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What it is: Constipation is the limited or difficult passing of hard, dry stools (faeces). The time it takes for food to pass through the gut will depend on the individual.
Why it matters: Constipation is common in people with palliative care needs. Nurses have a role in assessment and care because constipation reduces quality of life and can cause:
What I need to know: Constipation is a common concern in older adults. It is one of the most common symptoms in people receiving palliative care at an advanced stage of disease. Some specific factors relating to end of life that can influence constipation are:
A bowel management program developed to address constipation concerns should reflect the person’s preferences and be consistent with the current goals of care for the person.
Aperients as treatment for constipation:
To know what the usual bowel habits for the individual are ask the person or their family.
A bowel management program can include:
For palliative care:
Choice of aperient should be based on patient preference and circumstance. Consider what other medications the person is taking and for oral aperients the person’s capacity to swallow.
Tools that may be useful include:
Screening Tool of Older Persons Prescriptions in Frail adults with limited life expectancy (STOPPFrail) (272kb pdf) - identifies medications which can cause or exacerbate constipation.
Bristol Stool Chart - a visual aid based on seven stool types.
How could I investigate whether the older person’s medications are causing the constipation?
Careworkers are well placed to notice when a person’s toileting patterns change. How does this information reach nursing/supervisory staff in my organisation?
See related palliAGED Practice Tip Sheets:
Faecal Incontinence
Nutrition and Hydration
Opioid Analgesics
For references and the latest version of all the Tip Sheets visit www.palliaged.com.au/Practice-Centre/For-Nurses
CareSearch is funded by the Australian Government Department of Health and Aged Care. Updated May 2024