The healthcare assistant and bowel care

Abstract

In February this year, an inquest into the premature death of a 33-year-old man concluded that gross failures in care had led to his death. Mr Richard Hanley had learning disabilities, some mental health problems and had lifelong constipation. This was managed effectively when he lived in residential care; however, when he moved to supported living he became constipated. His family reported that his abdomen resembled that of a woman about to give birth. Mr Handley was admitted to hospital and 10kg of faeces was surgically removed from his body two days before his death. The coroner determined that the causes of death were inhalation of gastric contents, large bowel obstruction and faecal impaction ( BBC News, 2018 ; Hill, 2018 ; Inquest, 2018 ). Constipation is often considered a minor problem; however, it can have serious and even life-threatening consequences. Each year, 66 287 people are admitted to hospital because of constipation ( Department of Health (DH), 2015 ). The NHS spends around £250 million pounds annually treating constipation. Hospital admissions cost £145 million and primary care spends around £92 million in laxative prescriptions ( DH, 2015 ; Shafe et al, 2011 : NHS Information Centre, 2016 ). This article aims to enable readers to be aware of how normal bowel function varies in individuals, how ageing, frailty, long-term conditions and medication affect bowel function, how to promote normal bowel function and to manage constipation.