83 year old mom eats mass food, but hardly drinks fluids for years due to incontinence issues (possibly from a botched surgery for cancer 20+ years back or may also be related to parkinsons) to avoid peeing diaper initially started by herself and then get worse from my dad telling her not to drink as he was getting sick of dealing with her diapers and the smell.
Now she has a fractured hip and had a blood clot so her exercise which was walking a mile a day, sometimes more, plus light senior workout 4x a week has gone done to 0 and she now has impacted poop which causes her pain. I am lucky if she is drinking 12 oz of water a day.
She had another stroke and now barely speaks but seems she can understand quite a bit and catch her reading a lot of things so unclear if intentional not talking or some type of aphasia that really fluctuates from minute to minute.
I am trying to understand how to manage the situation as extracting poop situation will be tiring weekly and worried this can damage her rectum. I have tried all kinds of fluids - water, various nummy juices, ensure, herbal teas etc. I started to give her a bit more soup and making more stews, continued oatmeal, not sure what else to do.
Since she is eating so heartily it seems she may want to live or wouldn't she stop eating and the non-drinking has been a chronic condition going on for 10-20 years now.
I am not sure how to deal with this. I tried some stool softeners they gave us at hospital discharge after the stroke and that is what hospice is advising and she complained some were bitter when I ground them, I did test them myself and yes even the tiny little drop I had on my finger was very bitter. However even with having some of these, I was reading that some of these don't work without drinking enough water and some things like senna can actually cause constipation to be worse if not enough fluids.
Exercise has always been a great way to ensure she had bowel movements but now this is no longer possible until I can even figure out how to deal with her leg which I just found out 3 days ago has a severe hip fracture - I thought she only had a severe blood clot from groin to foot diagnosed mid July and actually gone early August after being on blood thinner a few weeks - and had been rehabbing her waiting for her insurance to kick in (as she had to switch insurance due to move) and was on the wait list to start pt next week. I thought the blood clot was what was preventing her from walking as when I picked her up her leg was double the size of the other one and i thought the edema was causing the pain and reason she didn't want to walk. Now I am on waitlist trying to get into an orthopedist..
You also mention hospice in your post. If your mother is under hospice care and on narcotic pain medication, they can order Relistor for her which is given in shot form in the arm for constipation, and it usually kicks in in about 15-20 minutes. And it will clean her out really well.
But the fact that you mention getting your mother in to an orthopedist at the end of your post, leads me to believe that perhaps she's not under hospice care, so just try the enema.
We did give her an enema yesterday followed by two warm water enemas since the purchased saline fleet enema was small. We got some stool out and once again had to manually extract the past two days.
I gave her more magnesium citrate today and her belly is now way bloated again and she doesn't seem to be doing that well but the bp went down quite a bit as well as temperature. I am hoping tomorrow will be a better day. She actually talked quite a bit more today, even though earlier the talk was about strange topics that did not make sense.
Tomorrow we get a follow-up CT from the stroke to see about continued bleeding/swelling etc and to determine what we need to do for anti-coag DVT (it was fully cleared 8/5 but could recur as she is not currently standing or walking) as currently just on a bit of aspirin.
She has slightly elevated kidney values (possibly stage 3) and may have prediabetes for some time based on her A1C and we reduced sugar a year ago but now are giving her whatever. I was slightly worried about this being a large sugar molecule but I liked that this one didn't seem to add any bitter taste and was going down at least somewhat undetected/or at least not to the point where she was saying it was terrible or bitter but sometimes still cringes her face.
I then was also a bit worried if I needed to separate out her parkinsons pills as sometimes I was giving her the parkinsons pills with the applesauce or yogurt and then adding the 3350. I then thought maybe this is a bad idea as possibly she may not be absorbing the full dose of her meds if fed in conjunction? I then was also worried about less nutrient absorption if she is having this in small amounts throughout the day as heard this is similar to lactolose and was told you can't give this long term as then you can't absorb all the nutrients from food?
One lesson I learned too late was to not go overboard and micromanage everything, I drove myself crazy (and no doubt mom as well) and when mom ended up in the nursing home she did just fine without any of the things I had been obsessing about.
Do not use fiber laxatives such as citrucel or metamucil because without enough fluid they clog things up with gelatinous mass that will not move.
I think there are many things going on here in terms of whole body generalized breakdown of many systems. This is a matter of addressing issues best you can understanding that things are getting worse, and unlikely to improve greatly as system after system is under barrages of problems. I am so sorry.
I am trying to determine what the bloating is coming from if it is from the powdered magnesium citrate, that may be what is easiest to get down her but worried it causes the most bloating?
TO'Day I thought I'd try another gel cap stool softener but typically we grind meds now as otherwise she tends to spit them out or get stuck in her mouth. I think this was bad idea as then there was coughing 30 min after putting her to bed as she may have had pill in mouth and then started choking, had to get her up give some water and a popsicle, it was a bit better but the few words she spoke sounded very raspy.
https://www.jellydrops.us
You mention bloating. This could now be an obstructed bowel which is an emergency situation. If she is not passing gas it is time to call EMS for transport to the ER. I do not know if you listen or can hear bowel sounds with a stethoscope? But I would suggest urgent care or ER today. EMS will get her into a cubicle at once for assessment. Elder's bowels are fragile. Don't delay.
Then got really sick, couldnt stop throwing up. Went to the ER, still throwing up. Then the nurses noticed he was throwing up fesices, is this possible?? Or was he telling stories