Incontinence Today: Changes in Care, Changes in Attitude

Catherine T. Milne, APRN, BC, MSN, CWOCN, ANP
Lisa Q. Corbett, APRN, BC, MSN, CWOCN
Tracy Houle, APRN, BC, MSN, CWOCN

Speaking as clinicians who practice in various settings along the continuum of care, we feel that this year marked some progress in the treatment of incontinence for our patients. Long-term care facilities are beginning to consult incontinence specialists on a routine basis; nurses are discussing incontinence issues with practitioners and initiating bowel and bladder training more often. In acute care settings, the diagnosis of “urinary incontinence”(instead of the order for “Foley catheter”) is showing up more frequently in medical histories and on problem lists.

Medications for incontinence are more easily identifiable, and surgical procedures to alleviate incontinence are more commonly performed. In the clinic setting, patients are initiating conversations about continence. Home care nurses are identifying incontinence as a co-morbidity factor for safety, readmission and outcomes.

In this new era of “evidence-based practice,” we have witnessed significant strides in the evidence supporting interventions for incontinence. The Cochrane reviews and other analyses, readily available online, inform clinicians about the strength of evidence for the success of incontinence-related medications, surgical procedures, behavioral strategies and mechanical devices.

Clinical algorithms help to guide clinical care, establish benchmarks and create an impetus to begin research in needed areas. With so much guidance at our fingertips, we should be able to attack incontinence with the same vigor as we do the other symptoms and conditions that we treat.

As both the public and health care professionals become exposed to the topic of incontinence through pharmaceutical print advertisements and other media, we all become a little bit more comfortable with the subject. Attribute it to the aging of baby boomers or the desensitization of “personal” information via medical television shows—whatever the cause—we are embracing the message that incontinence is not an inevitable part of aging and that treatments are available.