Constipation means infrequent, difficult or painful bowel movements, or a feeling of not emptying fully. It is common in older adults because of low fluid and fibre intake, inactivity and medicines. It may seem minor, but it can cause abdominal pain, poor appetite, urinary problems and, especially in people with dementia, restlessness and confusion.
Common causes
- Drinking too little and eating too little fibre
- Inactivity, being bedbound
- Medicines: some painkillers (especially opioids), iron tablets, some stomach medicines, diuretics and some antidepressants
- Putting off going to the toilet; difficult access to the toilet or a lack of privacy
- Conditions such as Parkinson’s, diabetes and thyroid disease
Daily steps for prevention
- Regular fluids spread through the day (unless the doctor has restricted fluids).
- Increase fibre gradually: vegetables, fruit, pulses, wholegrain bread, prunes or dried apricots.
- Move every day: short walks, seated exercises; even for someone bedbound, changes of position and joint movements.
- A set toilet time: offer an unhurried chance to sit on the toilet, especially after breakfast.
- The right position: a small footstool under the feet, so the knees are slightly higher than the hips, can help.
- Privacy: close the door and do not rush them.
Laxatives and enemas: only with medical advice
Do not use constipation remedies regularly, including over-the-counter laxatives, without asking a doctor or pharmacist. Which product is suitable depends on the person’s conditions and the medicines they take. If they have started a medicine that causes constipation, ask whether a preventive plan is needed.
Beware: constipation that looks like “diarrhoea”
In severe constipation, liquid stool leaking around hardened stool can be mistaken for diarrhoea. Giving an anti-diarrhoea medicine then makes things worse. Watch out for this especially in people who are bedbound or have dementia, and ask a doctor.
When to see a doctor
- Blood in the stool, or black, tarry stools
- Unexplained weight loss, constant tiredness
- A new change in bowel habit lasting several weeks
- Severe abdominal pain, a swollen abdomen, vomiting and being unable to pass wind: urgent assessment is needed
- Sudden confusion or being unable to pass urine together with constipation
Add bowel notes to the care diary: the date and a short description are enough. That way, changes lasting more than three days are noticed even if the person cannot tell you.
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Prepared by WellFamily using the public guidance below. This is general information, not a clinical assessment or a claim of medical review.