Any good suggestions for external hemorrhoids?

There is an rx a doctor can prescribe which does work better than over the counter. A bidet toilet seat is helpful, as is a “sitz bath” which is recommended for women post partem. At the very least, use a wet wipe, not toilet tissue in the area.
Ice packs are a nice relief too. Constipation and sitting on the toilet for long periods of time are bad.
Definitely more fiber (Metamucil)
and liquids! to keep stool soft.
PRUNES!! Kiwi.to stay regular. Miralax works for us if no bm for 3 days. Sadly, lack of movement thwarts a body’s functions.

The only thing with surgery is that eventually the hemorrhoid's do come back.(at your moms age you won't have to worry about that, but surgery at her age can be tricky) My husband who suffered with hemorrhoid's as long as I knew him, had surgery twice to remove them, and both times they returned.
The best bet to keep them at bay is to make sure mom is eating things with lots of fiber, and drinking lots of fluids to keep her regular.
Other than that, I would use the hemorrhoid cream regularly(as would the hospice aides later on) on my husband to keep them at in check.
Good luck.

There’s a prescription strength that’s much better. Do not use it every day or it will make things worse, according to the gastroenterologist.

I'd think many times before surgery - surgery for hemorrhoids is hell, they haven't
really improved it much, according to my doctor. If you get her on probiotics (check with her MD), it not only makes you regular, it softens stool and eases the problem.

OTC cream nupercainal is far better than Preparation H for discomfort. But getting the fiber (prunes was an excellent suggestion but plums are good too) is essential

My 98 yo Mom has an ongoing problem with external hemorrhoids.
I have the aides have her sit on a portable sitz bath that sits on the toilet bowl ( warm water and epsom salts.) A surgical supply store would have it. Use Preparatin- H on a clean bottom as well. we also use Tucks pads that prove to be soothing. Keep the Tucks pads in the refrigerator. Make sure she is hydrating enough and has enough roughage in her diet.

i developed one while throwing up sitting on toilet, didn't want to take a chance of other stuff happening..........anyhow...........wash gently in that area.......maybe put on a cold wet compress for about 10 minutes......then dry and put on some Tucks cream that has some lidocaine in it or try Prep H which can be used up to 6 times a day. The Tucks cream came (at least where I live) in with a small container of Tucks pads (sterile pads) to also help in cleansing that area. You can get a small donut pillow for her to sit on, make sure she drinks plenty of water and eats fruit to help her go without straining. And never let her sit on toilet too long IF she hasn't gone. IF she can take tylenol, she can also take that. I wish her luck..............i know her pain. Not sure about the surgery, they only would do that IF seriously bad and sometimes I think they can do a "band type" thing, but it would have to be really bad. I sure wish her luck and you.

Imho, this issue should be addressed by the SNF staff members via a donut pillow and more hemorrhoid cream.

My 91 year old mother had four or five hemorrhoid's banded and all but one fell off in a day or so. The surgeon did it in his office and did a great job. My mom was so relieved after suffering with them for so long. The one that didn't fall off was to large for banding and she would have had to have surgery.

The only thing I have to add, if your mom has allergies, check the ingredients before using Preparation H. My poor ex was allergic to the yeast they used in Preparation H and he was worse off even after he washed it off his bottom.