Incontinence among elderly community-dwelling dementia patients. Characteristics, management, and impact on caregivers.

Incontinence was identified by 36% of 184 caregivers as a problem in their care of older community-dwelling patients with dementia. Incontinent dementia patients had greater impairment of cognitive function and more frequent behavioral problems than did patients without incontinence. Burden scores were higher among caregivers of incontinent patients, but multiple regression analyses indicated that factors other than incontinence contributed more to perceived burden. Follow-up interviews revealed that incontinence had played an important role in most decisions to institutionalize among caregivers of patients who were placed in a nursing home between interviews; it rarely, however, was the primary reason. The majority of incontinent patients still residing in the community were being managed by nonspecific techniques such as diapers and toileting schedules. These data emphasize the need to educate community caregivers of dementia patients in the appropriate management of incontinence and the need for further research on methods of effectively targeting assessment and treatment strategies to this patient population.