Time to and predictors of dual incontinence in older nursing home admissions

Gurvich, Olga V; Eberly, Lynn E.; Harms, Susan

doi:10.1002/nau.23279

Cited by 12 publications

(22 citation statements)

References 21 publications

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“…6 The prevalence of double incontinence (DI), both UI and fecal incontinence (FI), is high among individuals living in nursing homes, 7 and the significant predictors for the development of DI are pre-existing UI, greater functional or cognitive impairment, higher number of comorbidities, older age and lower quality of nursing home care. 8 In an Asian study, a higher Clinical Dementia Rating Score was considered a significant predictor of DI. 9 The management of incontinence is a heavy burden in society in terms of human and financial resources.…”

Section: Introductionmentioning

confidence: 99%

“…Urinary incontinence (UI) is considered a geriatric syndrome, and is associated with multiple health‐related problems, including dermatitis, falls, lower activity of daily living (ADL), impairment of dignity and higher mortality . The prevalence of double incontinence (DI), both UI and fecal incontinence (FI), is high among individuals living in nursing homes, and the significant predictors for the development of DI are pre‐existing UI, greater functional or cognitive impairment, higher number of comorbidities, older age and lower quality of nursing home care . In an Asian study, a higher Clinical Dementia Rating Score was considered a significant predictor of DI .…”

Section: Introductionmentioning

confidence: 99%

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Nationwide survey of continence status among older adult residents living in long‐term care facilities in Japan: The prevalence and associated risk factors of incontinence and effect of comprehensive care on continence status

Suzuki

Okochi²,

Iijima

et al. 2020

Geriatrics Gerontology Int

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Aim This study aimed to identify the prevalence of urinary, fecal and double incontinence among Japanese residents aged ≥65 years living in long‐term care facilities. Furthermore, the association between baseline characteristics and changes in toileting activity after a 3‐month comprehensive care among older individuals was investigated. Methods We examined the prevalence of incontinence and its significant predictors. The association between the Functional Independence Measure score at baseline and each type of incontinence (urinary, fecal or double incontinence) was examined using a logistic regression model. Similarly, the association between the Functional Independence Measure score at baseline and improvement in toileting activity after a 3‐month comprehensive care was examined. Results In total, 2517 residents (670 men and 1847 women) were recruited. The prevalence rates of urinary, fecal and double incontinence were 66.9%, 42.8% and 41.1%, respectively. In multivariate analysis, the sum of the motor subscales after removing four continence items and the sum of the cognitive subscales of the Functional Independence Measure score at baseline were significantly associated with all types of incontinence. The sum of the motor subscales after removing four continence items of the Functional Independence Measure score was associated with improved toileting activity. Conclusions This study presented the prevalence of urinary, fecal and double incontinence among residents living in long‐term care facilities in Japan. The Functional Independence Measure items at baseline were associated with not only continence status, but also improved toileting activity after 3‐month comprehensive care. Geriatr Gerontol Int 2020; 20: 285–290.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Nationwide survey of continence status among older adult residents living in long‐term care facilities in Japan: The prevalence and associated risk factors of incontinence and effect of comprehensive care on continence status

Suzuki

Okochi²,

Iijima

et al. 2020

Geriatrics Gerontology Int

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“…12,13 However, FI is not an inevitable consequence of old age or dementia alone, 2 but has multiple underlying factors, 14 some of which can be identified and treated. 15 In the older person, FI may be the consequence of age-related anorectal deficits such as reduced anal sphincter pressure; 16 it also may be underpinned by cognitive impairment, 17,18 length of nursing home stay, 10,19 diarrhea, 20 constipation, 10,17 or effects of polypharmacy. 21 When a cure is not achievable, incontinence management can produce "social continence" (incontinence well managed so that it is not socially evident), thus alleviating embarrassment and preserving the dignity of a person.…”

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confidence: 99%

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

Musa

Saga

Blekken

et al. 2019

Journal of the American Medical Directors Association

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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.

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“…In line with these previous findings and our new results about toileting difficulties, prevention of ADL decline and toileting difficulties should be of concern for those providing in-home care and also for healthcare planners. Toileting difficulties developed after admission to nursing home have also been previously addressed, and some studies have found that prevalence of toileting difficulties can rise in a few months to years after admission (Bliss, Gurvich, Eberly, & Harms, 2017;Boguth & Schenk, 2008;Ihnat et al, 2016;Saga, Vinsnes, Morkved, Norton, & Seim, 2013;Saxer, Halfens, de Bie, & Dassen, 2008). Concerning incontinence among residents established in nursing homes, prevalence is repeatedly reported to be high (Ihnat et al, 2016;Offermans, Du Moulin, Hamers, Dassen, & Halfens, 2009;Saga et al, 2013;Saga, Vinsnes, Morkved, Norton, & Seim, 2015;Saxer et al, 2008).…”

Section: Discussionmentioning

confidence: 99%

“…Concerning incontinence among residents established in nursing homes, prevalence is repeatedly reported to be high (Ihnat et al, 2016;Offermans, Du Moulin, Hamers, Dassen, & Halfens, 2009;Saga et al, 2013;Saga, Vinsnes, Morkved, Norton, & Seim, 2015;Saxer et al, 2008). The seemingly complex relation between toileting difficulties and nursing home residency has been widely investigated, and the value of mapping and combating incontinence associated with nursing home residency is still being emphasized (Bliss et al, 2017;Offermans et al, 2009;Saga et al, 2013Saga et al, , 2015.…”

Section: Discussionmentioning

confidence: 99%

Toileting difficulties in older people with and without dementia receiving formal in‐home care—A longitudinal study

et al. 2019

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Aim To estimate the prevalence of toileting difficulties over time among older people (≥70 years) with and without dementia receiving formal in‐home care at baseline and to explore whether dementia at baseline was associated with toileting difficulties at the last assessment when adjusting for relevant covariates. We hypothesize that those with dementia have a higher prevalence and that baseline dementia is associated with toileting difficulties at last follow‐up. Design A longitudinal observational study with three assessments over 36 months. Older people (≥70 years) from 19 Norwegian municipalities with in‐home care needs were included. The participants and their next of kin were interviewed. Method In total, 1,001 (68% women) persons with a mean ( SD ) age 83.4 (5.7) years participated at baseline. Toileting difficulties were assessed using Lawton and Brody's Physical Self‐Maintenance Scale and Individual Nursing and Care Statistics. Information on physical comorbidity, number of prescribed drugs, cognitive function and formal care given was included. Dementia was diagnosed based on all information gathered. Results At all time points, toileting difficulties were more prevalent in people with than without dementia. In adjusted analyses, dementia at baseline was associated with toileting difficulties at the last assessment. Nursing home admission was associated with increased odds for toileting difficulties.

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Time to and predictors of dual incontinence in older nursing home admissions

Cited by 12 publications

References 21 publications

Nationwide survey of continence status among older adult residents living in long‐term care facilities in Japan: The prevalence and associated risk factors of incontinence and effect of comprehensive care on continence status

Nationwide survey of continence status among older adult residents living in long‐term care facilities in Japan: The prevalence and associated risk factors of incontinence and effect of comprehensive care on continence status

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

Toileting difficulties in older people with and without dementia receiving formal in‐home care—A longitudinal study

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