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My father has recently entered a nursing home. He has been for some time now obsessed with his bowel movements, mainly constipation. He suffers anxiety which has lessened since entering the facility. However he is obsessed daily with his bowel movements. If he goes first thing in a morning we all have a good day, but if not he is a nervous wreck. He is medicated for it, but sometimes asks for too much and then is the the other way. He will discuss it with everyone even if they're just delivering his cup of tea. I am not embarrassed by this but am concerned that it is off putting for others and that people will start avoiding him and not caring about him. I have asked him not to discuss it with everyone, however, he continues to. The doctor believes there is nothing wrong with him medically in this department and that he is simply obsessed. We are making arrangements for him to be seen by a mental health professional. I would be greatful for your input this is wearing me down I left the facility in tears yesterday. I'm at a bit of a loss as to how to help him.

I could have written this a year ago, so my empathy level is high. My father was completely all-consumed, obsessed, etc. with this, too. The moment he had success, he began to fret about the next episode. He would pace the floor and all of us were told non-stop every detail of his discomfort and concern. We were all about to walk the plank until the problem was solved. And here's the good news: this is fixable with a dose of MiraLAX every day with his meds. Instead of trying to convince him that he is over-worrying, let him know you understand this is a source of discomfort and angst, and introduce him to the new regimen. He must take it every day. Again, MiraLAX should be taken as part of his daily meds; not just when he is having a problem. You/the staff will need to monitor and skip a dose on the occasion that he is going too often. When things get this bad with a loved one we can't believe in such an easy fix, but trust me. It works. Follow the directions on the container and do not worry about his becoming addicted to a laxative. We are under the care of a doctor and he is the one who provided the solution. It was hard to get my father to believe in this. He was convinced he had a blockage and that the issue was structural. By the way, being sedentary doesn't help either. If your dad is able, make sure he gets some exercise every day. He will feel better all around. But with or without, the MariLAX will do the trick. My dad never complains anymore and if you only knew...that is nothing short of a miracle. Dry your tears, sweet caregiver. I will say a prayer for your success.
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cherokeegrrl54 Apr 26, 2019
Sounds like my mom....🤷‍♀️SMH. One day says she is constipated, NOT! “Just cant go enough”. I ask, well what is enough? Next day diarrhea because she took too much laxative. Cant keep up with her. And she has no dementia or anything like this, but does obsess over BMs..... are all elderly like this??
BTW, she has no medical reason either....shes had all the tests, blood work etc. and i make sure she gets plenty of fiber etc
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Well, to be honest, it sounds like you’re obsessing about HIS obsessing. Since he is in a nursing home, surrounded by other elderly people, the staff is well-used to this kind of discussion. They will smile, nod and if required, offer some sympathy and hopeful words for a good “outcome” if he hasn’t “gone”. They will also celebrate with him if he has gone. Then, they will simply move on to the next resident and the next discussion about bowel habits. Telling him not to discuss this with the staff is fruitless and it is obviously upsetting you. Take a deep breath and a hint from the staff. Listen, offer sympathy or congratulations and then redirect. Bowel obsessions are super common in the elderly.
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kemahe Apr 26, 2019
Thanks Ahmijoy for replying. He is 93 and at this stage on respite. The NH raised the issue with me as they are leaving his medical issues up to us at stage as his dr is not a local once he becomes permanent they will be able to manage it with a local doctor easier. That will be happening in the next few weeks. Your words have however given me a little reality check it that is not up to me to obsess over his obsessing. Cheers
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My Dad lives relatively independently and one of the first topics of conversation when visiting is his bowel movements or lack there of. But It is not new for him, as children he asked us if we were 'regular' on a daily basis.

Let the nursing home deal with it.
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kemahe Apr 26, 2019
Thanks Tothill, as dad is only on respite the nursing home still asks us to deal with it. Dad has asked that he become permanent as he loves it there and they are really good to him so hopefully they will be able to take care of it once he becomes permanent and the dr can visit the facility. At this stage I drive him an hour to his current dr. that will change as we will get him a dr closer to where he will be staying. We are in a small country town and there are some great drs. here. Thanks for replying.
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For those who say don't worry, let the nursing home handle it as they are experienced with it....not necessarily true. About a month ago my mom was in SEVERE pain when I got there, actually screaming in pain...I heard her when entering door of building. Nurse's ignoring the screams from her room. I ran down the hall, saw her, and demanded to see Dr. He was out of town for several hours. They had no suggestions. I made them call an ambulance and take her to hospital. She had bowel impaction and had a large buildup. In hospital for 3 days. She in not mobile. Had been complaing of pain for weeks from developing hemorrhoids.

Hospital prescribed the Miramax and prune juice daily regimen, with suppositories every day for the hemorrhoids. WE had been asking for weeks before this that she get prune juice every morning, but it did not happen. We even took prune juice up there and put cans on the dresser the prior week, but by then it was beyond just prune juice.

