Prevalence of and Risk Factors for Urinary Incontinence in Home Hospice Patients

Abstract

Urinary incontinence (UI) is a debilitating and embarrassing condition that is prevalent among aging males and females. Little is known about UI in the home hospice setting. We sought to determine UI prevalence and risk factors in a cohort of 15432 home hospice patients over 4yr. Most of the study patients were female (59%) and aged ≥75yr. This was a retrospective observational study and no patients were excluded. The median length of service was 19 d. Approximately one-third of patients were diagnosed with UI during their hospice stay. Female sex and age were associated with a greater risk of UI. Diagnoses that increased the risk of UI included dementia and stroke. The risk of UI diagnosis was lower among those without a health care proxy, as well among those with higher Palliative Performance Scale scores. UI affects a substantial number of patients in home hospice and there are no guidelines for its diagnosis or mitigation. There is a pressing need to further understand the impact of UI on home hospice patients. PATIENT SUMMARY: We investigated the prevalence of urinary incontinence (UI) among home hospice patients. Approximately one-third of patients were diagnosed with UI during their hospice care. Female sex, age, dementia, and stroke were associated with a greater risk of UI. Guidelines are required for UI diagnosis and mitigation in home hospice care.

Keywords: Home hospice; Older; Palliative care; Prevalence; Risk factors; Urinary incontinence.