Factors Associated With Toileting Disability in Older Adults Without Dementia Living in Residential Care Facilities

Abstract

Older adults without dementia living in residential care facilities with toileting disability have increased care costs and dependency. Understanding associated factors could guide prevention and management strategies. The aim of this study was to identify the prevalence of and factors associated with toileting disability in this population. This was a cross-sectional analysis of the 2010 National Survey of Residential Care Facilities. A subsample (n = 2,395) of adults aged 65 years or older, without dementia, and with the potential to implement behavioral interventions was examined. Associated factors were classified according to the disablement process as pathologies, impairments, functional limitations, coexisting disabilities, and intraindividual and extraindividual factors. Logistic regression models accounting for the stratified two-stage probability sampling design were used to identify factors associated with toileting disability. Residents were mostly White women, aged 85 years and older. Prevalence of toileting disability was 15%. Associated factors included reporting fair or poor health; living in a facility with four or less residents; living in a for-profit facility; having bowel incontinence, urinary incontinence, more physical impairments, and visual and hearing impairments; and needing assistance with bathing, dressing, and transferring. Multicomponent and multidisciplinary prevention and management efforts should be designed for residents without dementia. Future studies testing the efficacy of prevention efforts are needed and should include treatments for incontinence; physical activity programs targeting impairments with walking, standing, sitting, stooping, reaching, and grasping; and therapy to improve dressing, bathing, and transferring skills.