Promoting urinary continence in older people: proactive primary care

Abstract

GPs and practice nurses are important primary care partners for patients with urinary incontinence, who often require care co-ordination and long-term management. Multidisciplinary care through a continence clinic may also be valuable. Key Points Primary care providers are well placed to support older people with urinary incontinence. Urinary incontinence in an older person often arises because of more than one reason. Some factors may be reversible while other factors are not, so a careful basic evaluation can be rewarding. The management approach needs to be individualised based on the older person’s overall condition, and their wishes regarding investigations and treatments must be respected. It is important to recognise when referral for specialist care is required, for example if a ‘red flag’ condition is present or first-line treatments have not resulted in improvement.