A new report from The King’s Fund says that treatable conditions such as incontinence and depression were sometimes ignored within the NHS. The report also suggests that the elderly are being passed around hospitals in England like parcels, often going without treatment because of ageist attitudes and that even diseases like cancer and heart disease were not always tested for.
The report, based on both patient surveys and evidence from staff is the latest in a series of critical reports on elderly care.
The study by the King’s Fund criticised the whole approach to elderly care, saying the attitudes and language used, such as “bed blocker” suggested that staff, particularly doctors could be ageist.
Report author Jocelyn Cornwell said: “The health and social care system system has failed to keep pace with changing health needs. The report laid the blame on the system, pointing out the volumes of work and pressure on meeting targets was compromising care and called for better training for staff, leadership and involvement of patients to ensure the co-ordination of care improved.
It said elderly patients, who make up two-thirds of admissions, often found themselves on the wrong wards and passed around “like parcels” because of the rush to admit them.
The Department of Health commented on the report saying that addressing problems with elderly care was a key priority for the NHS and adding that the reforms being introduced in the health service were designed to free staff from the obstacles they were facing to putting patients first.
Leading Pharmaceutical manufacturer, Allergan Inc. of the USA continues to seek to expand the use of its wrinkle smoother Botox into other medical uses with an eye on the Incontinence Market. Allergan say that injections of the drug into the bladder helped decrease symptoms of severe urinary incontinence in two studies.
Botox led to a “statistically significant” decline in incontinence among patients with overactive bladder, the Irvine, California-based company said in a statement today. Based on the results, Allergan said it has applied for approvals from the U.S. Food and Drug Administration and European Union officials.
Botox, Allergan’s best-selling product, had $1.59 billion in sales last year, about half for cosmetic uses and half for migraine treatment, incontinence and other conditions.
The company was able to enroll patients in the trials and collect data faster than expected, the CEO said. A regulatory decision from the FDA should come by early next year, he said. The studies treated patients with overactive bladders not caused by a neurological condition and who had failed to respond to standard medication, according to the company’s statement.
As part of their ongoing work, NICE (The National Institute for Health and Clinical Excellence) are developing a clinical practice guideline on Incontinence in neurological disease for use in the NHS in England, Wales and Northern Ireland. The guidance includes treatments to improve bladder storage and emptying and treaments for Stress Incontinence, including Pelvic Floor Treatments.
Amy Bowen, Director of Service Development, MS Trust said “There are many positive options to manage bladder problems and it is vital that people with MS have access to appropriate continence information and treatments. The MS Trust welcomes the development of the clinical practice guideline and will be ensuring that the needs of people with MS are represented in the consultation process.”
MS Awareness Week runs from 30th April to 6th May 2012, The week provides aims to help people across the UK understand what it means to have MS and to focus the debate on how to improve MS services.
Allanda, are Incontinence Experts and offer a wide variery of disposable incontinence pads and washable incontinence pants which can help with the management of incontinence both within and outside the home. The full range of Allanda Incontinence products can be seen at www.allaboutincontinence.co.uk, alternatively a catalogue can be requested by calling them on 0845 0942 742 (Local Call Rate).
We’ve been amazed by the popularity of our new Brolly Sheets Mattress Protectors so now we’re offering Double sizes as well!
Designed for ultimate comfort and convenience, Brolly Sheets feature a 100% cotton top to sleep on and a soft breathable waterproof backing. These absorbent pads are designed to offer protection against incontinence for mattresses whilst keeping the user dry and comfortable. Just tuck in on top of fitted sheet, then simply replace when wet. By removing the need to completely strip the bed they save time, washing (and sanity!).
They are PVC/vinyl free and their innovative wide (45cm) tuck-in wings keep the Brolly Sheet secured to the mattress and allow for easy removal when wet. A cost-effective alternative to disposable bed pads, Brolly Sheets also save on energy bills as they can be washed on a low setting with the regular family washing. The pads can be machine washed at up to 40 Degrees C and can be line or tumble dried.
Brolly Sheet Bed Protector pads are also available as a Single size (38×38″/98x98cm) in White, Blue and Green. They are also available in King size (65×38″/165x60cm) in White, this size is suitable for King and Queen beds (simply tuck pad further into mattress for Queen beds).
We recommend that these products are used in conjunction with body worn incontinence pads or pants and also Mattress Protection. They are not recommended for use with an electric blanket.
Brolly Sheets Washable Bed Pad key benefits are:
- Unique 100% cotton top for ultimate comfort.
- Soft, breathable, waterproof backing – PVC/vinyl free.
