An Overactive Bladder Changes Quality of Life - Many Living in Long-Term Care Facilities Suffer with Bladder Issues

Bladder and incontinence issues increase as you get older, affecting your quality of life. The risks increase as you age and often coincide with other health problems like diabetes and Alzheimer's.

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An Overactive Bladder Changes Quality of Life - Many Living in Long-Term Care Facilities Suffer with Bladder Issues
4 Min Read July 20th, 2022

If you are over age 40, you probably notice that you need to go to the bathroom more frequently. The prevalence of overactive bladder with or without incontinence increases with age in both women and men. An overactive bladder (OAB) can alter someone's lifestyle, especially as you age.

Approximately 30 million Americans suffer from the annoying symptoms of OAB, which can significantly impair an individual's day-to-day activities. Overactive bladder is a common problem among older adults, affecting up to 40% of men and 30% of women ages 75 years and older. 

The problem can be embarrassing. Not only does someone have to get to the bathroom more often, but some people also leak urine by accident. Urinary incontinence (UI) is more common in older women. 

What is OAB?

Overactive bladder occurs when the bladder muscle contracts involuntarily. Symptoms may include urinary urgency (the sudden urge to urinate that is difficult to control), urgency incontinence (unintentional loss of urine immediately after an urgent need to urinate), frequent urination (usually eight or more times in 24 hours), and nocturia (waking up more than two times in the night to urinate.

As you age, you are also at higher risk of numerous other diseases and disorders. Conditions like diabetes and enlarged prostates can contribute to other problems with someone's bladder function. Many people with memory issues — for instance, those who have had a stroke or have Alzheimer's disease — also develop bladder problems.

People who live in long-term care facilities often must deal with OAB problems. A just-published survey of Directors of Nursing in U.S. long-term care settings highlighted the need for improved awareness, education, and management of UI related to OAB for those in long-term care settings. 

The survey results were included in a paper titled "Impact of Urinary Incontinence Related to Overactive Bladder on Long-Term Care Residents and Facilities: A Perspective from Directors of Nursing," published in the Journal of Gerontological Nursing.

The survey showed:

  • 62% of LTC residents had UI, with 81% of these residents managed using incontinence products. 
  • UI is a substantial burden to LTC facilities, residents, and staff. The survey reported that UI management protocols contribute to staff turnover, quality measures, and resident safety – with an average of 36% of resident falls occurring while trying to get to a bathroom.
  • Only 14% of residents with UI were being treated with medication. The majority of those treated were on anticholinergic medications. Anticholinergics are a broad group of drugs that act on the neurotransmitter acetylcholine. Numerous medications fit this category.
  • 75% of the Directors of Nursing were unaware of the potential link between anticholinergic medications and the associated risk of cognitive side effects. Given that many people in long-term health care facilities are older, this could significantly impact the quality of life for those people.

Few long-term care facility residents were treated with medication to lessen the impact of their condition. Most people are left to cope with their symptoms, using adult hygiene products.

  • 81% of residents with UI used incontinence products
  • Only 14% of residents with UI were treated with medication

The lead author of the report, Richard Stefanacci, D.O., of the Jefferson College of Population Health, Thomas Jefferson University, Philadelphia, said that drug therapy that does not add to anticholinergic burden may be the most appropriate.

Our survey suggests that long-term care residents with mobility issues, especially those requiring staff help for toileting, may benefit from safe and efficacious medication to control urgency, allowing more time to access the toilet.


Dr. Richard Stefanacci  

Proper Medication Can Improve Quality of Life

Sef Kurstjens, M.D., Ph.D., the Executive Vice President and Chief Medical Officer of Urovant Sciences, says that the goal should be to improve the dignity and quality of life of those living in long-term care facilities. The development and commercialization of additional OAB treatment options can improve the overall quality of life.

Dr. Sef Kurstjens

The survey emphasizes the need for improved OAB awareness and education in the long-term care provider community. A significant unmet need remains among long-term care residents with incontinence related to OAB.

 Dr. Sef Kurstjens

Urovant Sciences is a biopharmaceutical company that focuses on developing innovative therapies for areas of unmet need, with a dedicated focus on Urology. The company's lead product, GEMTESA, is a treatment for adults with overactive bladder with symptoms of urge urinary incontinence, urgency, and urinary frequency. GEMTESA was approved by the U.S. FDA in December 2020 and launched in the U.S. in April 2021. 

