Any anti-aging, drug free hourly schedules that helps Parkinson Alzheimer's elderly keep hydrated with smooth bowel regularity?

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Can any of you caregivers on this forum that use integrative preventive health protocols on their frail elderly, provide me with a sample of your natural protocol that happens to work for keeping your elders bowels moving regularly and "smoothly." And thus avoiding constipation, bloating, impactions or overgrowth's of candida or bad bacteria? DRUG FREE meaning no miralax or laxatives that create a lazy bowel that eventually doesn't work anymore. I have dabbled through a book called FIBER MENACE (yup believe it or not) and it basically swears that the more fiber you eat, the wider the stool, and more difficult the cycle of bowel issues becomes. When fiber is reduced, bad bowel symptoms subside. I am getting WAY TOO MANY differing and conflicting protocols from MD's and integrative type doctors. I'd like to see what is being used for most elders to keep things moving "Naturally" for most elderly who have parkinsons or Alzheimers and possibly neuro issues.... at the moment we are doing labs to see how symptoms might be a thyroid or iron issue.... By sample protocol, I mean an hour by hour schedule showing what time one wakes, takes their supplements or moring elixers, then toileting or bathing and dressing, strolling out or sitting for a meal, drink vitamins, then a walk .... dinner etc and then a walk or what type of exercise or what is everyone doing to keep their elders free from disease?

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Lactulose is often a last resort for those that do not have liver disease. For liver disease it is used to bind to ammonia in the bowel for excretion, as with liver disease ammonia build up can be toxic. 

Lactulose could really do a number on a person’s bowels so tread lightly. It may cause prolonged bowel movements or diarrhea which can lead to dehydration or heaven forbid C.Diff , and/or skin breakdown from diarrhea, &  loss of appetite from nausea.

I recommend Miralax, or Milk of Magnesium, and 4oz of warmed prune juice at bedtime.

I would follow the advice of her doctor. Parkinson’s patients unfortunately get constipated. Mag citrate can be too strong as well, but works well.

Also if you take too many magnesium products her Magnesium blood level can be effected; Milk of Magnesium every 3 days should be safe. 

It is common in the health field to instruct a person to take some form of a laxative if they haven’t moved their bowels in 3 days. 

Hydration is important as well. 

In my experience Miralax takes a while to work. In my days as a new nurse we used to give Milk of Magnesia 30cc + 5cc Cascara, and called it a “Black & White”. It was very effective in promoting bowel movements. 

Also think about adding docusate daily; it is a stool softener and comes in a liquid elixir form as well as a pill. I understand you want to avoid medications but it may not be feasible. A fecal impaction will also open a whole new can of worms. 

Then of course a last option was a Fleets enema. That worked pretty well too. 
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Lactulose does help with behavior issues if the liver happens to be compromised. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4625512/ I don't think my mom has a compromised liver since the good doctors are always giving us natural products to use to keep the liver and kidneys healthy. This is really not saying much about constipation but to think that lactulose has a dual purpose is a good thing to know. There were other articles which i did not open yet but i am wondering if it has preventive action on a person getting a toxic overload in the liver or other parts of the body.
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Early on after we ended up in the ER because poor mom had been straining for hours we met a doc who had worked with cancer patients and recommended polyethelene glycol 3350 (Miralax). At the time I was rather disgusted with them all since they sent mom home still in misery, but it turned out to be our magic bullet and worked for several years. I've never had a clear diagnosis with my mom, her GP suspected parkinson's , I thought perhaps her symptoms were parkinsonism due to small strokes although I still wonder. At any rate slow transit in the bowel was a very troubling symptom.

