Diarrhea in long-term care: a messy problem.

نویسندگان

  • John E Morley
  • Karl E Steinberg
چکیده

As can be seen from the above 2 quotations, although diarrhea is a major cause of morbidity and mortality, it is often not given the respect it deserves. Diarrhea and fecal incontinence are extraordinarily common in the nursing home. Diarrhea is a significant cause of increased expenditures in the nursing home because of nursing time and laundry expenses. Most deaths from diarrhea occur in older persons, usually in association with dehydration. Diarrhea can be a particular problem in frail older persons. In a Salmonella outbreak in a Maryland nursing home where 72% of residents and 24% of staff were infected, 24% of the infected residents died. Despite this, there is a paucity of literature on the prevalence and causes of diarrhea in the nursing home. In many cases of chronic diarrhea, weight loss is the presenting feature, yet diarrhea is seldom considered in nursing homes as a major cause for weight loss. Chronic diarrhea can lead to fat-soluble vitamin deficiencies. This is particularly true for vitamin D. Vitamin D deficiency is very common in nursing home residents and results in decreased function and in increased falls, hip fractures, and mortality. Diarrhea appears to be particularly common in frail older persons. The role of acute and chronic diarrhea in the pathogenesis of delirium secondary to dehydration and micronutrient deficiency is underrecognized. As in younger persons, diarrhea in the nursing home can be acute or chronic. Diarrhea needs to be distinguished from

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عنوان ژورنال:
  • Journal of the American Medical Directors Association

دوره 10 4  شماره 

صفحات  -

تاریخ انتشار 2009