Annemarie Dowling-Castronovo, The Evelyn L. Spiro School of Nursing, Wagner College, United States Abstract Older adults viewed new episodes of urinary incontinence as a part of a much broader concern during hospitalization: loss of control with physical, spatial-temporal, and social aspects. During hospitalization, a time crisis, patterns of regaining control became evident: transferring control, exercising “wobbly” control, and adjusting to degree of control regained. Three conditions modify this process of regaining control. Findings offer a unique perspective about the relationship of control and patient-centered care that provide a basis for research aimed to improve hospital care for older adults who are likely to experience new-onset urinary incontinence. Keywords: control, grounded theory, incontinence, new-onset urinary incontinence, older adults, patient-centered care, urinary incontinence. Introduction Urinary incontinence (UI) is an involuntary loss of urine sufficient to be characterized as a problem (Fantl, Newman, Colling, 1996; Resnick & Ouslander, 1990) affecting approximately 26 million Americans (National Institutes of Health: NIH, 2008). There are two categories of UI: transient, or acute UI, and chronic or established UI (Fantl et al., 1996). The term new-onset UI, which is classified as acute, was first noted in the literature to describe the finding that 12% older adults, who were continent at time of admission, developed UI during hospitalization (Sier, Ouslander, Orzeck, 1987). Since that time, evidence-based clinical guidelines that guide assessment and treatment of UI (Fantl et al., 1996) have been developed and tested. Nevertheless, these guidelines were developed with evidence from studies that focused on individuals in long-term care settings (LTC), such as nursing homes and residential facilities, or the community. The literature about UI offers little about new-onset UI among older adults in the hospital setting. In the literature, new-onset UI is portrayed as what Glaser (1998) has termed a professional problem. What individuals with new-onset UI view as problematic and how they go about addressing the problem has not yet been discovered. Instead it has been studied more from what professionals perceive as problematic. Incidence reports of new-onset UI among hospitalized older adults range from 12% to 36% (Palmer, Myers, & Fedenko, 1997; Palmer, Baumgarten, Langenberg, & Carson, 2002; Sier et al., 1987; Kresevic, 1997; Zisberg et al., 2011). Depression, malnutrition, and dependency are risk factors (Kresevic, 1997). Male gender and cognitive impairment are significantly associated with new-onset UI patients after hip surgery; and, specific to women with hip fractures, hospital-acquired UI is significantly associated with admission from LTC facilities, confusion, and mobility impairment (Palmer et al., 1997; Palmer et al., 2002). The use of indwelling urinary catheters, adult diapers, and dependency are significantly associated with new-onset UI (Zisberg et al., 2011). New-onset UI has been essentially studied from the perspectives of medical and nursing staff and not clearly delineated from established UI (Connor & Kooker, 1996; Cooper & Watt, 2003; Dingwall & Mclafferty, 2006; Fonda & Nickless, 1987; Hancock, Bender, Dayhoff & Nyhuis, 1996). It has been documented that hospitalized older adults (n=117) differed in their preferred treatments for UI in comparison to hospital staff (Pfister, Johnson, Jenetzky, Hauer, & Oster, 2007). Nevertheless, the preferences and perspectives of older adults with new-onset UI have not been documented. Since there were no identified studies from this perspective, the purpose of this study was to examine the experience of new-onset UI from the perspective of hospitalized older adults. Method Grounded theory (GT) methodology (Glaser, 1978, 1992, 1998, 2002; Glaser & Strauss, 1967) was used to discover the main concern of older adults with new-onset UI...