A strategy to reduce laxative use among older people

Institutions can be places of routine and unquestioned practice in the administration of medications. In one mixed ward of psychogeriatric patients constipation was a common problem for which laxatives were routinely given. In this particular ward, many of the patients were receiving up to five different laxatives a day either orally or rectally. Dementia and being bed or chair-bound greatly increased the risk of chronic constipation. Excessive laxative use is another cause of chronic constipation. A review of practice and a decision implement a new approach was prompted by the arrival of new ward managers. The use of laxatives was stopped almost entirely and a new dietary regime was started. This article outlines how the changes were implemented.