Dad has moderate to severe vascular dementia and has been living at the equivalent of NH at the VA for several months. I visit every month and I am here for 2 weeks. Today, he was having a severe problem with an incompletely expelled, very hard, BM. At home he was used to being reminded to drink copious amounts of water. He does not seem dehydrated, however from personal experience I know that clear water can sometimes help the situation. Here is not allowed clear fluids due to aspiration risk, because he is not always mindful when drinking. Nurse wants to add stool softeners to his medicine regimen "except for when he is loose". These take hours to work, I'm thinking more water might be better, but he is not dehydrated, just want to avoid more medicine especially one with unpredictable timing. I imagine it is quite uncomfortable for everyone should an aging man defecate in his drawers. I am wondering if milk of magnesia which is a mild laxative, would work better. It doesn't seem to be available to the nurses. Yesterday he knew exactly what dose he needed and how often, because apparently he's had this problem before when he was home, and I know they won't try to follow his own medical advice. Seems more water and an occasional gentle laxative might work better than a regimen of stool softeners. He does not appear dehydrated, but my personal experience says drinking water helps, regardless. Not sure he can be trusted or capable to drink water alone in his room. Maybe they could have him drink a full glass of water as part of the morning and evening medicine delivery system. Does anyone know the ins and outs of this issue as it relates to a sort of nursing home? SS vs laxative vs just getting enough water. Also the ins and outs of calling plain old H20 medicine! Thank you.