- Secured by extra wide 45cm tuck-in wings for secure location.
- Can hold up to 2 litres of liquid.
- Machine washable at 40 degrees, line or tumble dry.
Following on from last week’s news about new treatments for enlarged Prostrate, another new treatment was announced recently in America. This new radiology treatment called prostatic artery embolization may help men who experience urinary retention due to an enlarged prostate, say the researchers who pioneered its use.
“Having an enlarged prostate is very common in many men over the age of 50, and these new findings provide hope for those who might not be candidates for transurethral resection of the prostate, or TURP—and may allow them to avoid serious complications that sometime result from surgery, such as impotence, retrograde ejaculation and urinary incontinence. This could mean that more men have a chance at getting their lives back,” said Francisco Cesar Carnevale, M.D. Ph.D., professor and chief of the interventional radiology section at the Hospital das Clínicas Hospital of the Faculty of Medicine at the University of Sao Paulo in Brazil.
A man’s prostate can slowly grow larger with age due to a noncancerous process called benign prostatic hyperplasia, or BPH.
In many men this enlargement can compress the urethra and cause urination and bladder problems such as dribbling at the end of urinating, an inability to urinate, incomplete emptying of the bladder, incontinence, and having a strong and sudden urge to urinate or a weak urine stream. For these men, symptoms can cause a marked decrease in quality of life, said Carnevale.
“I saw firsthand how these men responded to treatment. With the possibility of faster recovery—on an outpatient basis—and with no bladder catheters, reduced symptoms, improved urination and fewer potential side effects, prostatic artery embolization could signal a bold new change in accepted prostate therapy,” added Haskal, a professor of radiology and surgery at the University of Maryland School of Medicine and editor-in-chief of the Journal of Vascular and Interventional Radiology.
Carnevale explained “Interventional radiologists have always pioneered the use of minimally invasive treatments for many disease states. Interventional radiologists have used embolization, where a catheter is used to deliver tiny beads to block blood flow to a target area, for many years to treat uterine fibroids, on an outpatient basis, with very few complications. Applying this same principal to the prostate by embolizing or blocking the prostatic arteries, thereby reducing its size and releasing the pressure on the urethra so that a man is then able to void normally, seemed like a natural progression.”
“This study looked at results from men who suffered with acute urinary retention due to an enlarged prostate and who were treated,” noted Carnevale, who indicated that prior to embolization, all had medical treatment and urethral catheters and were waiting for surgery.
“After the treatment, we assessed quality of life and evaluated how well the urinary system was working. Clinical success was seen in 91 percent of those treated and technical success was evident in 75 percent of those treated,” he added.
Using a tiny one-millimeter diameter microcatheter threaded into the prostate arteries, 12 prostatic artery embolization procedures using resin microspheres as embolizing agents were performed on 11 individuals (ages 59-78 years; average age, 68.5 years) under local anesthesia. Magnetic resonance imaging and ultrasound were also used to study the exact anatomy of the prostate.
Overall clinical improvement in lower urinary tract symptoms at the one-year mark was observed and corroborated by all patients. All of those treated also reported a high degree of satisfaction and increased quality of life after the treatment.
The findings were presented at the Society of Interventional Radiology’s 37th Annual Scientific Meeting in San Francisco, USA.
Cardiff city council and Monmouthshire county council are to become the first UK local authorities to send disposable incontinence products for recycling. As of March 2012 the councils are to send absorbent hygiene products (AHP) – such as disposable incontinence pads, incontinence pants, feminine hygiene products and nappies – to recycling specialist Knowaste’s facility in West Bromwich in the Midlands as part of a six month trial.
The trial is designed to evaluate the level of demand from householders for the service and determine the most efficient ways of handling the AHP materials.
If successful it could lead to a contract being tendered for the whole of Wales for such products.
Last month, the Daily Mail Good Health section revealed news of a pioneering procedure to tackle enlarged prostates, a common problem in men as they age and one of the main causes of incontinence issues in men.
Ken Jordan, 58, from Hitchin, was one of the first patients in Britain to undergo it a pioneering procedure to tackle enlarged prostates.
‘I scoured the internet for something that could help, and found a new procedure called Urolift,’ said Mr. Jordan.
In his late 40’s, Mr. Jordan realised that he had started to need the loo more frequently and was going up to ten times a day.
Knowing that this could be a sign of prostate cancer, after six months he decided to visit his GP who said it was likely to be a benign prostate growth and that needing the toilet more frequently was very common in men as they get older.
