Prevalence of constipation symptoms in fecally incontinent nursing home residents.
OBJECTIVE
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.


METHODS
Observational study.


METHODS
Five NHs.


METHODS
One hundred eleven fecally incontinent NH residents.


METHODS
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.


CONCLUSIONS
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.
Schnelle
John F
JF
Division of General Internal Medicine and Public Health, Center for Quality Aging, School of Medicine, Vanderbilt University Medical Center, Nashville, TN 37232, USA. John.Schnelle@vanderbilt.edu
Simmons
Sandra F
SF
Beuscher
Linda
L
Peterson
Emily N
EN
Habermann
Ralf
R
Leung
Felix
F
D000369:Aged, 80 and over; D001521:Behavior Therapy; D003248:Constipation / Q000150:complications / Q000453:epidemiology* / Q000517:prevention & control*; D005242:Fecal Incontinence / Q000150:complications / Q000453:epidemiology* / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D009735:Nursing Homes; D015995:Prevalence; D016896:Treatment Outcome