Factors contributing to fecal incontinence in older people and outcome of routine management in home, hospital and nursing home settings

Objective: Fecal loading, cognitive impairment, loose stools, functional disability, comorbidity and anorectal incontinence are recognized as factors contributing to loss of fecal continence in older adults. The objective of this project was to assess the relative distribution of these factors in a variety of settings along with the outcome of usual management. Methods: One hundred and twenty adults aged 65 years and over with fecal incontinence recruited by convenience sampling from four different settings were studied. They were either living at home or in a nursing home or receiving care on an acute or rehabilitation elderly care ward. A structured questionnaire was used to elicit which factors associated with fecal incontinence were present from subjects who had given written informed consent or for whom assent for inclusion in the study had been obtained. Results: Fecal loading (Homes 6 [20%]; Acute care wards 17 [57%]; Rehabilitation wards 19 [63%]; Nursing homes 21 [70%]) and functional disability (Homes 5 [17%]; Acute care wards 25 [83%]; Rehabilitation wards 25 [83%]; Nursing homes 20 [67%]) were significantly more prevalent in the hospital and nursing home settings than in those living at home (P < 0.01). Loose stools were more prevalent in the hospital setting than in the other settings (Homes 11 [37%]; Acute care wards 20 [67%]; Rehabilitation wards 17 [57%]; Nursing homes 6 [20%]) (P < 0.01). Cognitive impairment was significantly more common in the nursing home than in the other settings (Nursing homes 26 [87%], Homes 5 [17%], Acute care wards 13 [43%], Rehabilitation wards 14 [47%]) (P < 0.01). Loose stools were the most prevalent factor present at baseline in 13 of the 19 (68%) subjects whose fecal incontinence had resolved at 3 months. Conclusion: The distribution of the factors contributing to fecal incontinence in older people living at home differs from those cared for in nursing home and hospital wards settings. These differences need to be borne in mind when assessing people in different settings. Management appears to result in a cure for those who are not significantly disabled with loose stools as a cause for their fecal incontinence, but this would need to be confirmed by further research.

Contemporary ordinary language philosophy

There is a widespread assumption that ordinary language philosophy was killed off sometime in the 1960s or 70s by a combination of Gricean pragmatics and the rapid development of systematic semantic theory. Contrary to that widespread assumption, however, contemporary versions of ordinary language philosophy are alive and flourishing, but going by various aliases—in particular (some versions of) "contextualism" and (some versions of) "experimental philosophy". And a growing group of contemporary philosophers are explicitly embracing the methods as well as the title of ordinary language philosophy and arguing that it has been unfairly maligned and was never decisively refuted. In this overview, I will outline the main projects and arguments employed by contemporary ordinary language philosophers, and make the case that updated versions of the arguments made by ordinary language philosophers in the middle of the twentieth century are attracting renewed attention.

Applied philosophy of language

This chapter explores the extent to which philosophy of language can be considered an applied discipline. I consider, first, ways in which sub-sections of philosophy of language may be considered as applied in terms of their subject matter and/or the kinds of questions being addressed (e.g. philosophy of language which deals with derogatory or inflammatory uses of language, or the role of philosophy of language within feminist philosophy). Then, in the second part of the chapter, I turn to consider a more general (and perhaps more controversial) conception of philosophy of language as applied, which arises from the methodology adopted and the relationship of the discipline to empirical data.

Qualitative tools & experimental philosophy

Experimental philosophy brings empirical methods to philosophy. These methods are used to probe how people think about philosophically interesting things such as knowledge, morality, freedom, etc. This paper explores the contribution that qualitative methods have to make in this enterprise. I argue that qualitative methods have the potential to make a much greater contribution than they have so far. Along the way, I acknowledge a few types of resistance that proponents of qualitative methods in experimental philosophy might encounter, and provide reasons to think they are ill-founded.

Experimental philosophy of language

Experimental philosophy of language uses experimental methods developed in the cognitive sciences to investigate topics of interest to philosophers of language. This article describes the methodological background for the development of experimental approaches to topics in philosophy of language, distinguishes negative and positive projects in experimental philosophy of language, and evaluates experimental work on the reference of proper names and natural kind terms. The reliability of expert judgments vs. the judgments of ordinary speakers, the role that ambiguity plays in influencing responses to experiments, and the reliability of meta-linguistic judgments are also assessed.