Abstract:

An ethnographic examination of the social context in which urinary incontinence occurs among the community-living elderly, the meanings attached to urinary incontinence, & the management strategies used to maintain life in the community. Fieldwork with 30 incontinent residents of subsidized apartments for seniors over a 6-month period enabled the identification of 6 lay categories of bladder control disturbance: excessive frequency, nighttime urination, nighttime accidents, lack of warning time, dribbling, & urination when sneezing or coughing. Every informant reported more than one of these types of bladder control disturbance, but most believed incontinence to be a normal part of the aging process & managed their incontinence largely without the assistance of health professionals. Incontinence was redefined from a medical definition of involuntary loss of urine to a social or personal definition that focused on the "visibility" of urine loss. The social consequences of incontinence included increasing social isolation & strong negative social sanctions when incontinence could no longer be kept secret. The linkage of incontinence & incompetence in late life is also discussed.