The occurrence and risk factors of constipation in inpatient palliative care unit patients vs. nursing home residents

Introduction
Constipation is one of the most frequent clinical and nursing problems both in palliative care patients and in nursing home residents.

Aim
To assess the occurrence of constipation and its risk factors in adult inpatient palliative care units versus nursing homes.

Material and methods
An epidemiological study was performed in an inpatient hospice and a nursing home.

Results
Fifty-one hospice patients and 49 nursing home residents were included in the study. Cancer was the main clinical condition in 90% of the palliative care patients (PCPs), and dementia or other psychotic disorders were predominant in the nursing home residents (NHRs). More PCPs had constipation than did NHRs (80% vs. 59%; p = 0.02), although none of the single constipation symptoms differed statistically between these two groups. The insufficient food intake was twice as severe in the hospice patients (p = 0.0001). 68.6% of PCPs took strong opioids, while none of the NHRs did. Three times more NHRs spent at least 50% of daytime in bed than did PCPs (73.5% vs. 23.5%; p < 0.0001).

Conclusions
Constipation is very frequent in both palliative care patients and nursing home residents, but PCPs are more prone to it. The NHR and PCR groups should not be treated uniformly as the end-of-life population, referring to prevention and treatment of constipation, therapy needs, and the means enrolled for optimal symptom control.