There remains a lack of clear evidence to guide the management of constipation in clinical practice, especially at the end of life. Often, clinical approaches to tackle this common and distressing problem are based only on experience and anecdotal evidence. This situation is less than ideal. Constipation at the end of life may present additional problems, as conventional therapies may be unsuitable or inappropriate. This can create a considerable challenge to those caring for individuals with life-limiting illnesses.
This article will explore the issue of continence care during the terminal phase of life. This period is often referred to as ‘the end of life’ or ‘the last 48 hours’. Patients are thought to be in the dying phase of their illness when they only have hours or days left to live (referred to as the ‘terminal phase’ in this article). Continence care is complex during the terminal phase as it can have a significant impact on the dignity of patients and adds to their physical and emotional burden.