Incontinence in nursing home residents with dementia : Influence of an educational program and nursing case conferences.

Abstract

Up to 90 % of nursing home residents with dementia suffer from urinary incontinence with adverse effects on the quality of life. Nurses are often insufficiently prepared for incontinence management and their knowledge is incomplete. Urinary incontinence management for people with dementia is complex due to the multifactorial nature of the disease and cognitive impairment. This study explored the effects of an educational program and subsequent nursing case conferences on urinary incontinence and quality of life of nursing home residents with dementia. The stepped-wedge trial design was used and seven nursing homes were included. In total 140people were included in the study. The intervention consisted of an educational program and six case conferences at each ward. Urinary incontinence and quality of life were measured at baseline, after 2 and 6 months as well as at the end of the study. Univariate analysis of variance (ANOVA), repeated measures ANOVA and linear regression were used to compare the groups and the results at different times of measurement. The responsible ethics committees approved the study. After 6 months urinary incontinence decreased or was approximately equal to the initial measurement. At the end of the study urinary incontinence was slightly but not significantly higher. In the whole sample the quality of life increased in seven out of nine categories up to the end of the study. Urinary incontinence management for people with dementia is complex and an educational program and case conferences during 6 months proved to be effective in reducing urinary incontinence and improve the quality of life in nursing home residents with dementia.