Geriatric incontinence--selected questions

Co-existing incontinence (urinary and fecal incontinence), often referred to as double incontinence, is a poorly defined syndrome in older adults. Nevertheless, urinary and fecal incontinence are common problems in the elderly population, particularly affecting individuals in the community and nursing homes. In addition to the inconvenience of the incontinence for the patient and caregiver, it is a marker of poorer health and associated with increased mortality. All patients with fecal and/ or urinary incontinence warrant a focused medical evaluation including comprehensive history and genital examination. Fecal impaction must be excluded by rectal exam and x-ray film of the abdomen. Cognitively impaired patients benefit most from habit training. Several surgical procedures are available and may be helpful in selected older persons with incontinence.