Urinary Incontinence and Nursing Home Residents’ Quality of Life
The incidence of urinary incontinence (UI) in American nursing homes is high. According to recent studies, between 43% and 81% of nursing home residents in the United States have UI.[i] Urinary incontinence is increasingly common with age, and older adults with UI often have underlying cognitive and mobility problems. Urinary incontinence can increase risks of falls and fractures, as well as risks of urinary tract infections and skin irritation.
To evaluate the effects of UI on nursing home residents’ quality of life (QOL) and domains of QOL, Dongjuan Xu, RN, of both the Shandong University School of Nursing in China and the University of Minnesota School of Public Health, and Robert L. Kane, MD, of the school of public health, analyzed data from the Long-Term Care Minimum Data Set, the 2010 Minnesota Nursing Home Report Card, and 8,600 Minnesota nursing home residents’ responses to a questionnaire.
The questionnaire asked each resident question about both his or her overall quality of life, and about 11 domains of quality of life. The questionnaire also asked the residents about their mood. The residents had an average age of 87 and two-thirds of the residents leaked urine and, as a result, met the criteria for UI.
The 11 domains of quality of life included:
- environmental adaptation,
- meaningful activity,
- food enjoyment,
- relationships, and
The study, “The Effect of Urinary Incontinence on Older Residents’ Self- Reported Quality of Life in Nursing Homes,” found that both residents who had UI, and those who did not, ranked their overall quality of life similarly. Both groups gave it an equally high average score of 7.0 out of 10. Both groups also ranked eight of the 11 domains of QOL similarly.
“We found no difference between residents with and without UI in the domains of comfort, environmental adaptation, privacy, meaningful activity, individuality, security, relationships, and satisfaction,” the researchers report. Residents with UI, however, reported lower scores in the domains of dignity and autonomy, as well as mood, than those who did not have urinary incontinence.
“The embarrassment of wetting themselves may result in residents feeling a loss of personal dignity (so these) residents… make extra efforts to preserve dignity,” Dr. Kane and Ms. Xu note, emphasizing the importance of dignity among these older adults. In light of this, long-term care facilities should focus on protecting and fostering dignity among these older adults, the researchers recommend.
“These findings underscore the need for improved recognition of how UI affects nursing home residents’ quality of life,” write the researchers. “Interventions should specifically target…domains of dignity, autonomy, and mood among nursing home residents with UI to improve their quality of life.”
“The Effect of Urinary Incontinence on Older Residents’ Self-Reported Quality of Life in Nursing Homes.” It appears in the September 2013 issue of the Journal of the American Geriatrics Society. The report is authorized by Dongjuan Xu and Robert L. Kane, MD.
[i] Effect of urinary incontinence on older nursing home residents' self-reported quality of life. Xu D, Kane RL. J Am Geriatr Soc. 2013 Sep;61(9):1473-81. doi: 10.1111/jgs.12408. Epub 2013 Aug 8.