Constipation is a problem for my 81-year-old husband with dementia and severely impaired mobility — we had to go to the ER a few months ago for de-impaction, and although I swore “never again,” I let the daily dose of Miralax slide last week when he was afflicted with chronic hiccups (that happens every year or so) and we were dealing with that. Now, he’s really stopped up and I fear impacted again, but he is resisting another trip to the ER (COVID running rampant in TX). Yesterday: 1 dose of Miralax, 3 tabs of Dulcolax stool softener, 3 tabs of Colace stimulant laxative, and today: 2 more doses of MIralax and a bottle of Magnesium Citrate. No satisfactory result yet, but he wants to get out of bed every 10 minutes only to produce a tiny amount. Tried to give him an enema and that did not go well. This will be the second night of his constantly saying he must go to the toilet immediately for no result. He has no pain, nausea or bleeding, but seriously backed up. I want to give him 3 laxative tablets, as if one were preparing for a colonoscopy, but if he is really impacted I don’t know if that is advisable.
Thank you for letting me vent - this is a wonderful group and you just can’t share this with the ladies who lunch. Any suggestions welcome.
It works. Besides, the fruits are very good for you. Hoping this helps.
Warm prune juice with 1 capful of Miralax always worked for me. And staying very hydrated. Good Luck--and get out the CHUX.
And YES to the Squatty Potty.
Hospice told me not to worry but to keep working for relief. Then I added miralax (nothing), then senna-s (nothing), then senokot (nothing) over a few days. Finally, I purchase that old Phillips Milk of Magnesium and 15mg over a course of two days and bingo without an explosion. After that, the following day he was back to normal.
I would start with treatment around 5 because I didn't want a situation during the middle of the night.
Walking and exercising can help.
This is not a criticism, but I kind of gasped when I read all the meds he's been given. Food is just so much more safer, and it tastes good as well!
Good luck
Next time he thinks he has to go to the bathroom, let him sit on the toilet fir at least 10 minutes and run water in the sink where he can hear it and also wet a hand towel with warm water and apply to his lower stomach.
Also, while he is sitting on the toilet, have his feet flat but raised up on a little step stool, that also seems to help.
And buy a container of fiber that can be mixed in his drinks and or food every day so he won't be constipated.
Prayers
Contact his doctor and see if he can arrange for a visiting nurse, home health care, or something similar.
I just noticed that someone recommended walking...yes, physical movement could help move things around too.
Laxatives only dehydrate more. It turns into a viscous cycle...
Palliative care team advised giving my dad a tablespoon of olive oil each day because he was on restricted liquids.
He also drank warm prune juice when things slowed down.
You can put on a glove and generously apply vaseline inside the rectum for moisture.
Unless you know what you are doing do not go digging the impaction out. You could create a tear easily.
A gentle belly massage and a heating pad may help move things along.
Good luck and if no results soon he has to go to the ER.
I buy the Amazing Prunes, they come in a little bucket, she eats a couple every day.
If a bottle of magnesium citrate didn’t work- it might be serious enough to take him in to the ER.
check his diet, sometimes too much fiber is not good for elderly since they don’t walk around much.
How much does he eat? Sometimes they eat like birds and absorb a lot of it and don’t have that much waste. A bottle of water in the morning really helps get the intestines alive and give them the urge to go.
I’d throw a stool softener into his daily meds regimen.
Good luck, it’s scary. 💕🙏
Can you please share the detail or the picture of the product.
Thanks
stool softener suppositories - draw fluid to that area and may help with stool passage.
Fleets enemas - they are essentially salt water and will not cause electrolyte imbalances.
If neither work, he will need to be disimpacted.
Once his bowels are moving again, he needs both fiber (MIralax, prunes, whole grains, crunch plant foods...) and fluids. Talk with his doctor about medications (Linzess is one) that may make help him move his bowels a little faster
1/4 Cup Prune juice
1/4 Cup Milk of Magnesia
1/4 Cup Orange Juice
Warm this up a bit until it is body temperature. (generally works in about 30 min.)
I would also puree Papaya and Pineapple and portion it in 1/4 to 1/2 Cup amounts. I chose these because most of the OTC "cleanse" products contained them and I figured if they worked, great but if not he liked the flavor.
A Herbal tea called Smooth Move often will work, it is made of Senna so not much different than the Senna I gave him daily anyway. (he did not much like tea)
Once in a great while I did resort to opening a bottle of Magnesium Citrate and he would drink some of that. Depending on how much he drank would depend on how well it worked.
I finally did get a prescription for Lactulose and that was given every morning.
Have you seen the product called "Squatty Potty"? As odd as it sounds that particular position of the knees a bit higher seems to work. I noticed often when I was transferring my Husband using the Hoyer Lift and he was angled just right he seemed to have a BM. I would kid with the CNA that it was the "squatty potty" position.
Last but not least sometimes is takes a gloved hand and to get things going!
After she drank the warm mix, I would give her an 8 oz glass of warm water to drink. After that she would eat her breakfast. Within an hour she would need to go to the bathroom. She would have about 3 BMs and then she was done.
I would keep her seated close to the bathroom so I could transfer her quickly to prevent any accidents.
Praying for the best health - In the best possible way. Be well.
I also got her the "Squatty Potty", only remembered after I read the next post suggesting it. That has also helped her to not sit so long on the toilet.
Yes, this is a great place to vent. I have had many great suggestions from this wonderful group.