By: Katie Holterman


Senior Director of Clinical Programming & Development

“We don’t talk about Bruno-no-no-no”—come on, sing along. We know you’ve heard this hit from Disney’s Encanto. Well, today, we’re going to talk about the “Bruno” of the senior living—incontinence.

Let’s start with a story.

I pulled up to my house as the babysitter was playing kickball with my two boys, then ages 4 and 9 years old. They were having a blast! But I noticed that my youngest was wearing a jacket even though the weather was warm. As soon as the babysitter left, my son took off his jacket and revealed the stain of urine on his pants. 

“I was membersed”, he said quietly. 

I corrected him on two points.  First, the word was embarrassed, as I helped him sound it out.  Second, and most importantly, I explained to him that an “accident” is nothing to be embarrassed about, and the more we talk about it, the more I can help you! 

I shared this story recently with Luanne, an older friend of the family, as she was recounting her episodes of urinary incontinence and the struggles she was having. The conversation had started with her revealing her episodes of incontinence, and then she stated, “I just have to live with it. I think at my age there is nothing you can do.” I explained that it was in fact not something she had to live with, nor was age a limiting factor. Whether you’re 4 or 64—by bringing it forward, you can get help.

Her eyes lit up.   

According to the National Association for Continence, approximately 25 million Americans are affected by incontinence, 85% of them being women. Furthermore, only 1 in 12 of those affected will seek help. Additional statistics indicate that individuals wait up to 6 years before requesting support and intervention. This delay in intervention has the potential to cause a significant impact on a person’s quality of life. In addition, to potential effects from the quality of life including social isolation and avoidance of activities, incontinence increases a person’s risk for falls, skin breakdown, dehydration, and pressure ulcers.  

Using Legacy’s approach to continence management, we can reduce episodes of incontinence as well as the additional risks that are associated with the condition as outlined above. In fact, in 2021, we identified that as a result of our continence management program, we were able to decrease episodes of urinary incontinence for residents on the program by 33% and the use of incontinence products was reduced by 40%.  Even by conservative estimates, that 40% reduction in the need for incontinence products could add up to nearly $1,000 a year for one person.

But still, are we really talking about incontinence?  It’s not glamorous, many find it embarrassing, and it’s not something we often hear discussed at the dinner table!   Nonetheless, in the senior living space, we must continue to bring it forward, we must talk about it and most importantly we always address it with evidence-based and successful strategies to allow senior adults to live a healthy life full of purpose, safety, and dignity.


National Association of Contienence. Incontinence Contidons From A-Z.

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