The Prevalence, Incidence, and Correlates of Fecal Incontinence Among Older People Residing in Care Homes: A Systematic Review

Abstract

Objective: Older people resident in care homes often rely on staff for support relating to their activities of daily living, including intimate care such as continence care. Managing fecal incontinence can be challenging for both residents and care staff. We conducted this review to describe the prevalence, incidence, and correlates of fecal incontinence among care home residents. Design: Systematic literature review. Setting and participants: Older care home residents (both nursing and residential care) aged 60 years and older. Measures: We defined double incontinence as the presence of fecal plus urinary incontinence, isolated fecal incontinence as fecal incontinence with no urinary incontinence, and all fecal incontinence as anyone with fecal incontinence (whether isolated or double). The CINAHL and MEDLINE databases were searched up to December 31, 2017, to retrieve all studies reporting the prevalence and/or incidence and correlates of fecal incontinence. Results: We identified 278 citations after removing duplicates, and 23 articles met the inclusion criteria. There were 12 high-quality studies, 5 medium-quality studies, and 6 low-quality studies. The medians for prevalence (as reported by the studies) of isolated fecal incontinence, double incontinence, and all fecal incontinence were 3.5% [interquartile range (IQR) ¼ 2.8%], 47.1% (IQR ¼ 32.1%), and 42.8% (IQR ¼ 21.1%), respectively. The most frequently reported correlates of fecal incontinence were cognitive impairment, limited functional capacity, urinary incontinence, reduced mobility, advanced age, and diarrhea. Conclusions/Implications: Fecal incontinence is prevalent among older people living in care homes. Correlates included impaired ability to undertake activities of daily living, reduced mobility, laxative use, and altered stool consistency (eg, constipation or diarrhea) which are potentially amenable to interventions to improve fecal incontinence.

Association of Work Environment With Missed and Rushed Care Tasks Among Care Aides in Nursing Homes

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“…It concerns both men and women. It more often affects the elderly, especially patients staying in nursing homes, and it may be associated with limited mobility and care possibilities [ 4 ].…”

Impact of agitation in long‐term care residents with dementia in the United States

“…This may be due in part to the profound cognitive deficits and functional impairments that can render these individuals less active and less communicative about their health, thereby increasing their risk of infections 50 . In nursing home residents, urinary tract infections are the most commonly diagnosed infections, which may also be due to reduced hygiene associated with urinary and fecal incontinence in this population 51–53 . Studies have also shown that incontinence may lead to an increased risk of urinary tract infections in residents with agitation who may be more likely to refuse care from staff 54 .…”