As we recently transitioned to 2024, I wasn’t even a little bit surprised to read on the second day of the new year an article written by a pharmacist related to helping people grow old safely at home by reducing their risk of falls. These types of aging-in-place articles have become quite common as more older adults express a desire to stay in their own homes versus living in senior living communities.
On a weekly basis, one can probably read at least two or more articles along these lines in these pages and a host of health care-related publications. I share this finding in a positive light as “it takes a village” to care for older adults, and, as we have learned over time, education and knowledge are critical to overall well-being.
Articles on this topic often touch on safety checklists, hospital-at-home program adoption, federal reimbursement rates and their effect on care in the home, caregiver staffing challenges, the importance of navigating medication management, and so on. The authors may focus on the importance of proper grab bar installation, suitable home lighting, transportation options for older adults, home monitoring needs, home security, the side effects of specific drug therapies, etc. They often suggest solutions to keep people healthier, happier and in their homes for longer periods. In my opinion, these authors deserve a thumbs up, as they demonstrate their passion and commitment to helping older adults maintain quality of life as they age.
Unfortunately, even with all of this great content, the subject of urinary incontinence challenges for older adults living at home is often overlooked. But understanding how to manage urinary incontinence can be as essential as many of these other topics in terms of producing favorable patient outcomes.
Think about medication management, for example. While both topics immensely affect the quality of life connected to people aging in place, medication management content is widely publicized, but it is rare to read even one or two sentences about handling urinary incontinence and its link to keeping people safe at home.
Think about the many nurse practitioner groups, mobile physician groups and expansion of in-home acute care programs that are taking care of patients where they live today. Think about the many pharmacists who have become consulting pharmacists, working with hospital discharge planners, to specifically ensure that patients leaving the hospital understand their prescribed medications to ensure their safety back at home. Think about the mobile X-ray groups that are now equipped to service people in their home settings.
While all of these offerings are intended to provide significant value for people, the reality is that if a person living with incontinence is wearing an inferior brief or pull-up that leaks, these other acts of assistance can be all for naught. For example, if a person falls, gets a urinary tract infection (UTI), or develops a pressure injury due to a lack of education addressing urinary incontinence and how to properly choose incontinence products, other efforts to keep them safe at home can be quickly nullified.
There is a lot to understand regarding the implications of urinary incontinence challenges. We should no longer be thinking about adult incontinence products as a disposable commodity. As more people wish to stay in their homes, it is time to shift our mindset to thinking about choosing high-quality incontinence products as a critical component of the continuum of care. In a sense, addressing urinary incontinence is as essential as addressing medication management.
For example, most providers will look for ways to avoid medications when they can. Diabetes is one instance of how lifestyle changes may prevent a person from having to take medication for a disease.
Educating oneself about urinary incontinence shares common ground. How do we improve some level of continence first? Are medication side effects the culprit? Does a toileting schedule help improve the situation? How many people are familiar with Kegel exercises?
Prescribing medications is complex, as the physician must understand the most appropriate medication for an individual, the proper dosage and the potential side effects of the prescribed medication—and all parties must understand how and when to take the medication. Most will agree that many improvements in the health and overall well-being of older adults can be attributed at some level to over-the-counter and prescription medications developed throughout the decades. When done right, they help improve quality of life.
The same principles ring true when people living with incontinence are wearing a fully breathable product that has inner leak guards, has no plastic acquisition distribution layer, is super absorbent and is the right size. High-quality products have features that help reduce the risk of falls, UTIs and pressure injuries.
Correct product sizing can be compared to the proper dose of medication—for it to work the way it was intended, size matters just as much as dose does. When done right, understanding urinary incontinence and knowing how to choose proper absorbent products also helps improve quality of life.
In a 2023 report published by the National Library of Medicine, caregivers reported that 53% of homebound elderly are incontinent. While urinary incontinence is not a disease, when and if we start thinking about this common chronic condition with regard to being as essential as medicine, people living with urinary incontinence will have a better chance to age in place at home with overall improved outcomes.
