Continence nursing: a whole person approach

Urinary incontinence has significant medical, social, psychologic, and economic implications. Continence management requires a sensitive, comprehensive, and holistic approach that accounts for the many facets of this distressing and life-altering condition. Assessment of urinary incontinence includes a focused physical examination, comprehensive history, and accounting for factors that can impact continence, such as cognition, functional ability, and impact on quality of life. Behavioral therapy for incontinence includes diet modification, toileting programs, bladder retraining, and pelvic muscle re-education. Biofeedback and electrical stimulation are treatment modalities that help clients to identify, recruit, and strengthen pelvic floor muscles and improve treatment outcomes. Other approaches include medications and devices, such as a pessary.