I need to prepare a dementia patient with rectal prolapse for a procedure. The preparatom is identical to a Colonoscopy. We hoped for the hospital but the insurance doesn't cover this. Any tips? How to wash down the solution? To organize it properly?
I can’t see any other way to clean her out. The prep is nasty.
Hope it works out for her!
I had verbal and written instructions from the surgery center about 1 week before my colonoscopy. The nurse explained to me what I needed to drink, no eat, not drink, etc... What time to start the prep, etc....I was instructed to fill the whole gallon, but the surgeon's nurse told me that I just have to finish half the gallon. (Other people I spoke to - had to finish the whole gallon.) After each set of instructions, she would ask me if I had any questions. For my prep, drinking starts at noon before the procedure. I had no problem with 12noon, 1pm, 2pm. By 3pm, my stomach was not very happy with the silver taste. By 4pm, I was gagging while forcing myself to drink it. By 5pm, I was leaning over the sink, fighting hard not to throw it all back up. It took me longer to finish the cup... What I'm trying to say is - if I remember my mom, who had dementia. When she didn't like something, she would clamp her mouth shut and refused to open it. Will the dementia patient, like my mom, clamp her mouth and refuse to drink full glasses over and over within several hours?
Don't take "no" for an answer.
I would ask if there is any other options for the prep. I was told that if I ever need to 'prep' again I can avoid the citric acid stuff, but I have chronic IBS.
Ask if she eats a low residue diet for a week instead of a few days and a clean liquid, tea, coffee (no milk), broth, Jello etc. for a couple days if it would be adequate?
First though I would ask what is the prognosis if she does not have the procedure? What is the prognosis if she has the procedure? General Anesthesia is not great for seniors and for someone with dementia it may worsen their symptoms.
CM it is about a gallon, one glass every 20 minutes.
There are pills that can be given instead of the liquid but I believe there are about 20 so that is another problem.
It may be possible to cleanout with numerous enemas.
Depending on the stage of the patient's dementia is it actually a good idea to do the surgery.
You really need to discuss all this with her gastroenterologist.
Washout could even be done once she is anesthetized. She could take something like Miralax for a few days before and a low residue diet for about a week. Personally I did not find the prep liquid too foul. it was slightly sweet and lemon flavored. I just sat on the toilet for the duration and kept drinking.
My mom had her last colonoscopy at the age of 85, pre-cognitive decline. She came out of the anesthesia and said to me "I'm never doing this again". The GI doc showed up a minute later and said "you never have to do this again". We laughed and said we were glad that we were all in agreement.
Who thinks that this is necessary?
How much fluid do you have to get down her, and in what time frame, and what happens if you can't?
This is a question that's really too specific to be answered on a nonmedical forum.