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

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.

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.