1 / 13

Doron Garfinkel , M.D., Svetlana Zludkov , M.D ., Sameira Jamal, R.N., Ronit Har-Noy , R.N .

The effects of Stopping Enemas in Disabled Elderly Patients Suffering from Constipation in Nursing Departments. Doron Garfinkel , M.D., Svetlana Zludkov , M.D ., Sameira Jamal, R.N., Ronit Har-Noy , R.N. The Shoham Geriatric Medical Center, Pardes-Hanna, ISRAEL.

kalil
Télécharger la présentation

Doron Garfinkel , M.D., Svetlana Zludkov , M.D ., Sameira Jamal, R.N., Ronit Har-Noy , R.N .

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. The effects of Stopping Enemas in Disabled Elderly Patients Suffering from Constipation in Nursing Departments DoronGarfinkel, M.D., Svetlana Zludkov, M.D., Sameira Jamal, R.N., RonitHar-Noy, R.N. The Shoham Geriatric Medical Center, Pardes-Hanna, ISRAEL

  2. Shoham Geriatric Medical Center • Owned by the Government • The largest geriatric campus in Israel • 360 square Km of land • 800 patient’s beds

  3. מ ד י נ ת י ש ר א ל מ ש ר ד ה ב ר י א ו ת המרכז הגריאטרי המשולב ע”ש שוהם פרדס חנה

  4. The effects of Stopping Enemas in Disabled Elderly Patients Suffering from Constipation in Nursing Departments BACKGROUND : • Constipation is a very common age - associated problem in elderly people. • The incidence of Constipaion increases with Age, Co-morbidities, Drugs, Disability and Immobility. • The incidence is higher in Nursing Homes (NH) and particularly in Nursing Departments (ND). • Constipation can be relieved by diet, several types of Laxatives and Enemas.

  5. BACKGROUND : • In many disabled patients in ND, Constipation can be relieved only by enemas. • In September 2004, supply of Fleet Enemas (FE) ( Sodiumbiphosphate 16g/ Sodiumphosphate 6g/ 10cc, ) was unexpectedly stopped and we had to use our Reserve or give Lactulose instead. • The influence of Discontinuation of Enemas (DoE) in our ND patients was evaluated.

  6. METHODS • 270 disabled patients in 10 ND were evaluated. • Begining September 1, in all patients teated with FE, an attempt of DoE was made and they were all given Lactulose. • Using medical and nursing follow up notes, several parameters were compared in all patients between July-August and October-November of 2004 (before and after DoE, respectively).

  7. R E S U L T S 270 patients Fleet Enema 194 (72%) NO treatment 16 (6%) Lactulose 60 (22%) DoE Attempt Unbearable Symptoms Requiring Readministration of FE FAILUE 120 (62%). SUCCESSFUL 74 (38%). LATE EFFECTS Control Group 196 Pt. DoE Group 74 Pt. Comparing parameters before & after DoE

  8. RESULTS LATE EFFECTS OF DoE Following 3 months of DoE, There was No difference between the Doe and controls in: • Urinary symptoms • Sleep • Appetite • Irritability • Urinary or Respiratory Infections • Number of sedatives/tranquilizers prescribed • Referrals to Hospitals before and after DoE • Findings of Rectal Examination were comparable in both groups

  9. RESULTS LATE EFFECTS OF DoE Following 3 months, The DoE group Did Have: • A significantlly increased number of Physical Examinations by physician (123 before 226 after DoE, no significant change in controls, P< 0.01). • A higher prevalence of increase in body weight (35% compared to 15% in the controls, p < 0.001).

  10. CONCLUSIONS • In Nursing Departments, stopping Enemas and starting Lactulose with NO significant adverse effects, can be accomplished in less than 40%. • However, in most disabled patients in ND, Stopping Enemas is Inpractical and has No Clinical or Financial Benefits.

  11. Thank You ! DoronGarfinkel, M.D. The Shoham Geriatric Medical Center, Pardes-Hanna, ISRAEL

More Related