Prevalence and correlates of fecal incontinence among nursing home residents: a population-based cross-sectional study

Abstract

BackgroundFecal incontinence is highly prevalent among nursing home residents. Previous nursing home studies have identified co-morbidity associated with fecal incontinence, but as this population is increasingly old and frail, we wanted to see if the rate of fecal incontinence had increased and to investigate correlates of fecal incontinence further.MethodsCross-sectional study of the entire nursing home population in one Norwegian municipality. Registered nurses filled in a questionnaire for all residents in the municipality (980 residents aged ≥65). Statistical methods used are descriptive statistics, binary logistic regression and multivariable logistic regression.ResultsThe response rate of the study was 90.3%. The prevalence of fecal incontinence was 42.3%. In multivariable analysis of FI, residents with diarrhea (OR 7.33, CI 4.39-12.24), urinary incontinence (OR 2.77, CI 1.73-4.42) and dementia (OR 2.17, CI 1.28-3.68) had higher odds of having fecal incontinence compared to those without the condition. Residents residing in a nursing home between 4–5 years had higher odds of having fecal incontinence compared to residents who had stayed under a year (OR 2.65, CI 1.20-5.85). Residents with deficiency in feeding (2.17, CI 1.26-3.71), dressing (OR 4.03, CI 1.39-11.65), toilet use (OR 7.37, CI 2.65-20.44) and mobility (OR 2.54, CI 1.07-6.00) had higher odds of having fecal incontinence compared to residents without deficiencies in activities of daily living (ADL). Needing help for transfer between bed and chair was a protective factor for fecal incontinence compared to residents who transferred independently (OR 0.49, CI 0.26-0.91).ConclusionsFecal incontinence is a prevalent condition in the nursing home population and is associated with ADL decline, frailty, diarrhea and quality of care. This knowledge is important for staff in nursing home in order to provide the best treatment and care for residents with fecal incontinence.

Prevalence of fecal incontinence (FI) and associated factors in institutionalized older adults

“…From the results of this research, it was observed that almost 43% of the institutionalized elderly presented involuntary losses of feces, a prevalence value that agrees with the ranges presented in literature, which generally vary between 33% and 65% (Saga et al, 2013;Shah et al, 2012;Zarate et al, 2008). However, the severity of the incontinence in this sample was higher, considering that most residents with FI did not present any episodes of continence, with liquid and solid stool losses (Aslan et al, 2009).…”

“…Both geriatric syndromes are widely studied in literature and are placed among the most important factors associated with FI, in institutionalized elderly as well as those living in community settings (AlAmeel, Andrew, & MacKnight, 2010;Aslan et al, 2009;Burge, von Gunten, & Berchtold, 2013;Melville et al, 2005;Saga et al, 2013;Shamliyan et al, 2009;Townsend et al, 2013).…”

“…Specifically, tasks such as locomotion and use of bathroom are strongly correlated to FI (Saga et al, 2013). In this way, the resident can develop functional incontinence, due to the incapacity to reach the bathroom in a timely fashion, due to mobility problems or due to cognitive decline (Aslan et al, 2009;Saga et al, 2013;Townsend et al, 2013).…”

“…Although it is a health issue frequently neglected, it affects between 2% and 20% of the elderly in community settings and prevalence increases considerably when an institution environment is considered (Aslan, Beji, Erkan, Yalcin, & Gungor, 2009;Leung & Rao, 2009;Leung & Schnelle, 2008;Saga, Vinsnes, Morkved, Norton, & Seim, 2013;Shah et al, 2012;Zarate, Lopez-Kostner, Vergara, Badilla, & Viviani, 2008). This problem entails a strong impact for health systems, as well as social impact to caregivers, family members, and on the health and life quality of the elderly (Leung & Rao, 2009;Shah et al, 2012).…”

A Physical Simulation to Investigate the Effect of Anorectal Angle on Continence

“…The overall prevalence of FI in adults is estimated between 11 and 15% and increases with age, with approximately 33% of people living in retirement homes (or similar institutions) affected [1]. Stigma and social taboo are associated with FI, leading to its underreporting [2].…”