Then last week one day, she started complaining of the same hemorrhoid type pain. I had the aide change her in front of me and I checked her bottom....hemorrhoids again. I went out and asked whether she was still getting the suppositories for them..and the nurse said, well no, we didn't know she still needed them. Well, I wonder, do your aides not report this when they change her ? As my brother says, nursing homes are just warehouses for the elderly. There is little or no compassion.....and not just in this one. I talk with several friends who either have family or friends in a NH in this county...and all the same problems. Sorry for the rant, but I am sooooo frustrated. She does not deserve this.

By the way, we went to NH administrator about this. When we told her about the nurses and aides just standing around nurse's station while my mom screamed and screamed, the administrator brushed that off, saying they get immune to screaming because they hear so much of it. On the other hand, I still have dreams about that.
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anonymous903302 Apr 26, 2019
Okay.

This is not going to help your relative get better, but it may help you in the future to know that you did not allow the NH to slide by and not take care of your relative in the right way.

#1. Person to person conversations or phone calls with the NH staff are not recorded. Which you know, of course. And, yes, some of the nurses and staff and even unit managers will lie to you.
#2. If possible, alter your visitation times. If you always go the same days and time, believe me, they know that. Just show up at other times; don't even tell your relative in advance. Trust me, if this particular NH is shading you, they will freak out if you just start showing up when they do not expect you. Watch and see what they do. If all of a sudden, within one hour after you get there, everyone from the nurse to the aide to housekeeping shows up in the room......hey....they are afraid of you. That's not their normal schedule. That is how you monitor them.
#3. Every time something happens that seems not right to you, and every time your relative calls and complains, just take the time to enter the time and date of the call and the complaint in your calendar; whether that's on your iPhone or Samsung, or even just get a normal notebook, whatever. Just do it. It won't prove anything as far as evidence, but it will show that you were keeping track and entering details.
#4. You need to put your concerns and complaints in writing, and send them to the NH, to everyone to the top administrator to any unit manager and unit nurse, and do not email it and do not snail mail it: you must mail it registered/certified mail so that you have proof that someone signed for it. I always go to the UPS store. Yes, it costs money. But, I always know that it was delivered, and can track it, and I have a record. And, CC everyone you want to. The "CC" scares the crap out of people below the top level. You can follow the same letter up with an email, but PLEASE do not opt for the easy, free way to lodge your complaints. If you do not do it in a way that you can prove you did it, it's the same as not doing it.

Lastly, based on what you told all of us, your relative is in a shitty NH. I hope that there is a way to transfer your relative.
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We all talk about what is bothering us. I would frankly rather talk about this than politics!

Keep working with his doctors, nurses and aides to get him as many of those good mornings as possible— he will talk about it less. Maybe that will incentivize his healthcare workers.
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You have arrived! The poop obsessive stage. In my experience. It happened to Grandma 25 years ago and Grandpa 2 years before. They we're more obsessed with the end result rather than if they had a bowel movement but bodily function obsessions seem to be the norm rather than the excecption. Maybe his Dr could prescribe a mild setative for when he can't calm down? At this stage please don't be worried about addiction. He may become physically dependant on certain medication that helps him. Like pain meds which if doesn't need don't start that would be really bad for his bowl movements. Next month he'll be talking about something else and you'll be like dad can we please talk about your bowl movements again? Lol
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kemahe Apr 26, 2019
Iv arrived alright, can I take a plane to the previous destination. He is on a sedative that helps him calm him. He is 93 so not sure I am worried at this stage about addiction. Sadly some of the meds side affects are constipation, its a lesser of 2 evils at this stage. He is already talking about how tired and lathagic he is and I think you are right, I will look back and want to talk about his bowel motions, I think we may need to embrace it and just enjoy the time we have left with him. Thanks for taking time to reply I do appreciate it.
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Since YOU are at your wits end and to soothe your mind, ask your dad’s doctor to do an abdominal X Ray to prove there is no impaction. (I’m assuming that the doc has already done a digital (finger) exam rectally.)

If the X Ray comes back negative then all is well. The radiologist is the one “reading” the X Ray and has the final diagnosis. Ask for the radiologist’s report. If everything is not OK, then steps will need to be taken to remove the impaction (Enema first, hopefully that does it.)

Its easy to “dismiss” older people’s idiosyncrasies but you need to make sure nothing is wrong before you write off their complaints.

After everything has been checked, things you can do to encourage your dad to keep his bowels moving are;
1. Drink more water (or non-caffeinated drinks). Elderly NEVER drink enough.
2. Eat prunes or drink 4 oz. prune juice/day.
3. Walk as much as possible-even if it’s only up and down the halls of the facility.
4. Eat fruits and vegetables every day.
5. On the advice of his doc, add Miralax to his medication regimen. (I believe it’s over the counter but you would need the doctor’s approval first.)
6. Also ask if he can start stool softeners. Do not confuse these with laxatives-they are not! Stool softeners just keep more water in the stool, making it easier to pass.
7. Check with the doc to see if any of dad’s other meds cause constipation.

