A cross sectional survey of constipation prevalence and laxative use among older adults residing in a nursing home setting in Ireland.

Background: Constipation is a common, distressing and troublesome condition and whilst it may affect any one of any age, it is said to be one of the most common complaints among the older person population. Indeed, prevalence rates within this population are high as 74%.In the older person population disturbed bowel function is often associated with depression, immobility and isolation. The costs of this condition are high, not only for the individual sufferer, but for society as a whole. Whilst laxatives are said to be the most frequently prescribed drugs in long term care settings, the costs of these treatments have not been systematically reported. From an Irish perspective, there appears to be a significant gap in the evidence based literature in relation to this condition. Aim of Research: The aims of this research were to: determine the prevalence of constipation in an Irish nursing home population; to assess the use of laxatives among the study population; to determine local policy in management of constipation in the nursing home population; to conduct a micro cost analysis of current treatment of chronic constipation. Methods: A Quantitative cross-sectional descriptive survey was carried out. A total of 94 residents from 6 nursing homes in Ireland participated in this study. Results Of all individuals residing in the 6 nursing homes, 38% were suffering with constipation. The mean age of participants was 83 years and 64% were female. The mean Barthel score was 9.60 indicating a medium level of dependency. The mean BMI was 27.41 indicating that the participants were, on average, overweight. Constipation prevalence was higher among females and among older rather than younger participants. The use of laxatives was very high, with all participants prescribed at least one laxative; however, some (38%) were using 3 to 5 different treatments for constipation. Management strategies were diverse suggesting a lack of a uniform approach to both the prevention and management of constipation. Furthermore, related costs of management were higher than those cited in previous international research. Conclusion: Over one third of the population residing in the nursing home setting were constipated. Thus, the prevention and management of constipation is an important issue among this population. Management approaches lacked uniformity suggesting the need to focus on a standardisation of policies of assessment and prevention.