I hope someone has some experience with bowel issues. I apologize in advance for a graphic description. My mom is 92 years old and 90 lbs in a NH. She has dementia but can express herself, usually happy, very rarely cranky or acts out, just her memory is shot. She had major bowel resection surgery 2 years ago due to ruptured diverticulosis. She is not on a bag and can tell the aids when she has to use the potty. She is now on 100 mg tramadol at night (up from 50mg) and 50 mg in morning for arthritis. She’s not really what I’d call “constipated” as she does have a BM daily or 2nd day, but they are immense. Scary immense. The aides describe them like softballs, the Lpn call one a football. (Good grief, I never thought I’d be having this conversation.) Needless to say they are very painful. Today when I was there with 2 aides she was on the toilet screaming, and still didn’t “go”. She sometimes experiences vasovagal syncope, almost faints on the toilet, so today we gave up and let her lay down and gave her some apricot juice. Obviously I don’t want her in pain. I don’t know if these bowel habits are the result of missing some of her bowel, or maybe the tramadol? Opioid induced constipation like I see on TV? She has been on Miralax 2X a day and Senna once a day, but they may not be doing the “job”, and I’ve read that senna shouldn’t be used long term. We’ve started offering her prune juice at meals but she hates the taste and won’t drink it. Maybe I should request apricot juice routinely instead.
Does anyone have any suggestions for a better way to address this issue in a teeny old frail lady? Thanks.