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A nursing analysis of the causes of and approaches for urinary incontinence among elderly women in nursing homes.

Urinary incontinence is a widespread but often ignored problem among elderly women residing in nursing homes. Despite numerous research studies performed within this setting, few have been able to demonstrate lasting change in the care of and enduring outcomes in this population. However, neither the most commonly used definitions of incontinence nor current management approaches are meeting the needs of institutionalized frail elderly, particularly women, who are twice as likely as men to demonstrate symptoms of the condition. Costs in terms of quality of life and expense of care are staggering. Because many believe that a holistic approach may provide direction for management of urinary incontinence, and because nursing is a holistic profession, a solution to the challenges involved in treating incontinence among the elderly potentially lies in utilizing a nursing as opposed to medical framework for the analysis of factors and care. Specifically, the complexities of testing necessary to differentiate current diagnoses might be simplified by classifying incontinence in a different way, such as using nurse-identified levels of need as opposed to physiologically-based factors. The use of nursing theory to guide patient assessment and an evaluation of systems of care provides a fresh approach to this long-standing problem.