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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.

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I read in a health bulletin about eating two kiwi fruits each day for constipation.
It works. Besides, the fruits are very good for you. Hoping this helps.
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Grapes
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Warm prune juice.
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Fleet Suppositories and lots of water. My mother goes through this several times a month and she cries for me to help her. What can I do? Nothing but the above suggestion. Sometimes (because of burnout) I have told her it's not like I can go in and get it for her. lol I know it's not funny, but what can you do?
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Get him a Squatty Potty or a small stack of books to put his feet up on when he's on the toilet. It might help things move along a bit better.
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Cover99 Sep 2021
LOL
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My mother was consipated and the only thing that worked for her was lactulose. I only gave it to her for a few weeks per doctor. No more constipation. She eats lots of fruit, beans and veggies.I give her a probiotic as well.
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As much fluid as possible even in his solid foods: jello, grapes, cukes, watermelon, soups. Is he on pain meds? Or taking Tylenol PM? Pain meds really block you up badly.
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Midkid58 Sep 2021
Tylenol PM has Bendryl in it, no narcotics, so it shouldn't back you up.

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.
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I use prune juice every single day but it seem that the nortriptyline and ibuprofen pm that was helping with sleep was doing what you speak of in your post and the cup of daily prune juice was no longer working.

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.
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kahill1918 Sep 2021
Better have the situation during the midddle of night at home than during the middle of the day somehwere else outside of the house.
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I have this problem and take Magnesium Glycinate. It helps move the bowels. I have to take at least 400 mg/day.
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Isthisrealyreal Sep 2021
Yep magnesium is a wonder for many, many things and helping clear the bowels is a bonus.
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Grapes are helpful.  Cantaloupe and watermelon also help, as does more water.    Raisins and nuts eaten together (1/2 to 1 c) are another good combination.   Prune juice is an old standby.

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!
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If you've given DH all that stimulant laxative and he STILL can't produce a BM, then he needs to see the doctor right away. Fruits and veggies are all fine and well, but it's too late to think it's gonna help him now. Please seek the advice of a qualified doctor before doing anything else.

Good luck
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Lots of water, apple juice, prune juice, bananas, no dairy products and no fatty foods until he starts going. A diet high in fiber will help, in the long run. Juice celery, 16-32 ounces first thing in am or on empty stomach this is a natural liver detox and makes you go. Good luck to ya
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Mare sure he is drinking a lot of liquids.

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
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Glove up. Lubricate and dig out. Then Miralax fluids and try to control it getting so bad. You have to get the dry hard feces out first.
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Cover99 Sep 2021
Lysol spray as well
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Wow! I would be very concerned with his situation after all the medicine he has taken already. If he is impacted he could rupture his intestines and sepsis could set in. Patty Duke the actress, her cause of death was sepsis from a ruptured intestine. It is nothing to play with take him to the Hospital ER.
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Do you have home nursing care or is he on hospice? My mil had to have the nurse that came to our home clean out her impactions. It is not for the faint of heart.

Contact his doctor and see if he can arrange for a visiting nurse, home health care, or something similar.
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Not sure of this will help but I tried this with my Mother and it worked. A prune every day in her cheerios. Raisins too. More salads and vegetables. She had a blockage awhile back and was hospitalized. I am more of a food person rather than medication. If you can get him to eat a bowl of stewed prunes that may help. Also, google natural cures for constipation in the elderly.
I just noticed that someone recommended walking...yes, physical movement could help move things around too.
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Colace with stool softener work great for my Mother home health nurse recommended that. Also florajen the probiotic the one for digestion really works well too. I take that every other day after my body got used to it.
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You should get medical (your doctor or the ER) attention right away. My mother had this issue and let it go on too long and ended up in the ER. They couldn't clear the blockage, and they had to do surgery. She ended up with a colostomy bag.
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Constipation is due to dehydration. He should be drinking lots of water. It takes just a few days for constipation to go way once appropriate amounts of water are introduced into our bodies.

Laxatives only dehydrate more. It turns into a viscous cycle...
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Probably impacted feces is dry, no moisture and that is why he is producing pebbles.

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.
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The lack of exercise is usually a big part of why they can’t go. My mom is 80 and she had a bowel movement as big as my forearm a couple of weeks ago. I was pretty shocked when she told me she was afraid to flush it. I gave her a stick to break it up since I was gagging.
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. 💕🙏
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Cover99 Sep 2021
How was the smell?
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I use Smooth Move, it's a tea you can find at most any grocery store. Just follow the directions and I guarantee he'll have a Smooth Move next morning!
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My dementia husband had constipation issues real bad. I tried everything and then I was in Costco and saw their brand of stool softeners and said well I have tried them all but this and to my surprise they work better than any others. His doctor said to give him two a day at night before bed and see how it works. The next morning he went with no problems and every day since and they are cheap, 400 for $5.00. If you don’t have Costco I would be happy to send them to you… sometimes the big name brands don’t always work and are expensive.
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HelpingMyDad Sep 2021
Hello LMarrero,
Can you please share the detail or the picture of the product.
Thanks
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My brother had it and finally went to the doctor who recmmended surgery. A foot of his small intestine was removed due to blockage which had been sitting there so long that the foot of the intestine became diseased.
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Cover99 Sep 2021
How did that happen?
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My brother had it and finally went to the doctor who recmmended surgery. A foot of his small intestine was removed due to blockage which had been sitting there so long that the foot of the intestine became diseased.
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I an glad he is not uncomfortable. As a registered nurse, you have probably given him enough medication by mouth. The problem is that hard stool also needs to be softened from below. A few ideas to try:

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
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When my Husband was on Hospice they gave me a "recipe" they called "the bomb" (it does sound gross though, but it works)
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!
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Jingle1 Sep 2021
Yes, I used to give my Mum the mix of Prune Juice and Milk of Magnesia - 1/4 cup each, warmed and drunk on an empty stomach so first thing in the morning after she had her morning pills about 30-45 min prior.
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.
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My mom is 98 years young and now lives with me. She is in the bath room for extended periods of time but won't let me know whens he's constipated until I'm working or with a client.....It's okay. I moved her into a bedroom right next to the bathroom. I give her about 4 ounces of prune juice every other morning and I make fruit smoothies for her with fruit, flax seed, kale, ginger root, lemon, bananas, blueberries and strawberries. A hot cup of black coffee sometimes help...I encourage her to drink warm tea with her breakfast but I usually find the even tea serving sitting on the night stand the next morning. It's helped with the constipation but at 98 years young she's in the bathroom 4 - 6 times a day with a book. The elimination is small but it is an elimination. I be very careful with the excessive laxatives. If'f he is really impacted seek medical advise before proceeding since he will have to be clear for the colonoscopy.
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.
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Frances73 Sep 2021
My mother used to spend long visits to the bathroom with a book. Looking back I wonder if it was a habit developed decades ago as a refugee from a house full of kinds and chores!
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Husband had same problem. Two trips to the ER. He was admitted on one occasion and spent 5 days in the hospital. At the time he was discharged, he could not urinate. A catheter was placed for 10 days. Thankfully, it was able to removed without further problems. On our doctor's advice, he takes Miralax every day and two Citrucel caplets with breakfast. If he goes two days without a bowel movement, he is to also take two Dulcolax tablets. He drinks prune juice every day. So far, this "recipe" has been successful. Good luck and hope things work out.

Yes, this is a great place to vent. I have had many great suggestions from this wonderful group.
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