Miralax isn't something that works quickly, but it can be used daily for years without any problems, Milk of Mag also became our go to when that didn't work. The lactulose is a non absorbable sugar that has laxative effects and to my knowledge couldn't be used to treat behaviour issues, I'm not sure where you would have read that.
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JoAnn29 Yes... Milk of Mag seems to work the best so far. Less harsh than Magnesium citrate although that is also the magic bullet for some people. We have had a hard time finding the predictable dose for Mag Citrate because sometimes a teaspoon works on some days and not on others so i am not sure if it all depends on where the stool is inside the colon or what type of food is backed up or how hydrated the person is at the time. I can't seem to figure it out. Milk of Mag could also cause some type of imbalance in other minerals i am wondering,. but i hope not. We only use it every 2 -3 days and sometimes go longer and try Smooth Move tea. But i am still trying to understand how to use the tea which has a laxative effect which i don't like. But one dr said something about Milk of Mag creating some imbalance somewhere... Oh well.
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Tothill, Thank you for your input as it is soo greatly appreciated. You wrote; "I think there are far too many variables for anyone to give you an hourly schedule. " you also wrote, "For many people a routine is key and disruptions to the routine can quickly lean to constipation."
That is why i posted my question. I think if caregivers share what elders daily hourly schedule might look like that are achieving bowel regularity, maybe we will discover some common traits or habits or timing of activity or meals that equals regularity among the results posted?
I feel we never had a routine in my family. There was too much freedom to come and go. But perhaps on this site, there are mostly seekers of questions and answers because we are struggling . THose caregivers who are not seeking input and are caring for their elders who are aging gracefully, have routines that are working too well so they have no need to come to this sort of site looking for answers. :( I hope i am wrong.
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Cwillie, My mom was never a laxative user. I myself am also new to them. She use to be constipated years back and then got very healthy and lost weight going almost raw food or vegan and vegetarian and shrunk her hufe tumor that way. .but then the constipation came back. But i get it.. If the constipation is not responding to some kind of natural solution, and digging for the cause is proving to be futile or taking too long to resolve, then it is best to use the stuff that works, what ever that might be, and keep the person comfortable and things moving with some regularity.
I recall reading about lactulose a few months ago, but as a remedy to reverse a behavior issue or mental health issues perhaps parkinsons or Alzheimers? I was gung ho on trying to get that for the dual effect it would have with behavior and with bowels but the doctor instead said to try Milk of Mag every 2 -3 days or when my moms tummy feels full. That seemed to work but waiting for every three days bothers me because the fullness of bowels will press down on her prolapsed bladder. The goal is one BM per day if that is ever possible.
I am going to ask the dr to let my mom try the lactulose. Thank you for reminding me as i have misplaced my notes. One of my clients that had lupus and fibromyalgia and a host of other autoimmune issues swore by it.
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I struggled with my own mom's bowel problems for years. Mom had been a laxative abuser most of her life so I was so pleased when I was finally able to get her off of them and somewhat regular, but when her health declined the bowel dysfunction returned with a vengeance. I tried everything; diet, more fluids, supplements, then increasingly stronger laxatives, suppositories and enemas, but she would still often go a week or more without a bowel movement. It was horrible. The funny thing is that now that she is in the nursing home they keep her regular with a scheduled dose of lactulose, the one thing I had been reluctant to try.
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I think there are far too many variables for anyone to give you an hourly schedule. Parkinson's leads to constipation because in part the stomach is slow to empty and the gut slows down. So it is a top down problem, not just an emptying of the bowel problem.

There are two types of fibre, soluble fibre absorbs liquids, Oat Bran is an example of soluble fibre and was all the rage in the late 1980's early 1990's. Whereas wheat bran is insoluble and provides roughage, but does not absorb liquids. Some of the 'new' seeds that gel when liquid is added are examples of soluble fibre, chia, ground flax, psyllium.

It is my understanding that both are needed to encourage healthy digestion. But neither will help with the peristaltic action of the digestive tract. If disease has caused the peristaltic mechanism to fail, I believe other solutions need to be investigated.

For many people a routine is key and disruptions to the routine can quickly lean to constipation. I am curious though why you do not want to consider medications? The digestive tract is an important system in our bodies. If it is failing and medication will help, why not take it?
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I think that worrying about laxative dependence in those with diseases that cause chronic bowel dysfunction is a little like worrying about opioid addiction in those with chronic pain, you have to accept that the benefits outweigh the potential harm.
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I wish you the best of luck. My understanding is that constipation is just part of the Parkinson's. Dad has struggled with it for years.
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