Management of incontinence in the elderly.

Urinary incontinence in the elderly will continue to grow as a health and lifestyle issue as this population expands. Additionally, as older Americans seek to remain active in their careers and recreational pursuits, they are likely to be more intensive in seeking consultation for this condition. Evaluation of incontinence has become simpler and more focused to allow for an earlier and more precise diagnosis, which in turn expedites therapy. In the past, surgery was often thought of as the sole modality, which likely prevented larger numbers of patients from seeking relief. Today, more conservative treatments tend to bring more patient referrals to physicians' offices. Incontinence affects 15-30% of older patients living at home, one-third of those in acute care hospitals, and half of those in nursing homes. It is responsible in part for up to half of all nursing home admissions. Because of the diagnostic and therapeutic variability between men and women, a gender-specific discussion is called for. Catheter care is sufficiently challenging so as to merit a specific tutorial.