Factors contributing to fecal incontinence in older people and outcome of routine management in home, hospital and nursing home settings

Asangaedem Akpan1,2,3, Margot A Gosney2, James Barrett3,4, 1Directorate of Medicine and Elderly Care, Warrington Hospital, Warrington, Cheshire, UK; 2School of Food Biosciences, The University of Reading, Whiteknights, Reading, UK; 3Liverpool John Moores University, Liverpool, UK; 4Directorate of El...

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Autores principales:	Asangaedem Akpan, Margot A Gosney, James Barrett
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2007
Materias:	Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/52b2136b835a4f0da854461056e87ce4
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spelling	oai:doaj.org-article:52b2136b835a4f0da854461056e87ce42021-12-02T06:15:27ZFactors contributing to fecal incontinence in older people and outcome of routine management in home, hospital and nursing home settings1178-1998https://doaj.org/article/52b2136b835a4f0da854461056e87ce42007-04-01T00:00:00Zhttps://www.dovepress.com/factors-contributing-to-fecal-incontinence-in-older-people-and-outcome-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Asangaedem Akpan1,2,3, Margot A Gosney2, James Barrett3,4, 1Directorate of Medicine and Elderly Care, Warrington Hospital, Warrington, Cheshire, UK; 2School of Food Biosciences, The University of Reading, Whiteknights, Reading, UK; 3Liverpool John Moores University, Liverpool, UK; 4Directorate of Elderly Medicine and Rehabilitation, Clatterbridge Hospital, Merseyside, UKObjective: Fecal loading, cognitive impairment, loose stools, functional disability, comorbidity and anorectal incontinence are recognized as factors contributing to loss of fecal continence in older adults. The objective of this project was to assess the relative distribution of these factors in a variety of settings along with the outcome of usual management. Methods: One hundred and twenty adults aged 65 years and over with fecal incontinence recruited by convenience sampling from four different settings were studied. They were either living at home or in a nursing home or receiving care on an acute or rehabilitation elderly care ward. A structured questionnaire was used to elicit which factors associated with fecal incontinence were present from subjects who had given written informed consent or for whom assent for inclusion in the study had been obtained.Results: Fecal loading (Homes 6 [20%]; Acute care wards 17 [57%]; Rehabilitation wards 19 [63%]; Nursing homes 21 [70%]) and functional disability (Homes 5 [17%]; Acute care wards 25 [83%]; Rehabilitation wards 25 [83%]; Nursing homes 20 [67%]) were significantly more prevalent in the hospital and nursing home settings than in those living at home (P < 0.01). Loose stools were more prevalent in the hospital setting than in the other settings (Homes 11 [37%]; Acute care wards 20 [67%]; Rehabilitation wards 17 [57%]; Nursing homes 6 [20%]) (P < 0.01). Cognitive impairment was significantly more common in the nursing home than in the other settings (Nursing homes 26 [87%], Homes 5 [17%], Acute care wards 13 [43%], Rehabilitation wards 14 [47%]) (P < 0.01). Loose stools were the most prevalent factor present at baseline in 13 of the 19 (68%) subjects whose fecal incontinence had resolved at 3 months.Conclusion: The distribution of the factors contributing to fecal incontinence in older people living at home differs from those cared for in nursing home and hospital wards settings. These differences need to be borne in mind when assessing people in different settings. Management appears to result in a cure for those who are not significantly disabled with loose stools as a cause for their fecal incontinence, but this would need to be confirmed by further research.Keywords: Older adults, fecal incontinence, risk factors, care settings, digital rectal examination, mortalityAsangaedem AkpanMargot A GosneyJames BarrettDove Medical PressarticleGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 2, Pp 139-145 (2007)
institution	DOAJ
collection	DOAJ
language	EN
topic	Geriatrics RC952-954.6
spellingShingle	Geriatrics RC952-954.6 Asangaedem Akpan Margot A Gosney James Barrett Factors contributing to fecal incontinence in older people and outcome of routine management in home, hospital and nursing home settings
description	Asangaedem Akpan1,2,3, Margot A Gosney2, James Barrett3,4, 1Directorate of Medicine and Elderly Care, Warrington Hospital, Warrington, Cheshire, UK; 2School of Food Biosciences, The University of Reading, Whiteknights, Reading, UK; 3Liverpool John Moores University, Liverpool, UK; 4Directorate of Elderly Medicine and Rehabilitation, Clatterbridge Hospital, Merseyside, UKObjective: Fecal loading, cognitive impairment, loose stools, functional disability, comorbidity and anorectal incontinence are recognized as factors contributing to loss of fecal continence in older adults. The objective of this project was to assess the relative distribution of these factors in a variety of settings along with the outcome of usual management. Methods: One hundred and twenty adults aged 65 years and over with fecal incontinence recruited by convenience sampling from four different settings were studied. They were either living at home or in a nursing home or receiving care on an acute or rehabilitation elderly care ward. A structured questionnaire was used to elicit which factors associated with fecal incontinence were present from subjects who had given written informed consent or for whom assent for inclusion in the study had been obtained.Results: Fecal loading (Homes 6 [20%]; Acute care wards 17 [57%]; Rehabilitation wards 19 [63%]; Nursing homes 21 [70%]) and functional disability (Homes 5 [17%]; Acute care wards 25 [83%]; Rehabilitation wards 25 [83%]; Nursing homes 20 [67%]) were significantly more prevalent in the hospital and nursing home settings than in those living at home (P < 0.01). Loose stools were more prevalent in the hospital setting than in the other settings (Homes 11 [37%]; Acute care wards 20 [67%]; Rehabilitation wards 17 [57%]; Nursing homes 6 [20%]) (P < 0.01). Cognitive impairment was significantly more common in the nursing home than in the other settings (Nursing homes 26 [87%], Homes 5 [17%], Acute care wards 13 [43%], Rehabilitation wards 14 [47%]) (P < 0.01). Loose stools were the most prevalent factor present at baseline in 13 of the 19 (68%) subjects whose fecal incontinence had resolved at 3 months.Conclusion: The distribution of the factors contributing to fecal incontinence in older people living at home differs from those cared for in nursing home and hospital wards settings. These differences need to be borne in mind when assessing people in different settings. Management appears to result in a cure for those who are not significantly disabled with loose stools as a cause for their fecal incontinence, but this would need to be confirmed by further research.Keywords: Older adults, fecal incontinence, risk factors, care settings, digital rectal examination, mortality
format	article
author	Asangaedem Akpan Margot A Gosney James Barrett
author_facet	Asangaedem Akpan Margot A Gosney James Barrett
author_sort	Asangaedem Akpan
title	Factors contributing to fecal incontinence in older people and outcome of routine management in home, hospital and nursing home settings
title_short	Factors contributing to fecal incontinence in older people and outcome of routine management in home, hospital and nursing home settings
title_full	Factors contributing to fecal incontinence in older people and outcome of routine management in home, hospital and nursing home settings
title_fullStr	Factors contributing to fecal incontinence in older people and outcome of routine management in home, hospital and nursing home settings
title_full_unstemmed	Factors contributing to fecal incontinence in older people and outcome of routine management in home, hospital and nursing home settings
title_sort	factors contributing to fecal incontinence in older people and outcome of routine management in home, hospital and nursing home settings
publisher	Dove Medical Press
publishDate	2007
url	https://doaj.org/article/52b2136b835a4f0da854461056e87ce4
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Factors contributing to fecal incontinence in older people and outcome of routine management in home, hospital and nursing home settings

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