1. Hydration Management
2. Management of Constipation
3. Prompted Voiding for Persons with Urinary Incontinence

Water is an essential component of body composition. However, hydration problems rarely involve body water alone, but rather are a water and electrolyte problem. Older individuals are at increased risk for hydration problems for a variety of reasons.

The purpose of this evidence-based guideline is to help health care providers in all settings determine adequate oral fluid intake for elders and to use strategies that will improve and maintain hydration. Ultimately, this guideline focuses on the prevention of dehydration through careful assessment, identification of elders at risk for hydration problems, and implementation of individualized nursing interventions based on a risk profile. Written 1998; Revised 2011.


Management of Constipation [HERE]

The purpose of this evidence-based guideline is to reduce the frequency and severity of constipation among older adults. The guideline may be used as a reference guide to assist clinicians who care for older adults. The goal is to maintain bowel frequency within normal limits for each individual. This will vary with the individual's perception. Regular bowel movements are commonly defined in the literature as at least two-three times per week with straining at stool less than 25 % of the time. This guideline is applicable to older adults who are hospitalized, residing in long-term care or skilled care facilities, or living in the community. This guideline is not intended for the populations of enterally fed, paraplegic, or quadriplegic individuals. Written 1996; Reviewed 2001; Revised 2009.

Urinary incontinence (UI) is the involuntary loss of urine. The National Association for Continence estimates on the basis of multiple studies and expert opinion that 25 million adult Americans experience transient or chronic UI. UI is one of the most common conditions among residents of extended care settings; post-acute and long-term care (LTC) facilities. UI is seen in at least 55% of nursing home residents and is the second leading cause of institutionalization of the elderly.

The purpose of this evidence-based guideline is to provide information for implementing a treatment program of prompted voiding (PV) for individuals who have UI. PV is a toileting program that combines scheduled voiding with “prompting” from a caregiver. In this guideline, a caregiver may be formal (extended care professional and allied health) or informal (family member, companion). Written 1999; Revised 2018.

Permission to Copy & Copyright Notice:

To obtain permission to copy a guideline toolkit click HERE and fill out the form presented to you. Once you've submitted this form, please allow up to 6 to 10 business for your request to be reviewed. At that time, we will contact you by email to inform you of our decision.

Before you proceed, please note we do not grant permission to use and/or copy any one individual tool not developed under the Barbara and Richard Csomay Center for Gerontological Excellence. For individual tool use, please contact the author/publisher of that tool.

By purchasing and downloading permissions for the Guideline and Toolkit you agree to the following terms:

1. Guideline and Toolkit are for private, internal, non-commercial use only (unless special permissions are obtained).
2. If the Guideline and Toolkit will be distributed online, it must be password protected and unavailable to the general public.
3. Guideline and Toolkit cannot be modified without expressed consent from author(s) and/or publisher.
4. You must give appropriate credit when using materials from the Guideline and Toolkit by using the citation on the Contact Information (or Contact Resource) page of the Guideline and place the following copyright notice at the bottom of the page, " ^©2018 the University of Iowa, College of Nursing, Barbara and Richard Csomay Center for Gerontological Excellence. All rights reserved. Do not copy or reproduce without permission."
5. You may not reprint and/or redistribute materials from the Guideline or Toolkit for any of your own publications. Please email Csomay-Center@uiowa.edu if you wish to obtain permission to use material from the Guideline or Toolkit in a publication.