Urinary incontinence (UI) is a common condition that impairs quality of life. The prevalence of urinary incontinence increases with age and is highest in continuing care home (CCH) residents. As part of a larger, international study aiming to improve continence care in CCH, this study aimed to explore the education needs and perspectives of residents and their care partners on the content, format, and delivery of an educational resource to address their questions, improve knowledge, and support better UI management outcomes.

In this qualitative study which took place in three care homes, interviews of consenting continuing care home residents and their care partners were conducted by a single trained  research team member using a semi-structured interview guide, which explored participants’ knowledge of UI, challenges they had experienced, topics they wished to learn more about, and their preferred formats and sources of information. Separate guides were used for residents and care partners, with interviews conducted in person, digitally recorded, and transcribed verbatim, ensuring all identifiable information was removed.
Data were analyzed separately for care partners and residents using conventional content analysis. Two researchers independently coded the first two transcripts from each group to develop initial coding frameworks, followed by meetings to compare and refine the codes. To ensure trustworthiness, the frameworks were applied to three additional transcripts from each group, followed by a review and revision. The remaining transcripts were coded by a single researcher, with new codes reviewed by the second researcher. After coding, the data for each group were consolidated into categories and collapsed into themes. Finally, the findings from the care partner and resident groups were synthesized to compare and contrast the results, identifying key similarities and differences.

Data saturation was achieved after interviewing 12 care partners and 14 residents. The mean (SD) age of the care partners (9 female, 3 male) was 61.7 years and of residents (9 female, 5 male) was 82.3 (11.6) years. Care partner analysis resulted in 71 codes, collapsed into 12 categories, and 4 themes – (1) education preferences and needs, (2) current knowledge and experience of UI and care related to UI, (3) factors influencing engagement with and uptake of UI education, (4) Openness and willingness to receive UI education. Resident analysis resulted in 71 codes, collapsed into 11 categories, and 4 themes – (1) UI knowledge and information needs, (2) delivery format and preferences, (3) attitudes, beliefs, and motivations, (4) UI Experience & Communication
There was no single preferred mode of delivery for educational materials.  Residents and care partners expressed a wish for a variety of media, preferably delivered by knowledgeable, trustworthy clinician providers.

Care partners and residents shared common priorities such as earlier education, trusted sources, and reduced stigma and differed in openness and needs for UI education and format preferences. Importantly, care partners’ perceptions of residents’ reluctance to engage in UI education may not fully align with residents’ own reported openness and desire to have learned more earlier in life. In addition, most care partners reported limited interest in learning about UI, as continence care was largely managed by care home staff.

This study highlights important gaps and opportunities in UI education for both care partners and residents in CCH. These findings suggest that a tailored, multimodal educational approach that considers the distinct needs and preferences of both care partners and residents is essential to improve engagement and support for educational interventions in CCH settings. Based on these findings, a tailored educational program on UI for older adult residents and care partners will be developed.

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