Medical director's review of urinary incontinence in long-term care.

Abstract

Urinary incontinence is the involuntary loss of urine in sufficient amounts and with enough frequency to have negative health and social consequences. 1 Ouslander JG Johnson TM Incontinence. in: Hazzard WR Blass JP Ettinger WH Principles of Geriatric Medicine and Gerontology. McGraw Hill, New York1999: 1595 Google Scholar Identification of those with this symptom is not regularly accomplished because this is a problem that is underreported and underdiagnosed. Opportunities for early diagnosis and treatment are often missed owing to an individual's reluctance to address incontinence with his or her clinician because of embarrassment or shame. Clinicians fail to ask about urinary incontinence more than 90% of the time during outpatient care visits. 2 Fantl JA, Newman DK, Colling J, et al. Clinical Practice Guideline Number 2: Urinary Incontinence in Adults in Adults: Acute and Chronic Management. Rockville, Md: US Department of Health and Human Services, Public Health Service, Agency for Health Care Policy and Research; 1996. AHCPR publication 96-0682. Google Scholar One can speculate that the same might be true for clinicians visiting residents in the long-term care facility. Despite its prevalence, there is a lack of knowledge and understanding about urinary incontinence, its causes, and treatments. The prevalence of urinary incontinence in a community-dwelling population of elders is reported to be 30%. 3 Rutchik SD Resnick MI The epidemiology of incontinence in the elderly. J Br Urol. 1998; 82: 1-4 Crossref PubMed Google Scholar In long-term care, the prevalence is over 50%. 4 Ouslander JG Schnelle JF Incontinence in the nursing home. Ann Intern Med. 1995; 122: 438-449 Crossref PubMed Scopus (104) Google Scholar Urinary incontinence is frequently cited as the second most common reason for long-term care placement.