This is because the prostate is like a doughnut that wraps around the urethra, the tube which carries urine from the bladder. As men get older, the prostate grows and as a result it starts to press on the urethra, making it harder to empty the bladder properly — thus you feel you need to go more often.
Mr. Jordan was referred to a urologist, who told confirmed that there was some prostate growth. He also carried out a blood test for prostate-specific antigen, a protein that can be a sign of prostate cancer, but the levels were very low, which was obviously good news. The urologist prescribed alpha blocker tablets to relax the prostate — this helped initially, but then the symptoms got worse again. And although I often felt I needed the loo urgently, when I got there I’d produce less.
“Next, my urologist tried finasteride, which stops testosterone changing into a form that causes the prostate to grow. But it didn’t really help, and both the drugs had side-effects — I suffered light-headedness, nausea and sleeplessness.” Mr. Jordan said
The urologist mentioned the problem could be treated with surgery, where they would cut or laser away parts of the prostate. But he knew that it carried a risk of impotence and incontinence.
Although he tried cutting down on the seven mugs of tea he drank each day, and avoided drinks in the evening, nothing seemed to work.
“It was starting to annoy me — on holidays I’d find long coach trips really difficult. If my partner, Jacky, and I went to the theatre or cinema, I’d always want to sit on the end of the row, so I wouldn’t disturb anyone.”
However, whilst scouring the internet for something that could help, last summer he found a new procedure called Urolift.
Here, surgeons simply move the prostate so it’s not pressing against the urethra, and then use two tiny anchors to hold it in place out of the way.
As there was no cutting or lasering involved, just moving part of the gland aside, the risk of impotence was much less.
In July last year, Mr. Jordan saw a specialist, Professor Tom McNicholas. He confirmed that Mr. Jordan was suitable for the procedure and would be the third patient in the UK to have it as part of a pilot study at the Lister Hospital in Stevenage.
The operation was carried out under sedation and afterwards there were no bandages, though he needed painkillers for the first few hours. Mr. Jordan took one day off work and within days, felt as that he had much more control over his bladder, and didn’t need to go to the loo as frequently.
Now, seven months after the op, Mr. Jordan feels that his body is as good as it was 15 years ago, “I might occasionally get up just once in the night, but I don’t have to worry about long journeys and days out. I really do feel liberated.”
Professor Tom McNicholas is consultant urological surgeon at the Lister Hospital in Stevenage, Hertfordshire commented on the problem and the treatment. He says:
“Pretty much all men will have some degree of prostate enlargement once they are over 50 — and around 43 per cent will experience the need to go to the loo more frequently and more urgently as a result.
By the age of 80, 40 per cent of men will have been treated for it.
The prostate is a small, ring-shaped gland that lies directly under the bladder and surrounds the urethra. It grows as men age, and can start to compress and narrow the urethra.
The urethra can be around 7mm in diameter, but if the prostate becomes enlarged, it can narrow to just a few millimetres.
The bladder then has to work harder to empty, and as a result men have difficulty passing urine.
Doctors can advise men to avoid substances that irritate the bladder, including caffeine and fizzy drinks — smoking also makes the problem worse.
We can also offer drugs to relax the tissues of the prostate, which work very well, though some men have side-effects, including feeling dizzy, under par and having a stuffy nose. Or we can prescribe hormone-based drugs to shrink the prostate, which can affect erection and libido.
At the moment, the gold standard operation is transurethral resection of the prostate, which means operating through the urethra and trimming or lasering away parts of the prostate, taking the pressure off the urethra.
This involves a general anaesthetic, up to three days recovery in hospital, and carries a small risk of bleeding as well as a five per cent risk of nerve damage, which can cause impotence and urinary incontinence.
More often (in around 80 per cent of patients), it can cause a loss of ejaculation.
I have been working with a U.S. company that developed Urolift about five years ago. This is a brilliantly simple device to move the prostate aside and keep it there, which we have just started doing on the NHS in a pilot study.
The operation takes around 25 minutes.
First, I slide a protective sheath, about 5 to 7mm in diameter, into the urethra, and put a fine telescope in to find the narrowest spot.
Then I insert a handpiece, which is basically like a plastic tube with a firing trigger, through the same sheath. I use the handpiece to push one side of the prostate away from the urethra.
To fix the prostate into its new position, I use the handpiece to fire a surgical stitch from inside the urethra and out through the prostate.
On each end of the stitch is a tiny anchor. One anchor sits on the outside of the ring-shaped prostate, the other inside it, with the stitch connecting them.
After being pulled tight, the anchors squeeze the prostate and pull it away from the urethra.
