Training Found Able to Reduce Urinary Incontinence

A study reported recently said simple behavioral techniques may offer some solutions to urinary incontinence, which affects at least 4.6 million Americans and has annual health care costs about $10 billion.

Study director Teh-wei Hu, a health economist for the University of California at Berkeley, told a national meeting of the Gerontological Society of America that he found even very elderly people could learn the techniques to control their inability to hold urine until an appropriate time and place.

About 50% of all nursing home residents and 9% of all adults living outside such homes suffer from the problem, Hu said.

While some can be helped with surgery or medication, others--especially the elderly--must rely on other solutions such as adult diapers or catheterization.

Yu said that after a 13-week training program, he and his colleges found elderly nursing home residents with the highest frequency of “wet episodes” significantly reduced their incontinence.

Among 133 elderly women in seven Pennsylvania nursing homes, Hu said participants reduced these episodes by an average of 26% when trained and encouraged to ask for help getting to a bathroom quickly.

He said some of the 65 women who received training reduced their incontinence up to 75% and even six weeks after training stopped, the women still asked for help more than before.

While society views incontinence as an inconvenience rather than an illness, Hu said the problem can create secondary and sometimes serious health problems. They include skin irritations, bladder infections from catheterization and falls from slipping.

Families sometimes put older relatives in nursing homes because they can’t cope with the problem.

In addition to obvious costs such as diagnosis, treatment, laundry, sanitary supplies and labor, Hu said the condition results in extra hospitalizations, extended hospital stays and lost work time for those suffering incontinence and their families.

Although some diagnostic and treatment costs are reimbursed by insurance companies or the government, Hu said most individuals or nursing homes bear costs of routine care.

In 1987, that amounted to about $10.3 billion, he said.

“The magnitude of the impact of urinary incontinence on health care costs is quite substantial,” Hu said.

He conducted the three-year study in cooperation with clinicians from the Pennsylvania State University Hershey Medical Center on a grant of more than $1 million from the National Institute of Aging and the National Center for Nursing Research.

The Gerontological Society is the largest and oldest organization in the field of aging. It has more than 6,500 members worldwide.