Incontinence management
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THE (MANY) BENEFITS OF PROMPTED VOIDING PROGRAMS
Clearly, corrective action is needed. Besides being "the right thing to do," providing proper toileting assistance to residents makes sense clinically and economically. Urinary incontinence is estimated to cost nursing homes close to $5 billion annually (12). Some of these costs are ill-directed due to staff failure to identify residents responsive to toileting assistance. This oversight often means that staff will waste time trying to toilet some residents who are unresponsive to their help while better candidates go without proper assistance. Urinary incontinence also is associated with a high rate of infection, requiring costly medical treatment both in the hospital and within the nursing home. Prevention programs such as prompted voiding address both problems, enhancing clinical outcomes for residents while possibly improving the facility's bottom line.
Prompted voiding programs also offer enormous PR value. In one consumer survey, we asked family members and older board-and-care residents to compare the value of an intervention that improves continence to other nursing home perks such as improved meals or moving from a two-person room to a single. By wide margins, the respondents rated the incontinence prevention program higher than the other, more customary options (5).
Additionally, prompted voiding programs can contribute to better scores on publicly reported quality measures for nursing homes. The Centers for Medicare and Medicaid Services now publishes nursing home "report cards" on its consumer website, www.medicare.gov. Among the quality measures reported are the percentage of residents in a facility with infection and the percentage with loss of ability in basic daily tasks, which includes using the toilet. By improving continence among residents, prompted voiding programs may produce better "grades" on a facility's report card.
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