I am a huge fan of symmetry, order and (good) habits. OCD is a term thrown around waaaaaaaaay too much in a way that is offensive to those few who truly suffer with it. I am not that. I do, however, find joy in the natural order of things and in routines/patterned living. I drive the same way to work every day. I married the same/only girl of my dreams and have been married nearly 29 years (somehow the same number of years I have lived, but I digress even more than normal). My kiddos’ first names all have 7 letters, unbeknownst to us at the time but probably subconsciously caused by my proclivity for uniformity. I wear mostly the same clothes in a rotation although I do have a substantial collection of novelty socks. I watch the same movies/TV shows rather than venturing out, more often than not. (You know…you flip through the Netflix roster for an hour, read a few synopses, then settle in with an episode of Friends or Frasier that you have watched 27 times.) I eat the same things, drink the same things, get ready the same every day. I even poop the same time of day.
(Slamming on the brakes sound…….crash….broken glass sounds….cat howling….faint siren heard in the background from the patrol car of the “Things One Understandably Cannot Hope to Extrapolate on” police (T.O.U.C.H.E.). )
Yes, I said it, and I would bet you money that you are that way too (if I had money…I have kids instead). We all try desperately to use the bathroom #2 in our little routines and, when we get out of routine, it messes up the works. Have you tried “going” at the hotel or, heaven forbid, McDonald’s? Eek.
So, mom’s new environment (being out of the memory unit and in the general population) apparently has spawned a new-ish, hopefully/seemingly temporary problem: constipation. Poor mom, like the rest of us, is uncomfortable with changes in that area of life and apparently hadn’t “been” in multiple days as of when I got there yesterday. She was visibly uncomfortable and unable to tell us what was wrong. At first we were afraid that her rash had returned. (Note: rashes and UTIs are common and can be very bad for dementia patients). After some discussion and a quick Pillsbury poke at her belly we knew better. I feel very bad for her that we let it get out of hand.
Constipation can be caused by many things: not enough water, too much of certain foods, anxiety/depression, drug interactions, lack of exercise, bad posture on the toilet, normal aging, Thyroid problems, diabetes, or a problem with the nervous system etc. The good news is you can help move this process along. (Note: ALWAYS talk to your physician when your problems rise to an uncomfortable level like this. That is what they are paid for. When in doubt, there is no harm in asking.)
- Drink lots of water. Six to eight “water based” beverages a day totaling between 1.5-2 liters is recommended.
- Exercise. This can be hard for patients like my mom who lives exclusively in a wheelchair and has limited mobility from the navel up. Arm, head and neck exercises are a starting point. Anything to get some blood pumping and the heartbeat going in the right direction.
- Add in some fiber (25-30 grams) in the diet as long as the water levels are increased. This will help move things along, but could make things worse without the corresponding increase in water
- Use laxatives, suppositories and/or an enema as directed by your doctor.
- Encourage a regular time to use the bathroom and keep a record. (Marketing idea: Selling a urinal journal or a #2 Review binder has promise, but some may not appreciate the idea. …sorry, I am still a 10 year old boy at heart) It is easy to blink an eye and have 3 days pass without your loved one having a bowel movement. Unfortunately, you or the nurses need to keep track.
- Avoid foods that may make it worse, such as white rice and other refined grains, unripe bananas, tea, cheese, or sadly, chocolate.
- Prunes can also be your best friend in this area. 🙂
Constipation, in and of itself, if mostly just a pain in the rear (stomach) and not a life or death danger zone for dementia patients. There are certainly exceptions: when it causes “impacting”; when it causes the patient to not eat/drink, when it causes irritability which can cause other activities to go poorly (bathing, meds, etc…); when it causes serious pain, vomiting or fever; blood in stool; weight loss (more than 10 pounds); swelling; anal fissures/tearing; hemorrhoids. Take it very seriously.
Much more has and could be written about this topic. I have hyperlinked a half dozen solid articles throughout this piece since I am not a doctor. They all seem to agree that the problem is real and very uncomfortable and can get worse…so take it seriously. Ask the doc if in doubt…
Morning update: mom is doing much better in this topic this morning and her color has improved and she has more energy. This topic really does matter…I don’t write this stuff to entertain myself. I have plenty of memes yet to find for that 🙂 Mom’s 75th birthday celebration is coming soon (this weekend) and we are going to have a little party for her. More to follow about that.
Note regarding my intro: Here is a link to an excellent book about habits, both good ones and bad ones. I highly recommend it. If you use smile.amazon.com, a small fraction of the purchase price can go to a charity you support…pretty cool. 🙂
Note: I am sorry to at times seemingly make light of a very serious situation. A person wears down regardless of the situation and I am far from a 24/7 caregiver. A big hat tip to the millions out there who do this day in and day out! I love you all! (And if I could produce a Log Log or a Count the Poopula binder with jokes and funny memes that you could look at while you track bowel movements, I would certainly provide it for you for free today. 😉 Your job is extremely hard!!! You need a laugh now and then. Regardless, thank you for putting up with my odd sense of humor and keep up the good fight. 😉
(Note: I spent tooooo much time last night thinking of poo rhymes. I may be slipping a little. 😉 )