Elderly woman sitting on couch with hands on lap. The atmosphere is calm and bright.
Urinary incontinence is very common, especially among older women.
Photo: Getty Images

Better care for elderly people with incontinence


Incontinence is a major problem, especially among elderly women. A research collaboration between health and care science and gynecology aims to improve the quality of care provided to elderly people with incontinence in assisted and ordinary living facilities.

One in five women in Sweden has surgery for incontinence at some point in their lives. Living with urinary leakage has a very negative impact on daily life, despite the current availability of a variety of aids. Urine leakage is very bothersome and it that can be difficult for elderly and frail people to cope with it. In addition to the risk of ulcers and other skin problems, urinary incontinence also has a negative impact on relatives and other social relationships.

Anastasia Silverglow, a postdoctoral researcher at the Institute of Health and Care Sciences, is responsible for the work. She completed her PhD in 2022 with a thesis on how frail elderly people can be safely cared for at home, and is an expert in the qualitative studies that will now be carried out.

“A previous study has shown that although care is good, the level of knowledge about the use of the right incontinence aids is too low. All too often, elderly people in assisted living facilities are given a single incontinence device, with the attitude that “one size fits all”, which is not true at all. Individual people’s incontinence problems and their needs can be very different,” says Anastasia Silverglow.

Qualitative interviews

In the project that is about to start, data will be collected through interviews with elderly people living at home, but also partly in assisted living facilities. Nurses and specialist nurses within elderly care will also be included, as well as key staff for other municipal care settings.

Helle Wijk, Professor at the Institute of Health and Care Sciences, is involved in the research study. She stresses that incontinence care must be provided on a person-centered basis:

“It is very individual what people prioritize in their lives and what they think makes life better. Therefore, healthcare providers must listen to people with incontinence so that their care and their aids can also be individualized,” says Helle Wijk, whose research is linked to the Centre for Person-Centred Care (GPCC) at University of Gothenburg.

“We want to know what people with incontinence think. What is important to make their lives as good as possible? It often differs from the caregiver’s view of what is most important,” says Ian Milsom, Senior Professor in the Institute of Clinical Sciences.

Multidisciplinary research center

The research is part of the Gothenburg Continence Research Center (GCRC), which was established in 2016 on the initiative of Professor Ian Milsom and with funding from Essity. From the outset, the center has taken an multidisciplinary approach to improving knowledge, care and prevention of incontinence.

tre porträtt av de tre forskarna, fotograferade utomhus en ganska mulig vinterdag. De ser glada ut.
Anstasia Silverglow, Helle Wijk and Ian Milsom. ​<br /> Photo: Elin Lindström
Photo: Elin Lindström

“We have previously done research on pregnancy and how it affects the risk of developing incontinence later on. ‘We have now joined forces with the Institute of Health and Care Sciences to try to improve the quality of care for elderly people with incontinence,” says Ian Milsom.

Previously, joint studies have been conducted with the Centre for Person-Centred Care (GPCC) at the University of Gothenburg, where they implemented an educational initiative to improve incontinence care in two assisted living facilities.

“We could see that the training initiative worked well, but we learned that a one-off intervention is not enough. The effort must be supported at management level to be sustainable and have a long-term impact,” says Helle Wijk.

Adrian Wagg, Professor of Healthy Ageing, University of Alberta.

In parallel with the Gothenburg research project, the same study is being carried out by researchers at the University of Alberta in Canada, where Adrian Wagg, Professor of Healthy Ageing, is the lead researcher. The collaboration with Adrian Wagg has been well established for many years, and he is also an affiliated professor at Sahlgrenska Academy.