Prevalence of Incontinence by Race and Ethnicity of Older People Admitted to Nursing Homes

Bliss, Donna Z; Harms, Susan; Garrard, Judith; Cunanan, Kristen; Savik, Kay; Gurvich, Olga V; Mueller, Christine A; Wyman, Jean F.; Eberly, Lynn E.; Virnig, Beth A

doi:10.1016/j.jamda.2013.03.007

Cited by 45 publications

(41 citation statements)

References 38 publications

(39 reference statements)

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“…Our data are from for-profit NHs and may not be representative of all NHs. The characteristics of our admission cohort, however, are comparable with those of all U.S. NHs (Bliss et al, 2013) of which 69% are for-profit (Centers for Medicare & Medicaid Services, 2012). There is limited generalizability of results to NHs whose residents are only of one race or to Stage 1 pressure ulcers.…”

Section: Discussionmentioning

confidence: 83%

Are There Racial-Ethnic Disparities in Time to Pressure Ulcer Development and Pressure Ulcer Treatment in Older Adults After Nursing Home Admission?

et al. 2014

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Objective The objective of this study was to assess whether there are racial and ethnic disparities in the time to development of a pressure ulcer and number of pressure ulcer treatments in individuals aged 65 and older after nursing home admission. Method Multi-level predictors of time to a pressure ulcer from three national surveys were analyzed using Cox proportional hazards regression for White Non-Hispanic residents. Using the Peters–Belson method to assess for disparities, estimates from the regression models were applied to American Indians/Alaskan Natives, Asians/ Pacific Islanders, Blacks, and Hispanics separately resulting in estimates of expected outcomes as if they were White Non-Hispanic, and were then compared with their observed outcomes. Results More Blacks developed pressure ulcers sooner than expected. No disparities in time to a pressure ulcer disadvantaging other racial/ethnic groups were found. There were no disparities in pressure ulcer treatment for any group. Discussion Reducing disparities in pressure ulcer development offers a strategy to improve the quality of nursing home care.

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Section: Discussionmentioning

confidence: 83%

Are There Racial-Ethnic Disparities in Time to Pressure Ulcer Development and Pressure Ulcer Treatment in Older Adults After Nursing Home Admission?

et al. 2014

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“…18,19 The prevalence is either comparable 16,20 or lower in men than women. 21,22 Some 11,13,17,23 but not all 16,24 studies reported a lower prevalence in African-American than white women, but similar prevalence across races in men.…”

Section: F1 Fecal Incontinencementioning

confidence: 98%

Anorectal Disorders

et al. 2016

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This report defines criteria and reviews the epidemiology, pathophysiology, and management of the following common anorectal disorders: fecal incontinence (FI), functional anorectal pain, and functional defecation disorders. FI is defined as the recurrent uncontrolled passage of fecal material for at least 3 months. The clinical features of FI are useful for guiding diagnostic testing and therapy. Anorectal manometry and imaging are useful for evaluating anal and pelvic floor structure and function. Education, antidiarrheals, and biofeedback therapy are the mainstay of management; surgery may be useful in refractory cases. Functional anorectal pain syndromes are defined by clinical features and categorized into 3 subtypes. In proctalgia fugax, the pain is typically fleeting and lasts for seconds to minutes. In levator ani syndrome and unspecified anorectal pain, the pain lasts more than 30 minutes, but in levator ani syndrome there is puborectalis tenderness. Functional defecation disorders are defined by ≥2 symptoms of chronic constipation or irritable bowel syndrome with constipation, and with ≥2 features of impaired evacuation, that is, abnormal evacuation pattern on manometry, abnormal balloon expulsion test, or impaired rectal evacuation by imaging. It includes 2 subtypes: dyssynergic defecation and inadequate defecatory propulsion. Pelvic floor biofeedback therapy is effective for treating levator ani syndrome and defecatory disorders.

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“…There is limited generalizability of the results to non-profit nursing homes; however, nearly 70% of all US nursing homes are for-profit (Centers for Medicare & Medicaid Services, 2013b). We have shown that characteristics of our admission cohort are comparable to those of admission in all US nursing homes (Bliss et al, 2013). Not all relevant predictors of incontinence prevention may be known, available in our datasets, or perhaps possible to include in our models.…”

Section: Discussionmentioning

confidence: 59%

“…Incontinence associated skin damage (IASD), as we refer to this problem, results in symptoms of discomfort/ pain, itching, and burning sensations and comorbidity such as fungal infection (Arnold-Long, Reed, Dunning, & Ying, 2012; Bliss, Funk, Jacobson, & Savik, 2015; Gray et al, 2007). Considering that there are more than a million individuals residing in nursing homes in the Unites States (US) (Harris-Kojetin, Sengupta, Park-Lee, & Valverde, 2013), and as many as one-half are incontinent (Bliss et al, 2013; Gorina, Schappert, Bercovitz, Elgaddal, & Kramarow, 2014; Milson et al, 2013), the potential morbidity, negative effect on well-being, and treatment expense of IASD are large. Primary prevention of IASD can promote the health and comfort of incontinent nursing home residents and avoid costs of treating incontinence complications.…”

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confidence: 99%

Prevention of Incontinence-Associated Skin Damage in Nursing Homes

et al. 2016

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Racial/ethnic disparities in preventing health problems have been reported in nursing homes. Incontinence is common among nursing home residents and can result in inflammatory-type skin damage, referred to as incontinence associated skin damage (IASD). Little is known about the prevention of IASD and whether there are racial/ethnic disparities in its prevention. This study assessed the proportion of older nursing home residents receiving IASD prevention after developing incontinence after admission (n=10,713) and whether there were racial/ethnic disparities in IASD prevention. Predictors of preventing IASD were also examined. Four national datasets provided potential predictors at multiple levels. Disparities were analyzed using the Peters-Belson method; predictors of preventing IASD were assessed using hierarchical logistic regression. Prevention of IASD was received by 0.12 of residents and no racial/ethnic disparities were found. Predictors of preventing IASD were primarily resident level factors including limitations in activities of daily living, poor nutrition, and more oxygenation problems.

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Prevalence of Incontinence by Race and Ethnicity of Older People Admitted to Nursing Homes

Cited by 45 publications

References 38 publications

Are There Racial-Ethnic Disparities in Time to Pressure Ulcer Development and Pressure Ulcer Treatment in Older Adults After Nursing Home Admission?

Are There Racial-Ethnic Disparities in Time to Pressure Ulcer Development and Pressure Ulcer Treatment in Older Adults After Nursing Home Admission?

Anorectal Disorders

Prevention of Incontinence-Associated Skin Damage in Nursing Homes

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