Dad has moderate to severe vascular dementia and has been living at the equivalent of NH at the VA for several months. I visit every month and I am here for 2 weeks. Today, he was having a severe problem with an incompletely expelled, very hard, BM. At home he was used to being reminded to drink copious amounts of water. He does not seem dehydrated, however from personal experience I know that clear water can sometimes help the situation. Here is not allowed clear fluids due to aspiration risk, because he is not always mindful when drinking. Nurse wants to add stool softeners to his medicine regimen "except for when he is loose". These take hours to work, I'm thinking more water might be better, but he is not dehydrated, just want to avoid more medicine especially one with unpredictable timing. I imagine it is quite uncomfortable for everyone should an aging man defecate in his drawers. I am wondering if milk of magnesia which is a mild laxative, would work better. It doesn't seem to be available to the nurses. Yesterday he knew exactly what dose he needed and how often, because apparently he's had this problem before when he was home, and I know they won't try to follow his own medical advice. Seems more water and an occasional gentle laxative might work better than a regimen of stool softeners. He does not appear dehydrated, but my personal experience says drinking water helps, regardless. Not sure he can be trusted or capable to drink water alone in his room. Maybe they could have him drink a full glass of water as part of the morning and evening medicine delivery system. Does anyone know the ins and outs of this issue as it relates to a sort of nursing home? SS vs laxative vs just getting enough water. Also the ins and outs of calling plain old H20 medicine! Thank you.
33 Answers
Helpful Newest
First Oldest
First
You cant go wrong with magnesium and just about everyone is deficient due our depleted soil today, especially older people. Give it a try. Your Dad will thank you.
ADVERTISEMENT
http://www.sciencehealth24.com/2016/12/what-urine-colour-says-about-your-wellbeing.html?m=1
I found this website to be invaluable:
https://www.mamanatural.com/great-poop-looks-like/
The best remedy we found is PRUNES (recommended by doctor after hospital emerg visit) All we do now is make sure she drinks enough water, prune juice, and prunes. No laxative's etc.
There is also a similar chart for urine showing the color in relation to dehydration levels.
Good luck.
Of course, water is the great solution to almost everything, so don't back down on water consumption! But I'm pretty sure nursing facilities add stool softeners to all their patients' meds, simply because it virtually avoids any complications for them and their staff. In other words, it makes their job easier.
But before anyone gets "addicted" to needing a stool softener, you might want to look into acupressure. My mother was recently EXTREMELY constipated, due to some muscle relaxers for her back, and I quickly taught her what I had only briefly researched on Google, and she applied it, AND IT WORKED IMMEDIATELY! If you could teach your dad or anyone at the nursing facility to do it, it could be a beautiful thing.
My mom has never been a big drinker of water and it's only gotten worse. I have tried many mixtures of all the ideas mentioned in this thread, all under doctor's advice. Right now, since nothing seems to work on a regular basis, I have had to resort to suppositories every other day. She currently takes 2 Senna every night and 2 doses of Miralax every day and that worked for about 5 days but then back to the suppositories. It's a constant battle. Never thought I would get so excited about someone having a bowl movement :) Also, it can backup pretty quickly, mom ended up at the ER and they had to manually clean her out, that was horrible! And that was after about 6 days of a lot of little tiny poops all day, every day. I couldn't believe it when the ultrasound came back and showed she was blocked from top to bottom. So now the doctor says a bowel movement every other day at least, use the suppositories if necessary. So that is what I do. Good luck, it's an interesting adventure. Take care of yourself.
It is not a laxative.
We did a daily stool softener. 2 twice a day. And often that was not enough.
I did prunes daily as well. then when he could no longer eat prunes I heated them with a bit of water to make a puree. (by the way warmed prunes work better than room temp)
I also on occasion made a tea, Smooth Move Tea you can get it at the store it is herbal and contains pretty much the same ingredients that the stool softener does.
I also added Benifiber to cereal or a drink. BUT....when I had to begin using a thickener for liquids the Benifiber had to be discontinued. It thins out the thickened food.
I also resorted to a bottle of Magnesium Citrate once in a while. (I always discussed this with the nurse first)
Then I got a bottle of what I called Heavy Industrial Laxative, Lactulose and he got that 2 times a day.
Once in a while "we" Hospice was involved with this as well we used "The Bomb" ..wait for this..1/4 Cup Milk of Magnesia, 1/4 Cup orange juice and 1/4 Cup Prune juice. All of this gets warmed up a bit. This mixture does work.
As the body declines and the person does less and less all digestion is a bit slower. This is to be expected.
The last thing anyone wants is for the person to become impacted. This may require manual removal if possible (sorry for the visual there folks) or in the worst case surgical intervention. That can be major since Dementia patients do not do well with Hospitals in general nor do they tolerate anesthesia well.
The stool softener that they want to give is the easiest first step. Trust me you will eventually probably resort to at least 2 or more of the methods that I used.
He will be taking a low dose of something, maybe the miralax, unless he gets too loose. I'm afraid there's not much point in trying to solve it to the T naturally, he isn't functioning at a high enough level to explore all possibilities. He is on palliative care, just want him not to be uncomfortable. Or embarrassed!
Miralax (PEG 3350) daily was truly a miracle for us, at least for a while. Stool softeners (colace) can also be added. Usually the next add in is senna (various brands), M of M is not really considered a gentle laxative but worth considering before moving on to the big guns. Good luck.