Residents' perspectives on urinary incontinence: a review of literature

Background: Individuals in residential aged care facilities experience urinary incontinence more than any other single population. Despite these factors, the impact of the condition on their quality of life, their perspectives of living with the condition, and their preferences for care have received little research attention. Aim: To provide a descriptive overview of research about; the impact of urinary incontinence on residents quality of life; residents perspectives of having urinary incontinence; and their preferences for continence care. Design: A descriptive review of literature. Method: A broad search was undertaken for qualitative and quantitative research that evaluated residents quality of life related to urinary incontinence; their perspectives on having urinary incontinence, and their preferences for managing it. Data were displayed in tabular format, summarized, and described. Results: Ten studies were identified and reviewed (six qualitative and four quantitative). They reveal many residents value having independent bowel and bladder function, but believe that incontinence in inevitable and intractable. Some adopt self management strategies, however considerable barriers hinder their ability to maintain continence and manage incontinence. Residents often have low expectations, and hence decline further evaluation and treatment. Some express satisfaction with continence care even if this care is not consistent with their preferences. Little is known about how cognitively impaired residents perceive their condition. However some individuals with cognitive impairment respond with acute anxiety when carers attempt to provide continence care. Conclusion: Residents perspectives on incontinence and preferences for continence care relate to low expectations for improvement. Such misconceptions should be addressed and residents and their family members should be given a range of options from which to choose. As urinary incontinence impacts on residents quality of life, it is also important that continence care is delivered in a participative and sensitive way.