The cost of incontinence

Incontinence can have a substantial impact on wellbeing, social and workforce participation, and relationships of its sufferers and those who care for them, according to a new report released by the Australian Institute of Health and Welfare (AIHW).

The report, Incontinence in Australia – released to coincide with World Continence Week this week – shows 316,500 people – 1.5% of the Australian population experienced severe incontinence in 2008-09, at an estimated cost to the aged and health care systems of $1.6 billion.

“Severe incontinence refers to instances where people always or sometimes need help with controlling bladder or bowel functions and/or using continence aids. Milder forms of incontinence are harder to define and quantify,” said AIHW spokesperson, Dr Pamela Kinnear.

“Severe incontinence can profoundly affect the quality of life of those who experience it, as well as their ability to participate in work and social activities,” she said.

This report updates expenditure estimates and provides greater detail on the impact of incontinence on Australians compared with the bulletin released on the same topic last year.

Residential aged care ($1.3 billion) accounted for the largest share of total incontinence expenditure. This was followed by hospitals ($145.5 million), the Stoma Appliance Scheme ($67.6 million) and the Continence Aids Payments Scheme ($31.6 million).

Incontinence is more common among older people – nearly 25% of people aged 85 and over and 7% of people aged 65 and over experienced severe incontinence, compared with just 0.6% of people aged under 65 years. Severe incontinence is more common in females than males (2% and 1% respectively).

The labour force participation rate for people aged 15 to 64 with severe incontinence was about 26%, considerably lower than for people without severe incontinence (almost 56%). More than half (about 52%) of people with severe incontinence reported not being able to go out as often as they would like, and about 3% reported that they could not go out at all.

The report provides detailed information on people who care for sufferers of incontinence. There were 72,900 primary carers who helped manage incontinence in 2009. Most carers were female (81%), most spent 40 or more hours per week caring (73%), and more had their sleep interrupted often (42%) than other primary carers (19%).

“Primary carers who assist people with severe incontinence are more likely to report strained relationships with those they care for, to need more respite care, and to report lower labour force participation,” Dr Kinnear said.

“This could be due to the intensive nature of managing severe incontinence, as well as the fact that most people with severe incontinence had significant core activity limitation.”