Above: CFA President, Associate Professor Michael Murray

By Kate Horowitz and Keryn Curtis

Education about prevention, early intervention and timely treatment are essential if Australia is to see any easing of the increasing economic burden of incontinence.  This is the message from the Continence Foundation Australia (CFA) for World Continence Week this week Monday 20 June to Sunday 26 June

To highlight the message, the CFA has released a new report which sets out in stark economic terms the true cost of incontinence to the nation. The 2011 Deloitte Access Economics report - The Economic Impact of Incontinence in Australia, shows that in 2010, nearly 4.8 million Australians were living with incontinence – more than a quarter of the nation’s population. Moreover, the total financial cost to the community in 2010 was estimated to be $42.9billion or approximately $9,014 per sufferer.

The financial cost of incontinence formulated in the report does not reflect the impact on the quality of life of those affected. More people suffer from incontinence in Australia than asthma, anxiety disorders and arthritis.

CFA President and geriatrician, Associate Professor Michael Murray says the report has deliberately used an “economic argument” as a means to increase public awareness of the issue and encourage people to change their lifestyles accordingly or seek professional assistance early rather than later.  

Professor Murray said incontinence was an expensive problem that needs to be urgently addressed but that addressing the problem, would mean tackling the stigma head on. 

“We need a combination of raising awareness and tackling the stigma. Until we actually attack the stigma, as a society, people are not going to seek help. And they won’t reduce their disability and quality of life and the cost to them as individuals as well as society.”

Professor Murray said many incontinence suffers do not seek help due to the stigma and associated shame. “We need to get the message out that there are things you can do to cure, treat or improve incontinence but in most instances it is important to intervene early.”

“The CFA encourages sufferers to seek professional and assessment earlier than later. I have had people come to me who have had continence problems for 40 years – since childbirth. Waiting 40 years to be treated makes it a lot more challenging; it is easier to treat when someone is 40 than when they are 80,” said Professor Murray.

“Cures may be as simple as bladder retraining, learning how to exercise the pelvic floor, changing medications that may impair the bowel or bladder function or dietary changes such as increasing fibre and fluids in the diet. Other alternatives include medications or surgery to cure incontinence.” 

Professor Murray said that despite the persistent stigma, there was an increasing willingness among people with incontinence problems to seek assistance.

“While the number of documented cases has been growing, it is not because people are more incontinent than they used to be.  Partly it is because the population is ageing but also people have become increasingly more willing to admit that they have a problem and need help.”

Hidden costs

According to the Deloitte Access Economics report, there are many additional hidden costs associated with incontinence, including lower employment rates among people with incontinence. People with incontinence problems are less likely to be employed due to fear or embarrassment that their illness will be discovered. In 2010, total productivity loss due to incontinence was estimated at $34.1 billion.  

Another additional cost addressed in the report is the additional care people with incontinence often require that is most frequently provided by a loved one. Though this informal care is provided free of charge, it is not free in an economic sense. Time spent caring is time that cannot be directed to other activities, including paid employment or unpaid work such as housework. In 2010, the opportunity cost of informal care provided to those with incontinence was estimated to be $2.7 billion.

Above: CFA Chief Executive, Barry Cahill

Chief executive of the Continence Foundation of Australia, Barry Cahill, said another objective of the Deloitte Access Economics report was to promote awareness of the prevalence of incontinence problems to demonstrate to people that they are not alone.

 “There are a lot of people who have problems with incontinence but unfortunately many don’t think there is much you can do about it - they think it just relates to ageing. We want people to know that it can be better managed and even cured,” said Mr Cahill.  

“The awareness theme for this year is ‘pelvic floor first’ and we are encouraging both women and men to regularly exercise their pelvic floor muscles to prevent or lesson the severity of incontinence,” he said.

Professor Murray says he encourages younger women to start pelvic floor exercises before they have children.

“Everybody has some kind of fitness regime and they should naturally incorporate pelvic exercises into their routine.”

“Australians must address this issue. The population is getting older and we need to do something about it before it gets very expensive. If we can reduce the severity and frequency of the problem, we can reduce the economic impact and improve quality of life for the individual at the same time,” Professor Murray said. 

Anybody who wants advice or help with continence problems can call the National Continence Helpline on 1800 330 066 or email via helpline@continence.org.au for a private over the phone consultation with a specialised continence nurse. World Continence Week runs 20-26 June 2011. Click here for further details.

Australia is one of the leading countries in the world when it comes to government support for incontinence.  The Commonwealth is investing around $4.8 million this year to support people living with incontinence. The funding goes towards improving training for health professionals, research and awareness, as well as assisting those with incontinence through subsidies. The Commonwealth also funds the National Toilet Map, which lets people with incontinence or pregnant women know where public toilets are located.