Knowledge and beliefs about urinary incontinence in adulthood and old age

Public knowledge and beliefs about urinary incontinence in adulthood are potentially significant contributors to the success or lack of success of intervention strategies. This is especially true given the repeated finding that significant proportions of incontinent people (at least half) do not report their incontinence to a physician. Although there is little literature on this topic, at least three salient features need to be recognized. First, there is an indication that laypeople have vague understandings of the causes and parameters of incontinence. The functioning of the human body is a mystery to many adult Americans. This lack of information is fostered by cultural beliefs that the body is something off-limits, that its functions are the appropriate domain of specialists. Of course, educational factors and possibly ethnic affiliations modify this lack of information. Lack of information is compounded by lack of an appropriate vocabulary. Clinicians must be aware that a patient's understanding of the body or terminology for bodily functions may not fit their own framework. Second, there is consistent evidence that elderly people often consider urinary incontinence to be an inevitable and irremediable part of the normal aging process. This linkage of incontinence and normal aging is probably protective of self-esteem but does little to foster amelioration of incontinence. The belief that incontinence signals oncoming incompetence is a cultural construction that is apparent in popular culture, such as literature and movies and reflected in the secrecy attendant on much incontinence in later life.(ABSTRACT TRUNCATED AT 250 WORDS)