OBJECTIVE: The participation of older rural women and their caregivers in a pilot research study on behavioral management interventions for urinary incontinence is described. DESIGN: A quasiexperimental design was used. SETTING AND SUBJECTS: Women 55 years old and older and living in a rural county in North Florida who had episodes of urinary incontinence twice or more per week were included. Outreach was directed at two groups of elders with incontinence, those who were functioning independently and those who were frail and dependent on caregivers for assistance with activities of daily living. METHODS: Behavioral management of continence comprised three techniques for the management of urinary incontinence: self-monitoring, scheduling regimens and pelvic muscle exercise with biofeedback. MAIN OUTCOME MEASURES: The main outcome measures were episodes of urine loss and amount (In grams) of urine loss with time, determined with a weighed pad test. RESULTS: Behavioral management of continence resulted in significant decrease in urinary incontinence; decreases in frequency and volume of urine loss were found among all study participants when data were analyzed. CONCLUSIONS: Although behavioral management of continence was effective in reducing incontinence among independent, community-dwelling elderly women, there was a marked lack of response to this project by frail elders and their caregivers. The same barriers to implementing time-intensive behavioral management interventions among frail elders in long-term care facilities may operate in the home setting.

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