Prevalence of Constipation Symptoms in Fecally Incontinent Nursing Home Residents |
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Authors: | John F Schnelle PhD Sandra F Simmons PhD Linda Beuscher PhD GNP Emily N Peterson BA Ralf Habermann MD Felix Leung MD FACG |
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Institution: | From the Division of General Internal Medicine and Public Health, Center for Quality Aging, School of Medicine;;School of Nursing;;Division of General Internal Medicine and Public Health, Vanderbilt Senior Care ACE Unit, Vanderbilt University, Nashville, Tennessee;;Geriatric Research, Education, and Clinical Center, Veterans Affairs Medical Center, Nashville, Tennessee;;Sepulveda Ambulatory Care Center, Veterans Affairs Greater Los Angeles Healthcare System, North Hills, California;and;David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California. |
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Abstract: | OBJECTIVES: To determine the prevalence of constipation symptoms and the effects of a brief toileting assistance trial on constipation in a sample of fecally incontinent nursing home (NH) residents. DESIGN: Observational study. SETTING: Five NHs. PARTICIPANTS: One hundred eleven fecally incontinent NH residents. MEASURES: Research staff measured bowel movement frequency every 2 hours for 10 days. The following week, residents were offered toileting assistance every 2 hours for 2 days to determine resident straining, time required for a bowel movement, and resident perceptions of feeling empty after a bowel movement. Constipation data were abstracted from the medical record. RESULTS: The frequency of bowel movements during usual NH care was low (mean=0.32 per person per day), and most episodes were incontinent. The frequency of bowel movements increased significantly, to 0.82 per person per day, and most episodes were continent during the 2 days that research staff provided toileting assistance. Eleven percent of residents showed evidence of straining, and 21% of the time after a continent bowel movement, residents reported not feeling empty. Five percent of participants had medical record or Minimum Data Set documentation indicative of constipation symptoms. CONCLUSION: Low rates of bowel movements during the day that are potentially indicative of constipation were immediately improved during a 2-day trial of toileting assistance in approximately 68% of the residents, although other symptoms of constipation remained in a subset of residents who increased toileting frequency. |
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Keywords: | Constipation fecal incontinence nursing home |
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