I've asked this before... I think, but I'm looking for suggestions on how to possibly monitor Dad's poop a little better. He's OBSESSED with his bowels lately, and I've read that can be common in dementia. A couple weeks ago Dad reported being constipated (but I think he just forgets that he's had a bowel movement), so the nurse gave him a suppository. The next morning, he reported constipation again, so the AM nurse gave him extra senna. Needless to say, he had a ROUGH couple of days. The constant "going" exacerbated his hemhorroids so he was literally screaming in pain. He then couldn't tell the difference between needing to go and hemmhoroids, so I think he was trying to go when he really didn't have to and the pushing just made everything worse. I've been in constant contact with the Hospice nurse to see if she can help us make heads or tails of and since I'm not with him, I can't tell which side of the "going" spectrum he's on. I have been asking about Dad's bowel status every day and communicating with the hospice nurse on upping or reducing the Senna since the morphine causes constipation, but without being there, it's really hard to know if he's constipated or loose. Every day he says he's been going all day only to say that he hasn't gone in a couple weeks about 10 minutes later. I know logging poop is beyond the scope of AL, and I try not to ask anything at all if I can help it. Any suggestions? Can I hire someone to sit with him and log his bowels? That sounds silly...
I was working hospice for a lady who had mild cognitive impairment and she would need to go in the afternoon. She looked forward to this all day. One day she got on the commode and nothing happened. So she sat. And sat. And sat. I suggested she get dressed and we'd have some juice but she refused and she became so irate that she was banging things against the sink in a fury and screaming at the top of her lungs.
My own little granny would tell anyone who would listen when her last BM was and then she'd describe it. AT THE DINNER TABLE where we were all assembled.
In 20 years of working in health care, the last 5 working in hospice, I have never been able to figure out exactly why elderly people are obsessed with their bowels. My theory is that as children they were told by their mother's that they have to have a BM everyday (which isn't true) and mother's would administer homeopathic remedies to keep the bowels moving. And this was the cornerstone of good health for kids back in those days.
But getting back to your dad, he's finding out that any kind of stool softener or laxative (God forbid!) is cumulative. If someone takes Miralax in the evening they may not see results in the morning so naturally they'll take another dose in the morning but that initial dose is doing its job, it's just taking a little longer. There is the morphine to consider which can cause constipation but if your dad can get on a regular schedule of Miralax or Senna (if he prefers that) he doesn't necessarily go through this. It's the starting and stopping (with a stool softener and then with Immodium or something similar to slow it down) that causes irregularity. Try to get him to a place where he has a healthy BM (not loose, not something that irritates his hemorrhoids) and then start over with the stool softener everyday. On that first day don't give him a full dose of softener so that when you give him his next day dose it won't be too much. A bowel routine is essential for health and for comfort but it doesn't necessarily have to be every single day. His bowels can skip a day but once he's on a regular schedule of BM's and stool softener let things progress naturally.
(And this concludes my thesis on bowel movements)
So, the hospice staff did a check and Dad is still going from one extreme to the next. I feel so sorry for him because he's extremely sore and just sits on the toilet for hours straining which is making things worse.
Hospice put Dad back on a regular Senna regimen (two in the AM and one in the PM), and we're adding clear Pedialyte to his water (I think he would fare better if he drank more -- another thread). They also added a topical cream to try to soothe the hemorrhoids.
I'm hoping between the Tucks, topical cream and senna we can get him some relief and regularity.
I wish I could keep him OFF the toilet. When I'm there, he'll say he has to go and I'll just respond "let's wait a while" or tell him I just mopped the floor in the bathroom and he's "holding it" just fine.
It must be hard not to be able to distinguish when you have to go and when you don't. This one is a toughy
...and yes. What is it about dinner time that encourages seniors to discuss frequency, size, color, and texture of their glorious BM's... I SO GET IT!!!!!
Bedridden hubby is obsessed as well. I’ve often offered to take a walk around the neighborhood to see if any city workers happen to be using one of those cameras on the end of long cable to explore the sewer system and ask them if I could borrow it. If I got one I’d take a running start if you know what I mean.
I hope your poor Dad finds some comfort. My grandma took mineral oil every night. I can still see the little jar in her frig!
My mother grew up in the 20’s and 30’s and I believe that was the era of Cod Liver Oil. 🤢🤢 She was obsessed with her bowels most of her life. She was terrified of having a bowel accident when we went out. Occasionally she did. So, her pill pusher doctor gave her Lomotil. In her later years, although she denied it, she took it every day. Eventually it had the reverse affect on her. I started to suspect something was wrong “upstairs” when she called 9-1-1 on several occasions because she had loose stools. In the nursing home, she would proudly announce that she’d “filled the (toilet) bowl!” Wow!
my mom looked a little taken back. but answered. oh I don't have any problems with that (well she did, a history of constipation) anyway...
I went down the hall and basically told the lady in charge of the resident care. (oh and we get along just fine!) BUT I told her, there was no need to ask my mom. (I think they were starting a new requirement?) There was no need to ask her at all. and I don't really know why they were bothering, cause they know she has dementia. but I told them 'don't bother' . WHY ??
I think I could drive myself nuts trying to keep my mom 100% safe. so I just let her be. doesn't mean if she is ill I ignore it, I don't.
the only thing I have in my moms cupboard is prune juice. I can no longer get her to drink a little each day. because she cant remember. and because once I open the bottle its only good for a week or so. so prunes should probably be better if she needs them.
im not sure of what you can do? wait for the response from hospice...