Constipation in later stages

Discussion in 'Middle - later stages of dementia' started by Brogues, Apr 3, 2015.

  1. Brogues

    Brogues Registered User

    Apr 13, 2014
    150
    Hi guys

    My mum is in the later stages unable to walk talk properly pretty much everything she can eat herself she does miss alot and the floor gets more but one problem just will not "go away"

    Even with meds etc shes developing a real problem with constipation her nusing home are pushing fluids shes on high fibre they are doing everything thay can - but its just not responding to anything and its making her irritable - tot he point I think she must be uncomfortable all the time.

    Does anyone have experience / ideas what is the best way forward?

    Is this a progressionof the illness she is getting much worse at the moment xx
     
  2. jan.s

    jan.s Registered User

    Sep 20, 2011
    7,352
    Have they tried prune juice? My friend swears by that for her partner, and it seems to work a treat.

    Just a thought.
     
  3. BR_ANA

    BR_ANA Registered User

    Jun 27, 2012
    1,085
    Brazil
    My mom has a spoon of oil every day. And plenty of water.
     
  4. Brogues

    Brogues Registered User

    Apr 13, 2014
    150
    Thanks I iwll take her some prune juice in and give it a go - shes really struggling at the moment - and she cant tell us the problem
     
  5. jan.s

    jan.s Registered User

    Sep 20, 2011
    7,352
    I hope it works, and she starts to feel better. My husbands care home use it when necessary, and I recommended it to my friend. She now swears by it.
     
  6. nita

    nita Registered User

    Dec 30, 2011
    1,797
    Female
    Essex
    The only thing that seems to work for my mother is to give her Movicol mixed with apple juice (she doesn't like the taste of the Movicol) once a day. If necessary, it can be given two or three times a day.
     
  7. Pottingshed50

    Pottingshed50 Registered User

    Apr 8, 2012
    514
    Prune Juice , Syrup of Figs (shows my age) stewed apples. There is only one down side to all of this if you overdo the treats mentioned and I doubt anyone has to explain that one. :rolleyes:
     
  8. lin1

    lin1 Registered User

    Jan 14, 2010
    9,322
    Female
    East Kent
    My mum was on Movicol on a daily basis . It works by taking more fluid into the bowel , so softening the stools rather than making a person go like some meds do.

    Until u get the dosage correct if a person has been constipated for a while or is bypassing it can work er extremely well at first .
    perhaps have a word with her GP stool softeners .

    Hope you find something that works for your mum soon , I remember only to well how diatressed my mum was when she was constipated .
     
  9. MerryWive

    MerryWive Registered User

    Mar 20, 2015
    55
    If it gets really bad we have a laxative enema (Microlax) it is in a little white tube. I actually tried it myself once as was in a bit of a dire state and it worked really well, gently but fast, not scary as I had thought it might be!!

    For day to day we give my MIL half a pack of Movicol in her drink at lunchtime and that seems to work well. Luckily we seem to have found the right balance.

    I'm sure the care home are aware of these, but thought it was worth mentioning anyway. :)
     
  10. stanleypj

    stanleypj Registered User

    Dec 8, 2011
    10,650
    North West
    Doesn't a lot depend on whether the person concerned has always had a tendency towards constipation? If so, it might be worth trying a modification of their diet which could resolve the issue.
     
  11. Mfab

    Mfab Registered User

    Apr 16, 2015
    2
    Try dried figs. You can get soft dried ones in supermarkets, ready to eat and they keep in the packet for several days when opened and are a nice snack at any time of day. Sachets of Laxido on prescription are also good. Some medication causes constipation. In my mother's case this is the pain patch she wears following a hip replacement.


    My mum is in the later stages unable to walk talk properly pretty much everything she can eat herself she does miss alot and the floor gets more but one problem just will not "go away"

    Even with meds etc shes developing a real problem with constipation her nusing home are pushing fluids shes on high fibre they are doing everything thay can - but its just not responding to anything and its making her irritable - tot he point I think she must be uncomfortable all the time.

    Does anyone have experience / ideas what is the best way forward?

    Is this a progressionof the illness she is getting much worse at the moment xx[/QUOTE]
     
  12. stanleypj

    stanleypj Registered User

    Dec 8, 2011
    10,650
    North West
    I've posted about most of this before but it may be helpful to someone.

    Urinary incontinence usually strikes first and those who believe in 'the stages of dementia' put it in the later stages and remark that late stage dementia often involves double incontinence.

    I've always thought it odd that for S things developed the other way round. Like so many people, Sue had a longstanding tendency towards constipation. So when, over four years ago, she started to have soiling problems (mostly 'overflow' to start with), we used any number of laxatives and other drugs which various medics swore by. They turned out to be worse than useless. They simply complicated the issue and, whatever dose of whatever drug you used, you never really knew if there was any progress. Sometimes there seemed to be, but then you were suddenly back to square one.

