Interventions for Treating Urinary Incontinence in Residential Care: A Narrative Review

Background: Urinary incontinence (UI) is highly prevalent in elderly people residing in nursing homes. Care staff often lack the knowledge and management skills to effectively care for and treat residents with UI. The implementation of standardised treatment interventions at the individual or nursing home level can help to successfully manage and reduce UI in elderly residents. Aim: Review intervention studies evaluating the effectiveness of different treatment interventions in managing and improving UI in residential care. Data sources: MEDLINE and PubMed were searched from 2005-2019 using selective search strategies, detailing interventions and randomised controlled trials (RCTs) in residential care and nursing homes, focusing on elderly people. Pharmacological and surgical interventions were excluded. The search was limited to studies published in the English language. Methods: A narrative review of studies aimed at reducing UI and improving continence in nursing home residents. Results: 10 studies were identified that reported on interventions to improve continence care, and reduce UI with behavioural and conservative approaches for residents and/ or educational training for staff. Assessment of UI varied widely in each study from recording of prompt voiding and frequency, electronic devices, diary assessment, support and motivation from care staff, to quality of life. None of the studies could be compared on intervention effectiveness in terms of outcome and assessment. Conclusions and implications: Even though all studies reported some sort of improvement of UI, no comparisons can be made between studies. A core outcome set would be of great benefit to standardise the assessment and allow comparison of intervention effectiveness of UI in elderly.