Table 4:

Individual Systems: Knowledge and Behaviors

Bladder Health and the Life Course

Female health for me has been a long-haul journey trying to understand what’s going on with my body and then able to understand some of what I’ve got going on (with my bladder), I can pass it down to my children and they to their grandchildren… So female health is something, it’s to learn. New development, you know information, it’s unending to understand. (age 65+)

I just think that you know the more we know [about the bladder] and the more we share with even younger women because when I was young, I had no idea that this is on the way and I talked to my nieces, I talked to younger women, and I tell them enjoy, because you know it could happen. (age 45–64)

I think because parents have like a different perspective because like they’re our parents and like their body are different because they’re developed already and we’re still developing so it’s like we might go through different stages. (age 11–14)

Past Self: Retrospective Accounts of Bladder Health Knowledge and Behavior

Knowledge

We weren’t taught at a younger age about bladder, but now we was taught, so I think never too late to learn. (age 65+)

Back in those days, they didn’t explain anything about the body. They just felt like you should know and how would you if nobody explained? Even the doctors didn’t explain. (age 65+)

As you’ve gotten older, so that’s one of the things, that’s what made me start realizing that if it happened to me when I was younger, and we weren’t educated on nutrition health and wellness, we weren’t educated on the importance of drinking water, we weren’t educated on the importance of eliminating the, you know, your bowels and things of that nature. (age 65+)

Behavior

I remember playing outside all summer and when riding bikes. We would ride and not think about it and then realize we had gotten too far from home when we needed to go to the bathroom. (age 45–65+)

I’m a senior now and I didn’t really take care of myself earlier but now I’m trying to now and it’s very important what you eat, what you drink, what you do, you know so I’m really becoming aware of what I need to do for my body, for my life, and so forth. You know sometimes when you’re younger, you don’t think about all this stuff. (age 65+)

We drank Kool-Aid, pop, and all that, you know and, you know, I feel that if you really would take care of your bladder when you’re younger, it make it easier on you when you get older. But when you’re younger, you want what you want. Okay? I want a pop, I want some cognac, I want some gin, I want some wine you know and, you know, you just really don’t think about you know whether it’s going to affect you later. (age 65+)

Current Self: Emergence of Bladder Control Issues

I guess it’s the weak muscles or something that cause you not to be able to hold like you used to but controlling it. You can’t do it anymore at this age. I can’t. (age 65+)

When I was younger, like you didn’t think about it. But now when, when you have to go, it’s like I got to go now. I can’t hold it anymore like I used to, so there’s an urgency. (age 65+)

As I had children, I have five children, I definitely could not hold after I started having children… But now like we can wear Depends and things of that nature and that’s because we can’t hold it as long as we used to. (age 65+)

All of us have it, you know after a certain age, you got some kind of leakage, whether severe or not, you got it but you don’t hear anything about it until you have a problem with it. (age 45–64)

Future Self: Anticipated Bladder Decline

Moderator: Do you think people can have a healthy bladder their entire lifespan? Participant: No, I do not, from experience, age… I think that when you get up in age, you have trouble with it. (age 65+)

Supposedly it’s a known thing that the older you get, your bladder is not going to work and you’re going to have to go a lot, so we just accept it. (age 65+)

If you’re a senior, it’s going to go bad. No matter what you do… you can get whatever but as a senior, your body going to start deteriorating and your bladder is going to deteriorate no matter what. No matter what you take, eventually, it’s going to go bad and when it go bad, sooner or later. (age 65+)

I was thinking you can’t stop it. It’s something you can’t put a Band-Aid on. You can’t literally, like if you cut your finger or cut your hand or something, you going to put a Band-Aid on it, it eventually heal something inside you. You know like your bladder or something like that. You can’t stop it from getting weaker. You can’t stop yourself from not going to the restroom because it going to go (whether) you go or not. It’s going to come. (age 65+)

Before you close is it inevitable that all of us will be wearing diapers one day? I mean, really? [responses from other women in the focus group] Yes. Yes. Yes, mmm hmm. Start saving up now. (age 65+)