Why continence matters: A social work perspective

The International Continence Association defines urinary incontinence (UI) as the involuntary leakage of urine (Abrams, et al., 2003; Getliffe & Thomas, 2007). UI is a symptom or a collection of symptoms, not a disease (Hope, 2007; Perry, 2008). UI is widely underreported and undertreated (Fonda & Newman, 2006; Getliffe & Thomas, 2007; Lara & Nancy, 1994). These circumstances reflect (at least in part) reluctance among many health care workers to face UI squarely (Hope, 2007; Locher, Burgio, Goode, Roth & Rodriguez, 2002). Part of this reluctance may be attributable to lack of skills and knowledge (Getliffe & Thomas, 2007; Hope, 2007; Locher et al, 2002). Reflective practitioners must also recognise, and guard against, being influenced by their own life experiences and beliefs (Phillips, Ray & Marshall, 2006) and by erroneous and unhelpful beliefs in the society at large (Brashler, 2006; Getliffe & Thomas, 2007; Hope 2007). Moreover, the failure of persons suffering chronic conditions to be ‘cured’ can elicit negative reactions from health workers (Brashler, 2006).Ageism, defined as ‘a set of beliefs, attitudes, social institutions, and acts that denigrate individuals or groups based on their chronological age’ negatively impacts on older persons’ health and well-being (Whitbourne, 2005, p. 51; see also Butler, 1975; Myers & Schwiebert, 1996; Wilson, Ruch, Lymbery, & Cooper, 2008). The beliefs of individuals, families and groups too often do not reflect the reality that most persons with UI can be helped (Fonda, 2006: Getliffe & Thomas, 2007; Naughtin & Schofield, 2009; Locher, et al., 2002). This article addresses how health care social workers can contribute to delivering this central message to clients, whanau and other caregivers.