Perspectives of frail older adults and family caregivers on Urinary Incontinence interventions: A qualitative study

Background Urinary incontinence (UI) is highly prevalent among older adults living with frailty and is associated with substantial social, emotional, financial, environmental, and caregiver-related burdens. UI is underreported, underassessed and undertreated in this population. Little is known about older adults’ perspectives and experiences of interventions for UI. Aim This study aimed to explore the experiences and views of older adults with frailty and family caregivers on conservative, pharmacological and surgical treatments for UI. Methods A qualitative descriptive study was conducted using semi-structured interviews with community-dwelling frail older adults experiencing UI and family caregivers. Data were analysed using reflexive thematic analysis. Findings Ten participants were recruited (five older adults living with frailty and UI and five family caregivers). Five themes were identified. Theme 1 revealed current self-management strategies for UI and their limitations. Theme 2 describes the prevailing sense of UI treatment nihilism, as participants expressed the belief that UI is an inevitable part of ageing. Older adults with frailty voiced concerns about the potential caregiver burden associated with new treatment approaches, as highlighted in theme 3. Theme 4 indicated a reluctance amongst participants to consider invasive conservative interventions as potential options for UI treatment. In contrast, in theme 5, both older adults with frailty and caregivers displayed a cautious willingness to try new conservative interventions. Conclusion Findings indicate support from older adults with frailty and carers for non-invasive conservative interventions for UI. Acceptability was influenced by treatment burden, caregiver involvement, dignity, perceived effectiveness, and beliefs regarding the inevitability of UI in later life.