Understanding help-seeking behaviour in older people with urinary incontinence

Abstract

Background: The prevalence of urinary incontinence (UI) increases with age and can negatively affect quality of life, yet relatively few older people with UI seek help for this treatable condition. We sought to increase our understanding of this issue via an interview study. Methods: Older people with UI were recruited from three continence services: a geriatrician-led hospital outpatient clinic (n=18), a community based nurse-led service (n=22) and a consultant gynaecologist-led service specialising in surgical treatment (n=10). Data generated via semi-structured interviews was analysed using thematic content analysis. Findings: Three main themes emerged from the analysis: ‘Being brushed aside’, where participants expressed the feeling that general practitioners did not prioritise or recognise their concerns; ‘Putting up with it’, where participants delayed seeking help for their UI due to various reasons including embarrassment, the development of coping mechanisms, perceiving UI as a normal part of the ageing process, or being unaware that help was available; and ‘Something has to be done’, where help-seeking was prompted by the recognition that their UI was a serious problem, whether as a result of experiencing UI in public, the remark of a relative, the awareness that they had a serious illness, or the detection of UI during comprehensive geriatric assessment. Discussion: The lack of awareness of UI as a treatable condition that does not arise inevitably with ageing is a barrier to both seeking and receiving appropriate help. This issue needs to be addressed, both in the general population and amongst health professionals.