Treating urinary incontinence in older women

Abstract

Urinary incontinence is a common hidden problem which affects up to 30% of older people (Nazarko, 2008). It is often ignored or not treated effectively and often women suffering with urinary incontinence do not present to primary care practitioners, as they perceive it as an inevitable consequence of ageing. This article aims to discuss the types of urinary incontinence and treatments available to older women presenting with urinary incontinence in primary care.

Elderly Women and Urinary Incontinence in Long-Term Care

“…UI is one of the primary reasons for breakdown in care giving relationships for the elderly, and often results in nursing home placement (Du Moulin et al, 2009;Coward et al, 1995;Hu, 1990). Given our aging population and longer life expectancy of women, it is the aging woman who will be at the greatest risk for requiring additional care for UI, and the potential increased for associated nursing home placement to long-term care facilities (Sharpe, 1995;Stewart, 2010;Wilson, 2003).…”

“…Budget conscious administrators provide residents with the most cost-effective incontinence products, supplies, and staffing. Therefore, elderly women in long-term care facilities incur a personal cost for buying preferred incontinence products, and personal hygiene items to hide embarrassing odour associated with UI (Getliffe et al, 2007;Stewart, 2010). In turn, these disposalable incontinence and personal hygiene products are considered a burden for the environment, and may not be permitted for use in health related facilities and long -term care agencies (MacDonald & Butler, 2007).…”

“…Many elderly women view UI as an inevitable part of aging, and often develop their own coping strategies rather than seeking help for their incontinence (Beji et al, 2010;MacDonald & Butler, 2007;Porrett & Cox, 2008;Stewart, 2010;Zeznock et al, 2009). Even earlier on, Skoner and Haylor (1993) suggested that elderly women prefer to normalize UI into their daily routines in an attempt to maintain their self-esteem.…”

“…UI is commonly concealed to preserve a women's sense of identity, and accepted as a normal part of ageing and being a woman (Bradway et al, 2010;Bush et al, 2001;Stewart, 2010). Frequently, elderly women lack knowledge of treatments that are available and are not often presented with opportunities to discuss or explain their UI with healthcare providers (Mardon et al, 2006;Zeznock et al, 2009;Dugan et al, 2001).…”

“…Conversely, elderly women experiencing UI in LTC may subjectively define UI with respect to psychological, social, economic or physical implications and contexts (DuBeau et al, 2006;Getliffe et al, 2007;Hagglund & Ahlstrom, 2007;Howard & Steggall, 2010;Lifford et al, 2008;MacDonald & Butler, 2007;McDermott, 2010;Norton & Brubaker, 2006;Palmer, 1996;Parker, 2007;Wilson, 2003;Zeznock et al, 2010). The loss of bodily control, decrease in activities of daily living, social isolation, skin infections and dermatitis, falls, cost of incontinent products, and embarrassment maybe considered important in a UI definition to elderly women (MacDonald & Butler, 2007;McDermott, 2010;Nix & Haugen, 2010;Palmer, 2008;Parker, 2007;Stewart, 2010;Wilson, 2003). Also, it has been well documented in the literature that elderly women experience feelings of being less attractive and different from others resulting in shame, depression, and loss of self-confidence and inferiority, which must be considered when defining UI from the individuals perspective (Gallagher, 1998;Goldstein et al, 1992;Grimgy et al, 1993;Lifford et al, 2008;Palmer, 2008;Hunskaar & Vinsnes, 1991).…”