She should observe for incidents that relate to the occurrence of urinary leakage. If she uses absorbency products, have her note what kind of pads she uses, how many she uses each day, and the amount of wetness. Pad use can be marked down on the voiding diary. Functional disabilities or environmental factors can contribute to incontinence problems for women of any age, but particularly for the elderly. Access and the ability to get to the toilet, undress, and sit before voiding should also be addressed in the assessment.
Objective findings are necessary when evaluating incontinence as well.
Urinalysis will determine the presence of pus, blood, or glucose in the urine, suggesting diseases that should be explored further for their potential contributions to incontinence. Pay particular attention to specific gravity because it suggests fluid intake status. Physical examination of the abdomen, rectum, and pelvis will help detect atrophic mucosal changes, pelvic organ prolapse, masses, or hard stool. Pelvic muscle and sphincter tone can also be assessed. Neurologic assessment may suggest abnormalities contributing to incontinence.