The role of functional assessment in evaluating urinary incontinence

Abstract

Particularly for older people, ability to function can play an important role in generating and maintaining continence. Assessment of function is essential to proper clinical evaluation and treatment of urinary incontinence. Physical, mental, environmental, and social factors should be evaluated, including mobility, balance, musculoskeletal strength and flexibility, fine motor coordination, vision, body awareness, ability to understand and follow simple instructions, motivation, access to toilet, adequacy of physical supports, availability of a caregiver, caregiver-patient dynamics, and the effect of incontinence on social interactions. Assessment strategies should involve careful first-hand observations, use of clinically appropriate assessment instruments, and, where indicated, use of a geriatric assessment team. A functional profile is useful in tailoring treatment strategies to the needs and strengths of individual patients, as well as in monitoring progress. The development of treatment plans is often best carried out in the setting of a health-care team conference.