Any tips for how to deal with daily disimpaction of bowels?

Cost: I have read, and it is typically billed to medicare or medicaid, or if younger their insurance, I have never in my 8 years of care giving and 6 hospice clients seen a $1.00 being charged.

I wanted to add that:

Medicare requires certified hospices provide a basic level of care but the quantity and quality of all services can vary significantly from one hospice to another.

In general, hospice will assist in any way it can to make home care as convenient, clean and safe as possible.

Hospice staff visit regularly and are always accessible to answer medical questions.

Hospice patients are cared for by a team consisting of a physician, a nurse, social workers, counselors, home health aides, clergy, therapists, and volunteers. Each one provides assistance based on his or her own area of expertise. In addition, hospices provide medications, supplies, equipment, and other services related to the terminal illness.

Hospice staff is on call for emergencies 24 hours a day. Hospice care does not include a nurse in the home 24/7. If you require more care than can be provided in the home, some hospices have their own inpatient facilities.

I hope this bit of information helps.

I saw one word, and want to ask you, Hospice? If your mother is on Hospice, that should and would be the duties of the Hospice nurse. This is not something that is easily done for those that are not trained. Sure it is a job that needs to be done, but Hospice should and would be happy to do that for you. When your loved one is on Hospice, they provide all of this for you. All of it!!! They are wonderful, and my sister would have been a wreck without them with my brother in law. Perhaps I missed your question, but I will read again. I saw Hospice nurse several times. Tell them, that emotionally, it is just too much for you to do. That is what they are there for. They will understand. PLEASE CONTACT THEM. HOSPICE IS A SERVICE THAT WE ALL OR SHOULD KNOW ABOUT WITH AILING PARENTS, and can be used at home or in a care center. They are there to help you and do whatever you need them to do. Please take advantage of there kind help. Blessings to you. They also supply any and most all supplies that you do need, included in that is prescription medications. Cost: $0.00

Is your mom on a regular diet? Can she eat regular food? If so, prunes are the best thing ever. I also give my mother 1 tsp of Benefiber 3X daily in liquid. She drinks it in her water. Yes moving her regularly will help. Hospice should have someone coming in to do that for you. I also give my mother 500 mg of magnesium every night. It helps her sleep and helps with the bowel problem.

As an expert on bowel care, manual evacuation, and bowel management, I first have to say this: Impacted stools are much easier to AVOID then they are to deal with.

Adequate fibre in the diet, Metamucil or a cheaper alternative available from Walmart pharmacy, prune juice, fig juice, colase [Walmart Equate 'stool softener'], and store's own brand of Milk of Magnesia are all useful tools in the PREVENTION of impacted stools.

Impaction occurs when the stools remain in the bowel past thee they ought to be evacuated naturally.

Stools ar emade in the intestines of all the waste not utilised by thebody, and eventually makes its way into the large bowel to evacuate via the rectum and anus.

These stools are very soft and watery at first, but as they are in the large intestine water is continually reabsorbed back through the bowel wall. If these stools remain too long, they become dry, brick-like, and pile up against the anal sphincter until they become so large that they can threaten to tear the muscle when evacuated.

Use the above, finding quantities and products that make her regular. If the NH complains, tell them that unless they actively prevent impaction you will sue them for negligence and patient endangerment, They should do what is best for their patients and constipation is a bad thing. It can also lead to confusion in the elderly.

I have spent a lot of time doing manual evacuation on patients that have been allowed to become impacted. While I have no problem at all doing this, I know that it can be uncomfortable, painful, and distressing for some patients. There is never an excuse for it to be allowed to continue or to redevelop.

Patients unable to move by themselves or exercise are greatly at risk. However, in their cases, passive and active exercise in beds or wheelchairs will go a long way to improving their ability to evacuate normally.

Placing the patient in a particular position is usually futile.

I wish you well. Never be afraid to talk this over with the RNs or the Director of Nursing, attending physicians, etc. It is a serious problem that could lead to, permanent damage to the musculature of the colon. It cannot be left to chance.


