Managing faecal incontinence in people with dementia

Everybody S***s: how defecation stigma reduces care quality in dementia

“…[Type here] Language is very important when evaluating defecation stigma. Andrews (2017) argues that whilst needing to be direct it may be beneficial to use vernacular terms such as "poo" rather than faeces or stool to ensure the comfort of all involved. This coyness surrounding faeces is reflected in television advertisements; items such as toilet paper that are used by everyone are advertised whilst the actual act of defecation is conspicuous by its absence (Kama and Barak-Brandes, 2013).…”

“…This is evidenced by Hyde et al (2014) who argued that moving into residential care (RC) itself is a form of segregation used to hide unpleasant attributes from wider society. This, coupled with research showing that FI is often a catalyst for moving into RC (Andrews, 2017), shows that the stigma associated with ageing and inappropriate bowel function has colossal ramifications on older adults. These personal ramifications are ignored by wider society as once in RC, the issues of FI and dementia are "out of sight, out of mind".…”

“…Progressive cognitive decline means the ability of the brain to control defecation and urination in a socially acceptable manner often becomes compromised, leading to urinary and FI (Drennan et al, 2012). FI in people living with dementia can present as "inappropriate voiding", meaning defecation outside of the socially acceptable vessels or times (Andrews 2017;Russell et al 2017).…”

“…Dementia is understood to be progressive brain damage caused by a multitude of diseases that affect the brain (Innes and Manthorpe, 2013;Stokes et al, 2014;Cunningham et al, 2015). Progressive cognitive decline means the ability of the brain to control defecation and urination in a socially acceptable manner often becomes compromised, leading to urinary and FI (Drennan et al, 2012 with dementia can present as "inappropriate voiding", meaning defecation outside of the socially acceptable vessels or times (Andrews, 2017;Russell et al, 2017).…”

“…This means that when experiencing issues such as faecal incontinence (FI), symptom management becomes increasingly difficult. For the context of this article, FI refers to the involuntary excretion of stools (Forbes, 2015) or inappropriate faecal expulsion, meaning defecation that takes place outside of the bathroom and in an inappropriate receptacle or location (Andrews, 2017;Russell et al, 2017) This article also refers to formal carers, which in this context means care staff working in a nursing or residential home who are educated up to level 4.…”