Abstract
The present study aimed to examine toileting and eating in activities of daily living of patients admitted to Japanese public and private institutions for children with severe motor and intellectual disabilities (SMID) from 1988 to 2009. A survey of 12 items of body functions, activities and environmental factors associated with toileting and eating was conducted. The proportion of patients with severe impairments of urination and defecation and that of patients with the unspecified impairment were 30% and 50%, respectively. Approximately 80% of the patients had complete difficulty in understanding urination and defecation issues. This appeared to be caused by impairments of urination and defecation functions, as well as by limitations of communication-producing. Therefore, most of the patients needed intensive support for toileting. Ingestion functions, such as sucking, chewing and swallowing were impaired in 50%, 75% and 60% of the patients, respectively. The proportion of the patients who could not eat by themselves was approximately 70%, and 25% were able to ingest a meal with a spoon. Some extent of support for eating was provided to most of the patients, including full support to 75% of the patients. Different types of meals, such as liquid, hashed, gruel and usual meals were appropriately served according to the patient's ingestion impairments. These results indicate the presence of severe impairments and activity limitations of toileting and eating in these patients, as well as severe motor and intellectual disabilities.
