What Wait Time in a Soiled Pad Is Acceptable to Older Patients and Their Direct Caregivers?

We sought to establish views on wait times and hypothesized that they may vary depending upon perspective, circumstance, and incontinence type.

Cross-sectional, descriptive survey.

Eligible patients were inpatients, 65 years and older, in a single tertiary acute care hospital. Eligible staff were regulated (licensed) and unregulated providers of direct care to patients. Patients may or may not have used absorbent continence products prior to their admission.

We examined views on acceptable and actual wait times of elderly acute care inpatients and their direct care providers (DCPs). Participants were asked about wait times for pads soiled with urine or feces during the day and at night. Differences between patients and DCPs and acceptable and actual wait times were compared. Factors associated with tolerance to the presence of urine or stool in absorptive products were analyzed by logistic regression.

There was patient-provider mismatch for daytime urinary incontinence: 90% of patients but only 44% of DCPs reported urinary soiling more than 1 hour in the daytime as unacceptable (38.0 vs 85.0 minutes; P < .0001). A significant majority (80%-90%) of both groups reported short acceptable wait times for fecal incontinence (<15 minutes). The odds of being tolerant to any soiling were significantly higher in patients who were prior residents of care facilities (odds ratio [OR] = 6.2; 95% confidence interval [CI], 1.3-28.1; P = .019), previously used incontinence products (OR = 2.0; 95% CI, 1.0-3.8; P = .036), or used walking aids (OR = 4.0; 95% CI, 1.1-14.7; P = .039). Actual wait times were significantly longer than deemed acceptable by either patients or DCPs.

There are significant gaps in patient-provider perspectives on acceptable wait times in soiled incontinence products. Direct care providers need to take patient preference into account when managing continence.