Behavioral modification for institutionalized individuals with urinary incontinence.

OBJECTIVES: To review the evaluation of urinary incontinence (UI) in institutionalized individuals and to discuss the use of behavioral modification in this population.
METHODS: The functional characteristics and patterns of incontinence typical of the institutionalized population are described to explain the rationale for the use of behavioral therapies.
RESULTS: Both mental and physical status must be evaluated when considering behavioral therapies for UI in institutionalized patients. Institutionalized individuals often have significant functional impairment that prevents the use of behavioral therapies requiring extensive patient participation. Assessments of bladder function and the severity of UI are also important when planning therapy. In appropriate candidates, a prompted voiding program can be expected to reduce the severity of incontinence and improve the quality of life, even though normal bladder control is rarely achieved. Standardized protocols for the implementation of a prompted voiding program have been developed.
CONCLUSIONS: Few treatment options for UI are feasible for use in institutionalized individuals. However, prompted voiding can reduce the severity of UI in most of these patients and will thereby improve the quality of life.