A research agenda for promoting continence for people living with dementia in the community: Recommendations based on a critical review and expert-by-experience opinion.
Vanessa Burholt, Johanna Davies, Michal Boyd and 2 others
PMID 33091190WHAT IT FOUND
Home continence care for people with dementia is under-researched.
The review found no robust evidence for most interventions, yet clinicians should assess causes, discuss continence, and avoid defaulting to containment alone.
Key findings
01Continence care for people with dementia in the community is under-researched, and the reviewed intervention studies were often small or methodologically flawed.
02Clinicians and healthcare practitioners should initiate conversations about continence and assess root causes, because people with dementia and caregivers may be reluctant to raise it.
03Containment products are often the first or only solution offered, but there are no randomised trials comparing different products or comparing products with other strategies.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for RNs
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What it does not show
This is a critical review and expert-by-experience opinion, not a trial or a formal systematic review, so it cannot show that any continence intervention works. The review did not formally assess the quality of the included studies. The Expert Review Group was based mainly in Wales, UK, and the included studies came from several high-development countries, so local systems and practices may differ. Many intervention studies did not involve people with dementia or caregivers, so acceptability and outcomes important to them were often not measured. Prevalence and incidence varied widely because dementia and incontinence were measured in different ways and samples differed.
Declared interests
The authors declare that there are no conflicts of interest.
The easy way to misread this
Do not treat the many suggested toileting aids, alarms, behavioural prompts, containment products, or medication practices as proven. The review says evidence is limited, studies were often flawed, and future research is needed to test what works.