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My aunt is 88 in end stage dementia. She has been bedbound since 2019 when she lost her ability to walk.


She has suffered from chronic constipation for many years. Up until 3 weeks ago she was on Miralax 4-5 times a week. It stopped working. I realized then that she was losing the ability to pass stool. She is currently on Milk of Magnesia, prunes/juice, and colace, as prescribed by her hospice physician. The stool is soft, it's just not moving. My aunt is eating well. I know that stool cannot be allowed build up like this.


Anyone know what I'm talking about? Any suggestions would be helpful.

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Dear Nayners24, an elderly family member had the same problem for years, and stool softeners just didn’t cut it. Finally a kindly nurse recommended getting a combination stool softener and stimulant laxative. We bought Colace which combines those two actions, and the ongoing problem was solved within a couple of days. The doctors, who we looped in when we had solved the problem, recommended one pill in the morning and one at night on an ongoing basis. For us, the Colace was a Godsend. At our local drugstore there are at least a couple different brands of over-the-counter combination stool softener & stimulant laxative products you can buy.

For some people, using only a stool softener just means one then has a buildup of soft stool, which is going nowhere. Stimulant laxatives trigger the intestines to contract and push out the stool.

I do hope this recommendation will help your aunt.
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This is the order an RN told me : softeners, movers, washouts.

Start mild & work down the list. After the natural softener like prunes, come pharmaceutical softeners, then a herbal mover like Senna & stronger, then enemas.

1. Fluids & Fibre (specialised fibre drinks)
2. Stool Softeners (magnesium, Lactulose, Miralx, Movicol)
3. Stimulants (Senna)
4. Rectal enemas

It may be she is put on a clear fluids only diet until there is improvement.

There may be a bowel obstruction?

Keep speaking to your Aunt's Doctor & being her avocate ❤️.

Hopefully you have Advance Care Plans or an idea of her values and wishes. IE curative treatment options but weighing up if curative will be too burdensome, painful or non-productive at her stage of life. If so, a comfort care approach may be considered.

Kind thoughts to you through this journey.
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my mom use to do this in the past. I give my mom 12 grain sliced bread daily. A slice with her breakfast and dinner. I feed her brown rice on a regular basis with mixed veggies that you can buy in the frozen section which include green beans, green peas, carrots, and corn. I give my mom daily 2 adult chewable multivitamins daily and 2 chewable calcium w/ vitamin D plus a B12 sublingual 5000mg twice a week. My mom loves to take them she thinks they are candy. In addition, I use olive oil when I scramble eggs for my mom. My mom drinks a cup of milk with every meal and drinks water throughout the day. The 12 Grain bread twice a day, vitamins, and mixed vegetables made a major difference!
You might consider giving her (3) stool softeners several times a week until she has a bowel movement. I promise you it will work! I use to freak out when my mom would not go for almost 7-10 days! Vitamins are important for the elderly even if you have dementia / Alzheimer's
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Make sure she drinks enough.
I've mentioned here on the forum before how my mom's slow transit colon and inability to consistently produce any bowel movements more frequently than once in 7 or more day intervals caused my incredible worry and frustration - I was convinced that her bowels would be the death of her. Once in the nursing home she was prescribed lactulose and a probiotic, they didn't fuss beyond that and they counted every brown smear on her diaper as a successful bowel movement. If she's eating, has good bowel sounds and something is coming out then it may not be as life or death as we are constantly advised it has to be, trust your hospice team. And BTW, my mom spent 18 months in the nursing home and she died of pneumonia, not bowel dysfunction.
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