There are an estimated 1.5 million nursing home patients who suffer from urinary incontinence. These patients require frequent physical checks and staff assistance for toileting and changing. Two-hour toileting and changing schedules can result in improved continence for many patients during waking hours and most nursing homes specify that incontinent patients should be checked on two-hour schedules throughout the twenty-four hour period. The effects of two-hour checking schedules when applied at night are not known. It is possible that a two-hour nighttime check schedule is not necessary, does not lead to improved incontinence management, and may produce severe disruptions in normal sleep-wake cycles. This study proposes a descriptive analysis of nighttime patient incontinence. The effects of nurse checking and changing procedures on patient dryness levels and sleep-wake patterns will be determined. The data will help determine if there is a significant sample of patients whose nighttime incontinence care can be individualized to permit a minimally obtrusive checking, changing and toileting schedule. Physiological measures of skin integrity and sleep, as well as behavioral measures relevant to sleep fragmentation, will be developed in preparation for future potential intervention studies involving nighttime incontinence problems.
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