Preventing Constipation in People Living With Dementia: Co-Design of a Non-Pharmacological Care Bundle for Residential Aged Care.

AIM(S): To develop a care-bundle of non-pharmacological strategies with the potential to prevent constipation in people with dementia in Residential Aged Care (RAC).

DESIGN

Mixed-methods intervention development study using Modified Delphi and co-design, informed by evidence, current constipation prevention practices and stakeholder collaboration to define best practice.

METHODS

The draft bundle was developed using evidence from a scoping review, consultations with aged care professionals and staff at two RAC homes and field observations. It was then refined through expert and lived-experience panels via an online Modified Delphi survey (rating relevance, acceptability and feasibility) and a face-to-face workshop to finalise items for the constipation prevention care-bundle.

DATA SOURCES: Health data, interviews, observations, surveys and workshops.

RESULTS

The draft care-bundle comprised 24 items; 13 reached ≥ 78% agreement in the Modified Delphi, including dietitian consultation, adequate fibre, individualised hydration and toileting plans, beverage cart, constipation risk assessment, privacy during toileting, dementia-friendly signage, toileting positioning, contrasting toilet seat, electronic alerts, staff education and resident/family information.

CONCLUSION

An evidence-informed and co-designed care-bundle was co-developed with potential to prevent constipation in residents with dementia.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: This research has implications for nursing practice by offering an alternative to reliance on pharmacological strategies for preventing constipation in people with dementia.

IMPACT: This co-designed and evidence-informed care-bundle has potential to reduce the incidence of constipation among the growing population with dementia. To ensure sustained use, it was co-designed with stakeholders to be fit-for-purpose.

REPORTING METHOD: There were no reporting guidelines for this co-design study identified.

PATIENT OR PUBLIC CONTRIBUTION: End-users, including frontline staff and older people receiving care, as well as carers of people with dementia, were engaged in the co-design as equal partners in the constipation prevention care-bundle development process.