Unit 16 Diploma Level 2 in Health and Social Care

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1.1 Continence is the voluntary control over urinary and fecal discharge. Some individuals in the care home or any other health care setting find it difficult to manage continence and therefore express urine on themselves. Whilst this can be depressing for them, they have no control over their discharge because they are either weak or unable to hold it in for too long or suffer from a particular condition that does not allow them to be aware of it. This can affect the self esteem of an individual negatively. It might also mean that they cannot perform their daily activities in the health care setting. This can also make them feel unable because they cannot be dependent on going to the toilet themselves 1.2 Continence depends on properly functioning muscles and nerves in and around the rectum and anal canal. Any condition that interferes with these complex mechanisms may result in incontinence. Examples of events or conditions that can affect continence include: * childbirth, * constipation, * diarrhea, * irritable bowel syndrome (IBS), * inflammatory bowel disease (IBD), * pelvic or anal surgery, * neurological disorders or injuries, and * radiation treatments for certain cancers. Muscle damage or weakness Incontinence can be caused by injury to the ring-like sphincter muscles at the end of the rectum. The sphincter muscles normally stay tightly closed and keep stool in the rectum. If weakened by injury or disease, stool can leak out. In women, for example, the damage may happen as a result of complicated childbirth. Hemorrhoid surgery and other anal surgeries can also damage the sphincter muscles. Nerve damage Nerve damage can impair sensation and muscle control. An individual with nerve damage may not feel the need to use the bathroom and stool may leak out unexpectedly. Nerve damage can be caused by complicated childbirth, long-term

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