Laxative use in care homes

Abstract

This paper is a report of an investigation into the factors associated with laxative-taking by older people in care homes. Constipation is a common source of discomfort, pain and morbidity for care home residents, and laxative-taking is prevalent. Differences in the extent to which older people suffer from constipation may result from care routines rather than demographic or clinical factors. Primary data were gathered from care records as part of a larger study in seven care homes (without on-site nursing) in London, England in 2003-2004. Backward stepwise logistic regression modelling was used to investigate factors (age, sex, level of dependency [Barthel]), number of comorbidities, number of medications, constipating medications, length of stay in care home, diagnosis of dementia/Alzheimer disease) associated with regular laxative-taking. Of 168 residents, 99 (58.9%) were routinely given laxatives. Taking more medicines (moving up one category: 0, 1-2, 3-4, 5-6, > or = 7) increased the likelihood of taking laxatives more than threefold, after controlling for all other factors. Women were 2.9 times more likely to take laxatives than men. Having dementia/Alzheimer disease increased the likelihood of taking laxatives by 2.6 times. Laxative-taking was statistically significantly lower in two of the care homes. Laxative use amongst older people in care homes varies and may not be based on rational criteria. Nurses working in care homes and with care staff can help to implement appropriate bowel care for older people.