Promoting effective continence care for older people: a literature review.

Recent United Kingdom guidelines have identified the need for integrated continence services within health regions. While there is evidence of improvements in community services there is little evidence that the quality of nursing care offered for older people with urinary incontinence in care settings has improved. This literature review identifies some of the underpinning issues that impact on continence promotion for older people. Despite evidence that older people suffer physical, social and psychological distress as a result of mismanaged urinary incontinence, costs of promoting continence are higher in financial terms than containing incontinence. The extent of the problem is difficult to identify in terms of how many older people are affected by different types of urinary incontinence. Nurses' attitudes are found to affect the quality of continence care delivered, and there continues to be a lack of evidence around sustainable strategies for continence promotion in care settings.