Urinary Incontinence in Disabled Elderly Women: A Randomized Clinical Trial on the Effect of Training Mobility and Toileting Skills to Achieve Independent Toileting

Background: Urinary incontinence is very prevalent in elderly women, and it is considered a major burden for both patient and caregiver. Objective: To determine feasibility and effect of training mobility and toileting skills on the severity of urinary incontinence in elderly, dependent women. Methods: In a randomized, single-blinded trial, 57 dependent, nondemented, elderly women with long-standing urinary incontinence and a mild to moderate disorder in mobility and transfers were recruited in 24 long-term care institutions. The participants were randomized to receive either no treatment (n = 28) or an individualized 8-week training program of mobility and toileting skills (n = 29), provided by physiotherapists and/or occupational therapists. Results: The intervention resulted in a 37.7% reduction in the daily amount of urine loss. Three women in the intervention group compared to none in the control group became continent. A change from dependent to independent toileting occurred in 6 women in the intervention group and in 2 women in the control group. All these results, however, were not statistically significant. The intervention did have a significant effect on the daytime sum score of the toilet timing test. Conclusions: This study suggests that it is possible to influence long-standing incontinence in dependent elderly women by training mobility and toileting skills. Future studies should have a larger sample size, and more attention should be paid to the motivation of the participants.