The purpose of this guideline is to reduce the frequency and severity of constipation among older adults through the use of adequate hydration and dietary fibre, regular consistent toileting and physical activity. Achieving and maintaining a pattern of normal bowel elimination will prevent constipation, decrease the use of laxatives, and improve the quality of life for older adults. There is no agreed upon definition of constipation in the clinical and research communities. Some authors maintain that defining constipation on the basis of symptoms is misguided.
This guideline has relevance in all areas of clinical practice, including acute care, community care and long-term care. However, the recommendations should be implemented cautiously with clients who drink less than 1.5 litres of fluid a day, or for those with a neurogenic bowel disorder (lower motor neuron disease). It does not apply to those clients with medical conditions for whom a restricted fluid intake is prescribed, nor for those who receive enteral feedings, nor for those who are palliative or receiving narcotic analgesics. It is important to address the need for treatment of acute constipation and fecal impaction before implementing this guideline.
This guideline does not apply to those clients with medical conditions for whom a restricted fluid intake is prescribed, nor for clients receiving narcotic analgesics, palliative care, or enteral feedings. It should be used with caution with immobile (bedridden) clients, with those who have restricted toileting or who have a neurogenic bowel (lower motor neuron disease).