    Fast forward. For ages now, there has hardly been a problem. Sue has usually emptied her bowels every day and is almost completely clean all the time, i.e. 99% goes down the pan. This hasn't been achieved suddenly of course. There have been false hopes in the past but overall things have gradually improved over time.

    How has this been achieved? I expect that this is what some carers reading this will want to know. So these are my tips, mostly discovered by trial and error:

    1) Regular exercise, e.g. we aim to walk at least 5 miles a week whatever the weather.
    2) Vegetables are very important. We tend to eat a lot (we don't eat meat). Some vegetables are extremely effective - carrots, sweet potatoes, squash, onions all work well for S so I concentrate on these but not exclusively.
    3) Insoluble fibre, particularly wheat bran and anything that contains it, has to be treated with caution as it can have exactly the same unwanted effect as the drugs.
    4) Soluble fibre, in particular oat bran, is great and much of the improvement can be traced back to when we started to have porridge for breakfast - real porridge not instant refined muck.
    5) We discovered that immediately after the evening meal was the optimum time for a successful visit to the loo.
    6) Before every meal I give Sue fruit finger foods - mango, melon, apple, pears. I've always understood the importance of fruit but this fairly recently introduced tactic means that S eats way more fruit than she did before.
    7) Obviously, it's also important to keep hydrated and this is sometimes difficult - S has to be watched to avoid spills and she sometimes drinks very slowly.

    We can go for months with absolutely no problems. Then we might have a few weeks when, a few times, there'll be a small amount of faeces on her pad in the morning (never any other time for years). Then things sort themselves out again.

    I'm sure none of the above is particularly novel. And what has worked for Sue may not work for others but I hope that they may be of some use to someone.

    As I've said before on TP, I can't help wondering how many people who are labelled faecally incontinent are actually people who have always had a tendency towards constipation - a situation that has never been resolved.
     
  13. spurs50

    spurs50 Registered User

    Nov 11, 2012
    16
    Constipation

    My mum was constipated and what worked with her was puréed fruit two or three times a day along with Lactulose.
     
  14. In a Whirl

    In a Whirl Registered User

    Feb 23, 2015
    62
    Spouts & real sage & onion stuffing did the trick for OH (An unexpected Christmas present!).After that porridge & fruit kept things ticking along.
     
  15. JayGun

    JayGun Registered User

    Jun 24, 2013
    298
    This has really chimed with me, thank you for posting it. We've been on the constipation- laxative- explosive diarrhoea merry-go-round and we're going to try out your suggestions instead. Thanks ever so much. :)
     
  16. Kevinl

    Kevinl Registered User

    Aug 24, 2013
    4,760
    Salford
     
  17. Long-Suffering

    Long-Suffering Registered User

    Jul 6, 2015
    426
    Excuse the gross details here, but I'd like to know if anyone else is having the same problems.

    My dad's been having constipation problems for a while. He doesn't eat or drink much now, and that is probably one of the reasons.

    The doc prescribed Lactulose and he takes that every day. Dad has bowel movements, but they are very long, thick and hard. They often get stuck, and mum has to break them off with toilet paper. He has to be taken to the toilet by mum and coached on how to s*** When he's done, mum has to break them up with a stick to make them small enough to flush away.

    As well as being very uncomfortable for him, he panics every time he feels any kind of movement in his bowels and starts crying because he thinks he will s*** himself (though as he's constipated instead of having diarrhea, he never does).

    We're trying a slightly higher dose of Lactulose till hopefully we find the right one for optimum bowel movements.

    I just wish he wouldn't get so upset. It's like every basic bodily function throws him into a panic now.

    LS
     
  18. Beate

    Beate Registered User

    May 21, 2014
    11,696
    Female
    London
    I don't know much about Lactulose but we are having really good results with Fybogel which are sachets he drinks dissolved in water every morning and evening. The ones with Orange taste really nice and have the added advantage of getting fluids in him. We have them on repeat prescription now. I think they work by adding fibre to the diet and make it easier to have a bowel movement.
    It is really important to stay hydrated, also to try and avoid UTIs (though he seems to get them anyway).
     
  19. nitram

    nitram Registered User

    Apr 6, 2011
    18,914
    Male
    North Manchester
    As Lactulose appears to be working in a controlled manner, I'd try increasing the dose and, perhaps more important, increasing the fluid intake before changing the type of laxative.
     
  20. Long-Suffering

    Long-Suffering Registered User

    Jul 6, 2015
    426
    Thanks Beate and Nitram.

    I also think his lack of fluid and fibre intake is a big part of the problem, but it is so hard to get him to eat or drink anything. But as I said to mum, if his stools are that size, then I think you don't need to worry that you aren't feeding him enough!

    We'll try a slightly larger dose first and more fluids and see how it goes before talking to the pharmacist. We often get better results from talking to the pharmacist rather than the doctor.

    Thanks,

    LS
     

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