Good luck. :)

I am so sorry to hear you have all these issues with your mom. Please know that I am thinking of you, and sending good thoughts your way. Remember to take care of yourself first.

Now, I understand. I am sorry that I misunderstood. My sympathies to you. Yes, talk to the nurse. Mom is probably stretching truth and just want you to do it.

There is absolutely nothing wrong with your breaking down in that you are human and what you are witnessing is the death of your mother. It's hard. You tell her you love her and she's not any problem whatsoever. You tell her that you thank God for each and every day you can be with her and help her the way she helped you. And you start remembering with her. Find some time to laugh if you can.

As has been written above, talk to a nurse. Hospice is great. They have chaplains who deal with this along with staff. Volunteers are great, too. (At least I was :) ) .... death is a part of life. We don't see it very often and my God, it hurts.

Keep your chin up, give her the best hug she can withstand, kiss her, massage her (touch is important) and thank her for being your mom.

Hello Celticlass, Hard to tell from your wording, but are you saying you just found out that you have to do the disimpaction? (that's what I think you meant). Not that you just found out that you should turn her on her side to do it.

As as RN, and a caregiver for my Dad, (and previously for my Mom), I do not think disimpacting your mother should be your job. Not merely because it's not in your realm of training, (should at minimum be a nurse to do this). This is just beyond what a person should have to do for their parent. It's time for professional help, either in a nursing home, or for them to do it at home. This is time to just say NO. Call the hospice people, and tell them.

What is so bad about turning her on her side? Also, are you an RN? I am sorry that you are having such a bad time. Please tell us more about this situation.

You shouldn't be doing the disimpaction. That's for hospice and other medical support staff to do.

But yes, it's usually done while the person is laying on their side.

Our Hospice nurse asked us to put some petroleum jelly in the freezer. We are to form a pea-size ball of the frozen petroleum jelly and include it in her morning meds. It seems to be helping.

My mother requires disimpaction by a trained nurse 3 times a week. A trained medical professional should be the only one doing this. There is no reason for you to have to do it. Talk with the home health agency/hospice about having aides come to the house in additon to the nurse. The aides should be able to help turn your mom so you don't have to. My mom is bedridden 24/7, so I know her aides and nurse do a lot to help. Is your mom mobile at all? On the flip side, I care for my 90 year old grandmother in my home, and she is on Lactulose Rx to keep her bowels moving, and I sometimes need to give her Magnesium Citrate (over the counter) if she seems irregular. Maybe talk to her doctor about these or any other treatments you could try if she can still get up and use the toilet at all.

It takes a trained medical person to perform fecal Impaction removal. If hospice is involved, call them. I am coming from a place of being a R.N. & dealing with this issue both in hospice & in E.R.'s. There are meds that are available to use too. Patients need to be moved every 2 hours if bedridden to prevent bedsores. In doing the fecal impaction removal, such special care has to be give not to hurt the patient. It is so easy to do harm to them. Call hospice as much as is needed & also a word of advice, when this process of fecal removal is done, the patient MUST be on their left side.
I do not believe that you need to be doing this procedure. Get hospice to do it & it need not be done daily either. Every other day to 3 x a week is enough depending on the amount of food eaten. If your mom is in hospice, she is entering the end of life treatment. You may wish to consider having her moved to an inpatient hospice. I have worked them & it takes special loving people to work there. She will get nothing but wonderful care in an inpatient hospice.

Talk to the nurse to find out what she meant. You didn't say what your mother's condition is, other than she has hospice care. Is she ambulatory at all? Walking would help get her bowels moving. So would keeping her hydrated.

If your mom is confined to bed and unable to turn herself, then yes, she should be turned regularly to prevent bedsores. The nurse can show you how to turn her so you don't injure your back. It's not difficult, once you know how. I used to do it for my mother when she was bedridden with pancreatic cancer.

If you're breaking down, then hospice can help you, too. They have counselors who assist patients' family members. Good luck.