It can be a dark secret.  Many experiencing it are mortified.  It is coldheartedly joked about by some who don’t experience it. It’s a cause of over 53% of nursing home admissions.  It’s responsible for depression, anxiety and social isolation.   It affects about one-half of all homebound or institutionalized elders. And of community-dwelling, non-homebound persons over 60 years of age, 10-15% of males and 20-35% of females experience it.  In the US, the cost of managing this and its complications costs billions of dollars a year! Have you guessed what I’m talking about yet?

Here are a few more clues.  This condition can be transient, reversible or chronic.    There are four different types and sometimes a patient can have more than one of them.  It can be caused by medication, inflammation, irritation, or a neurological condition.  Treatment modalities can include surgery, medication, physical therapy, biofeedback, or behavioral therapy.  The most important fact is that it is treatable or at the very least, symptoms can be manageable.

OK, I’ll stop all of the intrigue.   But I’m trying to demonstrate a larger point.  Urinary incontinence is a problem, which many have great difficulty talking about.  Over 50% of geriatric patients do not report their incontinence to their doctors.  Many think that incontinence is a part of aging.  We shouldn’t be surprised about this.  Have you seen the adult diaper ads in magazines and on TV during the evening news?  I’m even guilty of including a box of Depends in my joke gift basket for friends celebrating milestone birthdays. How many times have you heard someone say that they wore a diaper at the beginning of their life and have to wear a diaper at the end of it?

As home care clinicians we can do much to help our patients with urinary incontinence.  Opening up a dialogue can be half the battle.  Informing our patients about diagnostic and treatment options can give them hope and may result in an improvement in their quality of life.   Here are three tools available on the CHAMP web site.

• The Daily Bladder Diary is a convenient tool to help providers gather more information about a patient’s incontinence and determine effectiveness of treatment.

• Urinary Incontinence Assessment in Older Adults: Part l Transient Urinary Incontinence  is a “Try This” issue that describes two methods to assist nurses in assessing acute urinary incontinence and its treatable underlying causes. Includes a Bladder Diary. Published by the Hartford Institute for Geriatric Nursing.

• Urinary Incontinence Assessment in Older Adults:  Part II Persistent Urinary Incontinence is a “Try This” issue that describes two evidence-based tools to assist nurses in assessing quality of life and symptom distress for chronic urinary incontinence. Published by the Hartford Institute for Geriatric Nursing.

Debra Bertrand, CHAMP Facilitator

Source for statistics:
Weiss, Barry D.  M.D., Diagnostic Evaluation of Urinary Incontinence in Geriatric Patients, Am Fam Physician. 1998 Jun 1;57(11):2675-2684.