Obscuring urinary incontinence. Diapering of the elderly.
To assess the prevalence, evaluation, and treatment of urinary incontinence in an institutionalized elderly population, the charts of 511 residents in a New York City nursing home were reviewed. Whereas the nurses' notes documented urinary incontinence in 62.4% of the total resident population, the physicians' notes listed this as a problem in only 10% of the residents. Most (90.3%) of the cases of incontinence were not classified as to etiology or pattern. Treatment emphasized the use of diapers in 78.2% of the cases, which was combined with bladder conditioning in most instances. This treatment approach had been initiated, administered, and monitored by the nursing staff. Indwelling catheters were used in 4.0% of the situations, and pharmacologic therapy was used in 2.5% of the cases. It is suggested that adult diapers may not be the optimal treatment for urinary incontinence since they treat the symptom instead of the cause. There should be a systematic approach to the classification and treatment of urinary incontinence prior to the long-term utilization of diapers.
D000368:Aged; D001521:Behavior Therapy; D002408:Catheters, Indwelling; D003020:Clothing; D005260:Female; D006801:Humans; D008297:Male; D009735:Nursing Homes; D012189:Retrospective Studies; D014549:Urinary Incontinence / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*