4.20 – Case study: Jim who has faecal incontinence

In this step, you meet ‘Jim’, our final case study on this course, who has faecal incontinence.

Jim has been admitted to an intermediate care unit. He had a stroke several years ago. He has a pacemaker in. He has cellulitis on his legs and a lot of health problems as a result of his stroke. He has dysphasia, making him unable communicate fully. He is confined to a wheelchair and had been managing his urinary continence himself by using a urine bottle, until he became so frail and weak that he was no longer able to do so.

Jim’s presenting symptoms at the time of his continence assessment:

• • His main urinary problem was some urgency

• • History of constipation

• • The unit were asked to keep used pads for a 24 hour period, upon review they had various amounts of urine in them and almost every single one had faecal smearing present

• • Fluid intake and output charts all had gaps, including those from hospital and intermediate care, 

• • Medication charts – prescribed laxatives but was not always getting them

• • In a face-to-face meeting with care home staff, his family and social workers, although he was not always understood because of his dysphasia, his daughter was able to translate for him and it was discovered that he had not sat on the toilet for three years

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Your task

Based on the information above, what would your first priority be in considering how to promote recovery of Jim’s bowel function? And why would this be? Do you think it is likely that Jim will recover his bowel function?

Share your thoughts with fellow learners.