Incontinence is a distressing, complex health problem which disproportionately affects older people. It is commonly endured silently, with many sufferers and carers not receiving appropriate support. In addition, incontinence is generally poorly managed both by families and health-care professionals, and is a major contributing factor in the institutionalization of the elderly. This paper argues that incontinence experienced in later life is often multifactorial in nature, thus health care professionals need to be cognizant of the many causes of incontinence, as well as the impact of lifestyle factors and 'normal' ageing processes. Incontinence in the community-based elderly can be cured or significantly improved in over 60% of cases with conservative management. Unfortunately community and professional attitudes and ignorance remain major barriers to continence.