Differences in coping strategies among community-residing older adults with functional urinary continence, dysfunctional urinary continence and actual urinary incontinence.

With a prevalence of urinary incontinence in the community of approximately 30 percent for older adults, and mixed findings on the relationship between psychosocial effects and bladder patterns, it is important to understand the effective (functional) and ineffective (dysfunctional) coping mechanisms older adults use to confront incontinence. This study examined 117 participants who were mentally competent, able to communicate in English, not confined to bed, and residing in the community. Ages ranged from 58 to 93 years with a mean of 75.6. Participants were distributed into three groups: dysfunctional continence (28.2%), functional continence (32.5%) and urinary incontinence (39.2%). A self-reporting, 4-point, Likert-like scale was used to determine coping methods. The functional continence group varied significantly from the dysfunctional continence and actual incontinence groups. Chi-square analysis indicated significant differences between the two groups in four items regarding the use of fluid restriction, management of odor, attitude, and the influence of age. There were significant differences in coping scores and gender, with women scoring higher. Finally, 73 to 85 percent of the dysfunctional continence and actual incontinence groups never talked to any healthcare provider about their urinary concerns. These high percentages emphasize that nurses must actively seek ways to open communication and discuss sensitive topics with older clients.