that the products fit the person well.
Discussion
Look at the product samples available in your service. Which do you think would be best for containing liquid stool?
Post your selection on the discussion forum.
If you are not sure, discuss with your mentor.