Evaluation and Management of Rectal Prolapse Among Geriatric Patients

Evaluation and management of older adults within emergency care settings is often complex and has the potential for avoidable complications. In an effort to prevent harm to the patient, treatment strategies need to be multifactorial. For geriatric patients presenting with rectal prolapse, unique management strategies, including the use of granulated sugar and gentle pressure, may assist in the reduction of the prolapsed tissue. Additional interventions that are important to incorporate into the older adult's plan of care include gentle approaches to positioning, involvement of family/caregivers, avoiding harmful medications, reducing risk for delirium, and a successful transition of care. A manual reduction completed in the emergency department can relieve discomfort and prevent further complications while the patient awaits surgical evaluation and intervention. Prompt evaluation and management by the advanced practice registered nurse may not only expedite recognition of the prolapse, but can reduce iatrogenic complications that may occur from delayed treatment.