Incontinence. The magnitude of the problem

Prevalence figures from various settings reveal a confusing picture of the true nature of incontinence, a disorder that causes physical and psychological stress in affected adults and their caregivers. One message that is evident from the literature, however, is that once incontinence begins, it tends to persist. The prevalence data from the studies reviewed are indicative of this persistence. Incontinence is more common in women than in men. It appears to become more severe with advanced age and other infirmities, such as immobility. Incontinence has also been linked with an increased risk of death. The reality of the problem is not difficult to gauge from the existing data. Nurses must use this information with their knowledge of the aging process and of the disruption of incontinence to plan intervention strategies. Targeting of appropriate groups for health education, clinical assessment, and intervention is necessary to alleviate or at least modify incontinence. Health care providers often do not recognize disruptions in urinary function. Some, like social workers, have difficulty in explaining the causes for incontinence and in identifying the appropriate treatment. Often, containment or management practices are the only measures utilized. Reliable and standardized methods for verifying the frequency and severity of incontinence in incontinent community-dwelling elderly persons are being tested. Methods of recording the pattern and amount of incontinence are also being tested. Nurses and ancillary staff within health care institutions are often left to manage incontinence without the aid of input from other disciplines, especially physicians. In the community, older adults may go to elaborate lengths to hide or disguise their incontinence. Knox reported that women are tolerant of incontinence. This statement is supported by the evidence that incontinent adults often do not utilize existing services. The energy expended in such futile attempts to deny or hide incontinence would be better spent in seeking care from knowledgeable and sensitive health professionals.