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Constipation in the daily lives of frail elderly people
C R Wolfsen1, J C Barker, L S Mitteness
1Department of Epidemiology and Biostatistics, University of California, San Francisco.
Objective:
To examine the meaning and context of constipation in frail elders.
Design:
Interview study with monthly follow-up for a 6-month period.
Setting:
Respondents' homes.
Participants:
Two hundred eleven randomly selected community-living, frail elders receiving in-home health care.
Results:
Constipation was spontaneously mentioned by 94 patients (45%); it was considered a major health problem by 11% of these frail elders. Of this 11%, over half rated it as one of their top three health concerns. Of elders who talked about management strategies, most (43 [61%] of 70 patients) used medication alone. Only eight people did not use pharmacologic agents. Few (16 [17%] of 94 patients) mentioned a health-care professional in the context of constipation, and only five of these people expressed satisfaction with advice or treatment.
Conclusions:
Constipation was a health problem for many of these elderly patients receiving home health care. Although the stated goal in the treatment of constipation is to avoid laxatives, both lay and medical management focused primarily on the use of medications. The results of this study underscore the importance of addressing quality of life as well as physiological issues for optimal treatment of constipation and similar disorders.