Living with incontinence : a qualitative study of elderly women with urinary incontinence

Urinary incontinence has been described as a devastating symptom, an embarrassing condition, and a major geriatric problem, creating substantial personal, medical, and social difficulties. Urinary incontinence is a problem which affects men and women of all ages, but is predominantly a concern for elderly women! It is estimated that 50% to 75% of cases of incontinence are hidden or unreported. A review of the literature on urinary incontinence reveals numerous studies describing prevalence rates and types of incontinence. Characteristics of incontinent individuals and experimental studies comparing different treatments are also available. However, qualitative studies of urinary incontinence as it is experienced by elderly women are nonexistent. The purpose of this study is to explore and describe the impact of living with untreated urinary incontinence upon the daily lives of elderly women living in the community. The phenomenological approach to qualitative methodology was used for this study. This approach seeks to discover and describe the human experience as it is lived, and for this study, that experience was living with untreated urinary incontinence. Incontinent women, 60 years of age and over, were contacted through seniors' community centres, seniors' newspapers, and community service agencies. Nine women served as informants and participated in intensive interviews guided by open-ended questions. Verbatim transcriptions of these interviews and field notes from contact with seniors provided the data for analyses. Four major themes comprise the research findings: the recognition of incontinence, the avoidance of exposure, the need for information, and the redefinition of normal. The first theme describes the women's struggle to recognize the incontinence for what it was, acknowledging to themselves that it was an ongoing problem. Even after incontinence was recognized, the women emphasized the importance of keeping their symptoms hidden. This avoidance of exposure necessitated reorganization of their lives and limited opportunities to talk about problems with incontinence. Despite their hesitation in talking about incontinence, the women identified a compelling need for information. Finally, over and above these three management strategies, living with incontinence led to an attitudinal strategy of redefining what would constitute normal. For these women, this new definition of normal included incontinence. In light of these findings, implications for nursing education and practice are identified. Suggestions for future research stemming from this study conclude the discussion.Applied Science, Faculty ofNursing, School ofGraduat