245 ‘Pad culture: the use of continence wear in older people in an Irish University Hospital’

Abstract

Abstract Background Incontinence in hospital patients can result in a longer length of stay, a greater risk of being discharged to a residential care setting, as well as increased healthcare and personal costs. Older adults may find it difficult to regain continence post discharge contributing to caregiver strain, social isolation and functional decline. There is evidence to suggest that there is an over-reliance on continence aids (wearable absorbent ‘pads’ & urinary catheters) for older adults in hospital. The aim of this study was to assess the prevalence of continence aids among older in-patients in an Irish University Hospital, as part of wider service improvement project. Methods Data was collected on consecutive in-patients 65 years or older on a single day. Medical, surgical, oncology, coronary care and medical assessment unit were included. Current incontinence aid usage and pre-admission continence aid usage was recorded, along with demographics and current mobility status. Results 156 older adults were included. 53.5% were male and the median age was 81. A total of 57.4% (N = 89) of older patients were wearing disposable pads. Of these, 64.5% (N = 58) were not wearing continence pads pre-admission. A total of 23.2% (N = 36) had a urinary catheter inserted. Of these, 91% (N = 33) did not have a urinary catheter pre-admission. 38.3% (N = 61) of those wearing pads could mobilise either independently or with assistance of one. We also found a direct correlation between pad use and length of stay. Conclusion This study highlights the high prevalence of continence aid deployment in the care of older adults admitted to an acute hospital, with conversion to an aid occurring even in those who are able to mobilise independently or with supervision. Continence care and rehabilitation may benefit from inter-disciplinary assessment and management, similar to other complications of ageing and hospitalisation, such as delirium.