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Related Experiment Videos

Constipation: assessment and management in an institutionalized elderly population

D Harari1, J H Gurwitz, J Avorn

  • 1Division on Aging, Harvard Medical School.

Journal of the American Geriatrics Society
|September 1, 1994
PubMed
Summary

In long-term care facilities, laxative use is high, with many residents reporting constipation. However, there

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Area of Science:

  • Geriatric Medicine
  • Gastroenterology
  • Pharmacology

Background:

  • Constipation is a common issue in long-term care facilities.
  • Prescribing patterns for bowel management medications require examination.

Purpose of the Study:

  • To investigate laxative, stool softener, and enema use in a long-term care setting.
  • To compare resident self-reports of constipation with objective symptom criteria.
  • To assess agreement between resident and nursing staff assessments of bowel symptoms.

Main Methods:

  • Cross-sectional study of 694 long-term care residents.
  • Data abstracted from medical records; interviews conducted with residents and nurses.
  • Constipation defined as ≤2 bowel movements/week and/or straining on >1 in 4 movements.

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Main Results:

  • 50% of residents used bowel medications daily; over half of laxative users took >60 doses/month.
  • Stool softeners were most common, followed by saline, stimulant, hyperosmolar, and bulk laxatives.
  • Only 62% of self-reported constipation cases met study criteria; resident-nurse concordance was poor (kappa 0.12-0.38).

Conclusions:

  • High utilization of bowel medications in long-term care.
  • Discrepancies exist between self-reported constipation and objective symptoms.
  • Poor concordance between resident and nurse assessments highlights potential for improved bowel care management.