I put a second stitch with two anchors further down in the prostate to ensure the urethra remains clear.
Then I use the handpiece to push the prostate away on the other side, and do the same thing, fixing four more anchors there.
If the prostate goes on growing, we can repeat the operation — ten per cent of patients need further treatment.
Our patients’ experiences have been encouraging.
Urolift is still at the pilot stage and is being done only at the Lister Hospital, but the plan is to extend it to six more NHS centres. Once past the trial stage, we expect it to be available both privately and on the NHS.”
The operation costs around £3,500 privately and the same amount to the NHS.
Women are nearly three times more likely to experience urinary incontinence for more than 10 years following a vaginal delivery rather than a caesarean section, finds new research at the Sahlgrenska Academy in Sweden.
Urinary incontinence (UI) is a common condition affecting adult women of all ages and can have a negative influence on quality of life.
A new study from the University of Gothenburg in Sweden looked at the prevalence and risk factors for Urinary Incontinence 20 years after vaginal delivery or caesarean section. The study included women who had only one child and assessed their prevalence of Urinary Incontinence for less than five years, between 5-10 years and for more than 10 years.
Overall, the prevalence of Urinary incontinence was considerably higher after a vaginal delivery (40.3%) compared to women who delivered by caesarean section (28.8%). The study also found that the prevalence of Urinary incontinence for more than 10 years almost tripled after vaginal delivery (10.1%) compared to women who had a caesarean section (3.9%).
The study also looked at the impact of weight (Body Mass index) on Urinary Incontinence. The risk increase of Urinary Incontinence in obese women more than doubled in comparison to women with a normal Body Mass index after vaginal delivery and more than tripled after caesarean section.
Maria Gyhagen, Department of Obstetrics and Gynaecology, Sahlgrenska Academy, University of Gothenburg, Sweden and co-author of the paper said:
“In conclusion, the risk of developing urinary incontinence was higher 20 years after a vaginal delivery compared to a caesarean section. There are many factors affecting urinary incontinence but obesity and ageing as well as obstetric trauma during childbirth are known to be three of the most important risk factors.”
At Allanda we are constantly trying to raise awareness of the prevalence of incontinence and how many people this condition affects, both women and men and young and old. Therefore it was good to read this blog post from Liz Campbell of Wellbeing of Women in the Huffington Post.
“Statistics show that one in three women over the age of 30 will suffer with some kind of incontinence.
This is not a condition of the elderly; it is something that will probably affect you or the woman sitting next to you at some time in your life.
The most likely times for incontinence to hit are after having a baby (especially if it was a big, heavy one) or as you approach and go through the menopause. Research is still being done to find out exactly why.
Suffice it to say that there are plenty of unanswered questions about why women (and men) wee when they don’t want to. And yet it is a condition rarely discussed and attracting very little funding. Presumably it is a topic best whispered about like so many health issues in earlier generations. However the longer we are content to avoid the topic, the longer people will suffer.
There are thousands of women in the UK today who have not left their house because they are too worried about wetting themselves.
Despite the best incontinence pads, despite having a map of all the local toilets sometimes it all becomes too much.
I think that two of the saddest stories I have ever heard are of the high-flying business woman who sneezed on the underground and wet herself. She was so embarrassed that she rearranged her coat over her knees and stayed on the train to the very end of the line where she could hurry off the train.
Then there’s the attractive 45-year-old who put an end to a happy new relationship because she was worried she would ‘leak’ during sex and couldn’t bring herself to talk to her new boyfriend about it. She was heartbroken.
At Wellbeing of Women we urge women (and men) to speak up about these health taboos, to openly discuss the treatment options because it is only when there is a noise that the money will be raised to find the answers to these profoundly debilitating conditions.”
You can read the full post at http://www.huffingtonpost.co.uk/liz-campbell/botox-bladder-female-incontinence_b_1347999.html
Many of you might have watched Mary Portas’s new show on Channel 4 last night. “Mary’s Bottom Line” is a new programme following Mary’s efforts to re-start British Lingerie manufacturing by starting up a company in Middleton to produce products in the United Kingdom.
Allanda seem to be a bit ahead of Mary as our Washable Incontinence Pants are already manufactured in the U.K. Our range Men’s and Ladies’s absorbent pants, Unisex and Pouch Pants are actually made in Nottingham, are made from 100% Cotton to look and feel like normal underwear. All are machine washable and will last upto approx. 200 washes. These high quality, full fitting briefs are available in a wide range of sizes fitting from a 28″ (Small size) to 58 inch waist (5XL size.)