Urinary incontinence in the long-term care facility.

Urinary incontinence is a common and expensive problem in United States long-term care facilities. The impact of urinary incontinence on residents, family, and staff is significant and may be exacerbated by lack of appropriate assessment and management. Aging, hospitalization, and resident and staff attitudes and behavior all affect a resident's continence. Inadequate and untrained nursing staff, lack of interdisciplinary effort, and "efficient" care delivered at the expense of quality precipitate learned helplessness and subsequent incontinence in the long-term care facility. Immobility, the greatest contributing factor to cascade iatrogenesis, is influenced by the environment, medical treatment, lack of physical and occupational therapy, and policy factors. Management interventions are necessary to prevent and manage urinary incontinence in the long-term care facility through appropriate assessment and interdisciplinary care planning.