Bladder and Bowel Symptoms, Dementia and Responsive Behaviors: An Integrative Review

Background: Dementia has become a worldwide healthcare and research focus. However, there is currently little research linking bladder and bowel symptoms with responsive behaviors in dementia. Aim: The aim of this integrative review was to identify research literature that explores the role of bladder and bowel symptoms as triggers of responsive behaviors  in persons with dementia. Design: This integrative review was informed by the method of Whittemore and Knafl and guidelines by Torraco. Methods: Electronic databases of Ovid Medline, Embase, PSYCInfo, Cochrane, EBSCO/CINAHL, Scopus, and Web of Science were searched. Five studies met inclusion criteria. They were assessed for quality using the Mixed Methods Appraisal Tool. Studies were compared, analyzed, and synthesized. Results: The categories developed were: (1) bladder and bowel symptoms examined, (2) relationship of behavior measurement to responsive behaviors, and (3) associations between incontinence and behaviors symptoms. Conclusion: The findings of this investigation demonstrate a limited understanding of the association between bladder and bowel symptoms with responsive behaviors. The conceptualization of behaviors as problems was evident in the studies. This conceptualization is not reflective of a contemporary view of behaviors as an expression of an unmet need. Future research is needed to understand the association between bladder and bowel symptoms and responsive behaviors