Managing chronic constipation in long-term care settings

Constipation in the elderly is common and has a significant impact on quality of life and use of healthcare resources in long-term care settings. A careful history, medication assessment, and physical examination are helpful in obtaining relevant clues that help direct management. Fiber supplementation and osmotic laxatives are effective for many patients. Simplifying bowel programs saves time and energy and provides a more unified approach to care. Special effort should be taken to identify features inherent to the elderly, and treatment should be based on the patient's overall clinical status and capabilities. Facilities should establish policies and procedures that promote good bowel function, understand the factors that contribute to this problem, and approach each resident to best meet his or her expectations.