Now, I’ll agree that lots of seniors are bowel obsessed. Many were told as kids that they would get sick if they didn’t “go” every day. Many poor seniors are straining to push out something that isn’t there or ready to come out. Bowels, like many other body functions don’t have a built in clock for when to work.
He’s NOT going to stop talking about it, so, after he’s been thoroughly checked and cleared, you will need to acknowledge his concern then turn off your listening. Do NOT continue to engage him on the subject-redirect the conversation. If necessary, get up to go get a drink of water (and get him one too) or go to the bathroom. If it won’t stop, you’ll need to politely excuse yourself and leave. You must take care of your sanity too.

Good luck. 😌
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anonymous903302 Apr 26, 2019
SueC1957,

Excellent response. I have learned that obsession with BMs is very common among elderly. Also, that someone can be impacted even if they are having some BMs.

It won't stop, if it's an obsession. You do have to just lay down the law and say that it's a topic that you will not discuss. And, then just ask the head Nurse if there's an issue. My mother now 91 has been obsessed with BMs for years. When she lived at home, she started every day with a suppository --- for years. When she had 24/7 caregivers, we hid the suppositories and found ways to bribe her to drink more water and also had a rule that she had to drink some prune juice at breakfast. And, give Mirolax or Dulcolax. At the times the doctor told us to.

Now she is in a nursing home. They have a fixed protocol (which can be adjusted, of course), consisting of a schedule every day for stool softeners and light laxatives, it probably consists of 4 things a day --- but no suppositories. And, prune juice at breakfast.

And, yes, it's true. If the parent doesn't eat well for only one day, but gets all the meds for constipation, then, yes, her bowels will try to expel everything. And you will hear complaints about diarrhea. Two days ago, my mother ate none of her lunch, but she is in a Jewish-based facility, and it's still Passover, so when they took way her "uneaten lunch" I had them leave the matzoh.....which is very binding.....but only because she was complaining about diarrhea all morning and I could smell in her bathroom that a lot had been going on in there. Like way too much going on.

They try to get her to NOT flush the toilet, so the aides can record when she has a BM, but of course she won't go along with that; probably just cannot remember. But, seriously....the smell alone should let them know that she had a BM. I definitely smell it, when I visit and she goes to the bathroom. And, that's even with gel air freshener.

There's really no way to get rid of the obsession. But, there is a way to have the doctor institute a medication protocol. Not a PRN....but a definitive schedule.
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i get a poop report every morning, rain or shine.
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mterpin Apr 28, 2019
Me too :)
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I have an old and I mean OLD book on child rearing---probably published in the 20's--the 1920's--more time is spent on making sure your child had regular bowel movements I couldn't believe it.

I guess "science" has begun to prove that fecal matter was poisonous to the body and you needed to get that out ASAP. The thinking was that you'd sit the child on the potty first thing, everyday and they could not get up until they had had a BM.
It went beyond obsession, really. That's how my dad was raised and I know he stuck by this principle of 'health' all his life.

He was also administered a 'glob' of Vicks VapoRub when he had a cold (put in the mouth and let it slowly melt) and when he had a sore throat grandma swabbed his throat with Mercurochrome, which I believe had mercury in it.

In his later years he was pretty much immobile and on large doses of Percocet. He HAD to take laxatives and MiraLax both, everyday, to ensure having a BM. Opiates will slow you down very quickly. Aging doesn't help, and yes, many elders are chronically dehydrated. My mom withholds fluids as much as she can, but I don't think she drinks more than 24 oz in a day.

We struggled with this with my FIL too. He'd be backed up one day and we'd hear about it all day, then he'd have these blowouts and --oh well--he wore thong underwear. I. Just. Can't. It was the grossest thing in the world. He WOULD NOT wear briefs, not for anything. When I threw out the thongs--he went commando. Oh well, one less thing to wash.

So I guess that generation came by the regularity issues naturally--obsessed mama's wanting to be the best, most 'scientific' mamas they could be.

We never did get dad to a state of 'normal' for him. He would have a BM and begin worrying about the next one almost immediately. He wasn't bad with anyone but mom. He spared us kids such intimate stuff, until the very end.
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cherokeegrrl54 Apr 26, 2019
O my gosh that made me laugh 🤣🤣reminds me of all the things my granmas used to make us do. I hated the vicks salve and also the methiolate....that stuff burned so bad!!!especially on a stubbed toe!! Then came the castoria or syrup of black draught to “clean us out”!!!! Those were the days, huh?? 😂
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This is my father. For years he was obsessed with getting cancer then it switched to BMs. I miss the cancer obsession. He would graphically describe it to me in the middle of a restaurant no less! I asked him why he was telling me all about his BMs and he genuinely thought I would want to know. This man would buy fleet enemas by the case. I just don’t get how he thought this was proper dinner conversation.
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shad250 Apr 26, 2019
He thought it would be funny, and in a way it is.
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