Abstract
Urinary and fecal incontinence as well as skin pressure injury are common healthcare problems in nursing homes; however, the prevalence and related risk factors were not well understood in the Japanese special elderly nursing home settings. We surveyed the prevalence of urinary, fecal and double incontinence, and skin pressure injury among the elderly living in special elderly nursing homes in Japan. A nationwide cross-sectional epidemiological survey was conducted with a total of 4881 residents. The prevalence of urinary, fecal and double incontinence was 82.9%, 68.9% and 64.9%, respectively. Skin pressure injury was found in 283 residents (283/4881, 5.8%). Age, Care-Needs level, loss of voiding desire, and fecal incontinence were significant risk factors for urinary incontinence. Residential period, Care-Needs level, loss of voiding and defecation desires, and urinary incontinence were significant risk factors for fecal incontinence. Only male sex was a significant risk factor for skin pressure injury. Our study revealed continence status and the prevalence of pressure skin injury among older adult residents who receive end-of-life care in special elderly nursing homes in Japan. Further studies should be conducted to examine whether recovery of urinary and fecal sensations improves continence status.
Highlights
Mean life expectancies of Japanese males and females were 81.41 and 87.45 years in2019 [1]
We evaluated caregiver-reported outcomes of the elderly residents including the prevalence of urinary, fecal and double incontinence, and skin pressure injury among the elderly living in special elderly nursing homes in Japan
Council of Senior Citizens Welfare Service to be involved in the present study, and 969 (41.4%) facilities responded
Summary
Mean life expectancies of Japanese males and females were 81.41 and 87.45 years in2019 [1]. In 2019, the proportion of the elderly aged ≥65 years became 28.1% in Japan and the Japanese situation has been in super-aged society Geriatric syndromes have been defined as multifactorial health conditions that occur when the accumulated effects of impairments in multiple systems render an older person vulnerable to situational challenges [4]. As for urinary incontinence, age-related changes in the lower urinary tract and external genitalia and other factors outside the lower urinary tract including comorbid medical illness, neurological and psychiatric conditions, some medications, functional impairments, and environmental factors are known risk factors of urinary incontinence. Aside from age, the following are primary risk factors of fecal incontinence: stool consistency, bowel-related disorders, impaired mobility, functional impairment, dementia, neurological diseases, diabetes mellitus, chronic medical conditions, and depression [5]
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