[A fact-finding inquiry on urinary management of the elderly in home care]

A fact-finding inquiry was made on elderly people in home care, in order to investigate urinary management. A questionnaire survey was performed on 2,322 elderly people (1,023 male and 1,299 female) cared at home by 40 home nursing stations in Aichi prefecture. The survey focused on the urinary management and the practical problems at home. The number of the elderly managed by an indwelling catheter was 225 (9.7%) and 1,301 (56.0%) of the elderly wore diapers. The rates of the people managed by an indwelling catheter or diapers widely varied among the home nursing stations. In 25.3% of the people managed by an indwelling catheter, the catheter was used because of urinary incontinence, which should not normally be indicated. Diapers were unnecessarily used in 23.9% of people mainly for a protective purpose. The majority of the people whose voiding dysfunction was managed either by an indwelling Foley catheter or diapers had had this treatment started before discharge from hospital. Only 5.8% of the elderly wearing diapers received consultation from medical specialists. Intermittent catheterization was performed in 36 people (1.6%), and in 23 (63.9%) the catheterization was carried out by the care givers. We conclude that the urinary management in the elderly cared at home is insufficient and that standardization of the urinary management and creation of a network of care givers, nurses, general physicians, medical specialists and government representatives should be urgently needed to improve the quality in urinary management in the elderly.