Although urinary incontinence (UI) can be managed conservatively, it is a principal reason for the breakdown of in-home family care. This study explored the social interaction processes of knowledge translation (KT) related to how UI management knowledge might be translated within in-home care. In-depth interview data were collected from a theoretical sample of 23 family caregivers, older home care recipients, and home care providers. Constant comparison and Glaser’s analysis criteria were used to create translating knowledge through relating, a substantive theory with 10 subthemes: living with the problem; building experiential knowledge; developing comfort; easing into a working relationship; nurturing mutuality; facilitating knowledge exchange; building confidence; fine-tuning knowledge; putting it all together; and managing in-home care. Findings inform both theory and practice of in-home UI KT, illuminating how intersubjectivity and bi-directional relational interactions are essential to translating in-home chronic care knowledge, which is largely tacit and experiential in nature.

Urinary incontinence is common in the elderly. The epidemiology of fecal and double (urinary and fecal) incontinence is less known. The Canadian Study of Health and Aging (CSHA) is a national study of elderly living in the community at baseline (n = 8,949) and interviewed in 1991–1992, 1996, and 2001. Using data from the CSHA, we report the prevalence of urinary, fecal, and double incontinence in each wave and the cumulative incidence between waves and investigate the predictors of urinary and fecal incontinence. Urinary incontinence increased rapidly in old age, being almost twice as high in women as in men. Fecal and double incontinence were less common, but also increased rapidly with age. In women, parity showed a positive relationship with (prevalent) urinary incontinence. In men, diabetes was a risk factor for urinary and fecal incontinence. We conclude that urinary, fecal, and double incontinence increase rapidly with age and that inquiry about incontinence should be part of routine medical and nursing assessment of all elderly.

This work seeks to identify factors that facilitate or diminish care-providers' propensity to improve continence care in long-term care (LTC) settings. We conducted a cross-sectional qualitative study using focus group methodology in four long-term care institutions in Montreal, QC. Forty-two nurses, nursing assistants, and orderlies caring for incontinent elderly residents were asked how they perceived urinary incontinence (UI), how it was being managed, and what factors enabled or hindered continence care in their institution. Content analysis was used. Facilitating and inhibiting elements of three individual/internal factors (beliefs about UI, attitudes towards the elderly, and knowledge about UI) and five institutional/external factors (workload demands, type of patient, environmental support, co-worker support, and attributes of UI interventions) emerged as important determinants of care-providers' propensity to manage UI. To be successful, continence programs must target multidimensional elements that take into account personal, systems, and organizational level factors.

While an association between UI and psychological distress among older adults has been established in the literature, the mechanisms underlying this relationship remain less clear. Using a sample of 4,689 older adults from the Canadian Community Health Survey (1.1), we test the potential mediating and moderating effects of four dimensions of social support on the UI–distress relationship. Incontinent older adults are significantly more likely to report higher levels of distress than continent adults. Although we do not find support for a mediating effect of any of the dimensions of social support, we do report a significant interaction between one dimension of social support (tangible support) and UI. A buffering effect of tangible support is evident for continent – but not incontinent – respondents. These findings emphasize the need to assess the types of social support and the context in which they operate.