Long-Term Care

Key elements of a bowel training program

LTC Nursing Assistant Trainer, February 12, 2004

There are many reasons for constipation, including a person's eating habits, physical build, and level of physical activity. Other reasons include intestinal obstructions, medication intake, stroke, and tumors. For seniors, however, decreased peristalsis also plays a part. Peristalsis is a series of rhythmic contractions that push the food through the body during the digestive process.

Because of the pain and discomfort constipation may cause residents, it's important to implement bowel training programs. Bowel training program measures include:

  • Adequate intake of fluid. Intake of enough fluids to keep stool soft will promote healthy bowel movements. Monitoring the resident's intake of fluids is an essential part of a bowel training program.
  • Provide fiber-rich foods. Foods heavy in fiber increase the size or bulk of stool, which helps it move through the intestines. Remember to increase residents' fluid intake when fiber-rich foods are eaten, because fiber absorbs the liquid and swells, encouraging peristalsis by stimulating the intestinal walls.
  • Exercise and physical activity. Suggest exercise and physical activity to residents suffering from constipation. Movement of the abdominal muscles will help stimulate peristalsis.
  • Provide a regular, private time for defecation. Doing so will help create a regular evacuation pattern. By familiarizing yourself with your residents' normal defecation patterns, you will better assist them in promptly responding to their toileting schedule. Following a structured program will also give residents ample time and privacy to complete the elimination process.
  • Suppositories. Suppositories may be used to stimulate defecation. However, do not regularly use laxatives and enemas.

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