Aging and Long-Term Health Care

The growing aging population is creating challenging health and care needs for older adults. People require long-term health care services due to declining health, mobility problems, dementia, and the frailty of aging. 

Long-term health care costs are exploding and are a problem for families and finances. Most long-term care services help with everyday living activities or provide supervision due to dementia. Traditional health insurance, including Medicare and supplements, pay for only a limited amount of skilled services and nothing toward help with daily living activities or supervision.   

Medicaid will pay for all types of long-term health care services, but the care recipient must have little or no income and assets to qualify. Long-Term Care Insurance will provide comprehensive benefits for care, but you can only purchase coverage when you have reasonably good health. Most people obtain coverage in their 50s as part of their retirement planning.

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About the Author

Linda Kople is a freelance writer with a personal family history in long-term care. She specializes in aging-related topics such as caregiving, health, and retirement planning. Her experiences and interests drive her to explore and write about the various aspects of aging and health issues.

LTC News Contributor Linda Kople

Linda Kople

Contributor since October 31st, 2017

Editor's Note

Long-term health care is a significant financial problem since the costs of care services are rising sharply nationwide. Few of us can afford an additional bill of $4000 a month or more today - much less the $8000 or more monthly in the decades ahead.

Health insurance, including Medicare and supplements, are not the answer either. These traditional health programs pay little or nothing toward most long-term health care. Don't think that Medicaid is an answer either. Unless you have little or no income and assets, you won't qualify for the Medicaid long-term care benefit.

The solution many people have found is affordable Long-Term Care Insurance. Before saying it is too expensive, think again and get the facts. LTC Insurance is custom-designed, and premiums can vary over 100% between insurance companies. 

Most people obtain coverage in their 50s. Getting LTC Insurance younger saves you a lot of money, and you have many more choices.

Long-Term Care Insurance means access to quality care. It also means choice. You get to choose the type of care, including care in your home. LTC Insurance also means income and asset protection. Care costs are exploding nationwide - your guaranteed tax-free benefits will ease the financial stress.

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You might have questions about long-term health care planning, and LTC NEWS provides the answers for many of the most asked questions here - Frequently Asked Questions | LTC News. Find all the resources available on LTC NEWS - Resources for Long-Term Care Planning | LTC News.

Find the cost of care where you live by using the LTC NEWS Cost of Care Calculator - Cost of Care Calculator - Choose Your State | LTC News.

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Long-term care is very specialized, and few insurance agents and financial advisors have the expertise. Find a specialist who represents the top companies, as premiums can vary over 100% between insurance companies. Leading specialists will often have over 500 clients with Long-Term Care Insurance.

A specialist will save you money, and you will have peace of mind knowing they are making the appropriate recommendations - Work With a Specialist | LTC News.

Experts recommend seeking the help of a qualified and experienced Long-Term Care Insurance specialist to help you find the right coverage. A specialist will match your age, health, and family history with the right coverage at the right price. 

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If your loved one is lucky enough to own a Long-Term Care Insurance policy, be sure they use it. Sometimes families wait, thinking they can save the benefits for a rainy day. Waiting on using available Long-Term Care Insurance benefits is not a wise idea. 

If your parent or parents need help be sure to get them quality care. LTC NEWS can help. We have put together several comprehensive guides to help you in your process.

Start by reading our guides -  

Advantages of Reverse Mortgages 

Today's reverse mortgages for those aged 62 and older could be an ideal resource to fund a Long-Term Care Insurance policy OR even provide money to pay for care if you, or a loved one, already needs help and assistance. You might be eligible at younger ages as well. 

Some people have much of their savings invested in their homes. With today's reverse mortgages, you can find ways to fund care solutions, care itself, and even help with cash flow during your retirement. 

Learn more by asking questions to an expert. Mike Banner, LTC NEWS columnist and host of the TV Show "62 Who Knew" will answer your questions regarding caregiving, aging, health, retirement planning, long-term care, and reverse mortgages. 

- Just "Ask Mike." - Reverse Mortgages | LTC News.

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