EXPLORING CAREGIVER EXPERIENCES IN PROVIDING CONTINENCE CARE FOR OLDER ADULTS AT AIC KIJABE HOSPITAL’S AMBULATORY CARE: A QUALITATIVE STUDY

Abstract

With increasing life expectancies, the burden of incontinence among older adults is rising. Incontinence in this population is often accompanied by comorbidity, requiring assistance with basic activities of daily living. Owing to the lack of affordable long-term care facilities, enabling environments and assistive technology in low-middle-income countries, the most significant burden is shouldered by family caregivers. Not much research in continence care for older adults has been done in low-resource settings, less so among caregivers in the community. Available evidence shows that incontinence is greatly stigmatized and invisible, presenting barriers to help-seeking in caregivers. Furthermore, there is insufficient support from primary care teams, who often overlook the problem. This research aimed to gain insight into caregivers' experiences in continence care and explore help-seeking behaviour in caring for home-based, care-dependent older adults with incontinence. This qualitative research was conducted among caregivers of older adults with either stool, faecal or mixed incontinence, with participants obtained using purposive sampling guided by the Australian-Modified Karnofsky Performance Scale. Ethical approval was sought from ethical review committees at Kabarak University, African Inland Church (AIC) Kijabe Hospital and National Commission for Science, Technology and Innovation (NACOSTI). Focus group discussions and in-depth informant interviews using semi structured questionnaires were done. After data collection, a thematic analysis of emerging themes was done, and conclusions were drawn. Caregivers of older adults with incontinence suffer significant physical and psychological strain, financial burden, social isolation and impacts on personal relationships. The healthcare challenges encountered are stigma, limited support from healthcare providers, and lack of information. Support from religious communities, stronger bonds with the care recipient, reciprocity and a sense of purpose and fulfillment were perceived benefits of caregiving. Recommendations include establishing community-based programs, enhanced caregiver education, economic empowerment, and increased access to resources to better support caregivers and improve the quality of care for older adults with incontinence. Caregivers should also leverage religious communities as auxiliary support. Findings will help spread awareness of the problem and influence policy to promote continence care for older adults living with incontinence.