When a Alzheimer person has a bowel obstruction and is throwing up, what's next?

If she's on strong pain meds, they have a side effect of monster constipation.
Those meds can also irritate some people's stomach. I know they do mine if I don't have something substantial in my stomach before hand. I think most hospice patients are not eating substantially anymore, so there's bound to be a problem eventually.

Constipation can make you nauseous.
So can bowel impaction, which not the same thing as a blockage that kills intestinal tissue.

A doctor needs to weigh in for you. None of us can diagnose via a website.
Bowel impactions are treatable - enema, laxative, manual removal. It's not for the weak of stomach, but the person's relief after is immediate.

Hospice isn't there to make any conditions improve other than pain, since there's no point when someone is in the dying process. *HOWEVER*, it's very tricky sometimes to know when a treatment is for relief and won't prolong life.

If mom has a bowel impaction from pain meds and not taking in enough water & fiber (from not eating really), then the discussion has to be around will more water prolong life, and does mom want that? If she gets ice chips or popsicles to stay more hydrated, what would that hurt?

I wouldn't jump to drastic conclusions or worst-case until a doctor checks her out.

I so agree; it is really an obstruction and she or he might get contamination throughout her body and there no reason for this. I don't know how hospice and i also would get on given a few of the things i often hear.

These days there seems to be so many possibilities; do as Nina suggested and search the web.
My friends mom had a large tumor in her stomach. She could not use anesthesia so they gave her a spinal and went to her stomach through the rectum...success and no cancerous!

My mother had a bowel obstruction and a nurse did a manual extraction. Usually this is done in a hospital with a doctor overseeing the procedure. She also had numerous laxatives and enemas. Google bowel obstruction and get some information on the subject for alternative treatments besides surgery and then discuss the options with your doctor or the Hospice doctor.

Thank you for writing. Black can mean blood so I hope all is okay. I also take care of my Mom with dementia/alz in my home, can your Mom walk? I am debating a hoyer lift as she is declining also. Keep up the miralax and try this, they love it...
2 small cans prune juice (about 5.5 oz each)
Small single serving of applesause
Fill applesause container 2x with brain flakes
Add some sugar if want
Boil all in saucepan slowly for about 10 mins on stove.
Cool and keep in fridge in a jar. I give moms am/pm pills with it to keep her poopin, she loves it.
Keep in touch.

My mom is still on soft bland foods, she finally had a BM which was very black, hospice has been here everyday keeping watch over her. She does seem to be improving since Sunday, sleeping a lot. Thanks so much for all your comments and concerns, I will keep you informed if it gets worse.

I am so glad to hear she is improving but what was it, constipation or obstruction? Miralax is for constipation and my Mom is on a teaspoon every morning no matter what AND eats prune pudding I make 2x daily. PLease let us know whats going on, you have a lot of caregivers out here worried and trying to help and we really care. Thanks

Thanks everyone, my mom has been on Miralax and is improving. We are changing her diet to bland foods and she quit throwing up. Will wait to see if this solves the problem, it was quite an experience.

ask your doctor as gastro doctor if there are newer easy methods of treating bowel obstruction these days and i'd get to the buttom of why she is throwing up so you can at least stop that. and who is to say that the outcome of surgery would be difficult. That is a question for the/a surgeon. get a few opinions.

The treatment is grueling. They pump out her bowel through her nostril for a few days. Then they cut her open and remove the blocked section of her bowel and then they attach that section of the bowel to the side of her and give her a colonostomy bag, that must be cared for on her side. My grandmother did this and stroked out within a week of surgery.

Sadly- to end the vomiting, she will probably have to end solid food. How salient is she?

Are her BM's all mucus? That would indicate a total blockage.

Hospice is not the same as a skilled nursing facility or hospital. The hospice staff is specifically trained in palliative care - to ease any pain and unnecessary suffering of patients that are dying. The key words here are PALLIATIVE and DYING. Your mom was placed in such a facility by the suggestion of her health care providers for a reason. I understand that you hold out hope for a possible recovery or her living much longer than is expected, but that's not keeping it real and may be unfair to her. To easy your mind, I'd suggest you have her primary care provider have a look at her. He/she may be able to help ease her and your suffering.

PPs. I can't believe Hospice, whose prime function is to ease the transition, would arbitrarily conclude this obstruction is an event that can be treated with simplistic remedies like a laxative. There is a reason mom is in Hospice care, her life expectancy is limited and normally choosing Hospice includes a decision, no heroics, such as surgery on a debilitated 88 yr old, assuming you could find a surgeon willing to perform a procedure that will most likely not have a good outcome. Think about why mom was placed in Hospice and let them make her comfortable

I so agree; this is an obstruction and she could get an infection throughout her body and there is no reasoon for this! I am not sure how hospice and I would get along given some of the things i have heard. An obstruction could be causing pain and i would never let my LO keep throwing up. Good way for your LO to get dehydrated.
There are times to let nature take hold but in my view this is a case where LO needs treatment. REAL HOSPITAL NOW!!!! Or, the ER with a copy of the report that says she has an obstruction.

I would get her to a REAL HOSPITAL AND DONT LISTEN TO HOSPICE IN THIS CASE, THEY HAVE BEEN KNOWN TO DO THINGS LIKE THIS! !!!!!!!! NO ONE CAN LIVE LIKE THAT, SHE NEEDS HELP IF ITS AN OBSTRUCTION AND NOT CONSTIPATION. I will say a prayer for you, oh my, poor thing.

i have the same problem. The doctor told me to take Miralax everyday. Try it. it may help her.

Question, does your mother have a advanced care directive? what are her wishes? If hospice says there is no alternatve that she can survive, why question their judgement. It's natural for us to want to hold on tho our LOs as long as possible, but this nay very well be natures way of saying enough. Take into consideration the tortures the medical profession can inflict in the name of extending life. My wife at age 65 with AD had the same symptoms. She had surgery, dx'ed with stage 4 bowel cancer, told she'd die w o chemo. Her response I wish I would rather than linger with AD. Now stage 5 Ad with bowel cancer living hell

It is somewhat hard to know but my thoughts would be she will become increasing weaker... Is she getting any nutrition by IV or anything? My Grandmother's hip broke and she fell, she had the surgery however she gave up and within 3 wks she was gone. She would not eat and just became weaker. This is hard I know I would encourage you to request that they keep her comfortable....

tell a dr to dee if there r alternative treatments; i'd hate to see her throwing up and in pain with an obstruction for the remainder of her life; i think something should be done!