Dementia and constipation; it's times like these I don't know what to do.

I have a problem with my dad. He’s not constipated and he goes to the bathroom on his on...but he does not clean himself very well. He wipes his hands on a wash cloth I have in his bathroom
For him to wash his face. It has poop all over it! He will never wash his hands unless I see him and make him. He acts like the water is to going to make him melt! I think he mostly just stands in the shower under the water. I am a 24/7 caregiver but I can not clean him or shower him. I had him put in the NH because I am sick and
Can’t take care of him the way he needs to be taken care of. I was told by the nursing home that I had to come get him because he did not qualify for the nursing home due to the fact that he can feed himself, go to the bathroom, and dress himself. It doesn’t
matter that he doesn’t know if he’s had lunch or dinner or even what time of the day it is. He does not have money for AL so I
Have no alternative except to take care of him. How do you 24/7
Caregivers do it??? I am at the end of my rope!!!

It's no wonder sometimes seniors can become obsessed with their bowels, they are either not going enough or not at all. If constipated, prune juice will definitely help and so will drinking lots of warm water behind it. You sure don't want to have toxins in your system and end up with colon cancer but you also don't want to have streaks or skidmarks in your pants either. They come usually when you have a little bit of leftover just inside the rectum after you're done and it keeps seeping out. This indicates some area of your bowel is backed up and full. Perhaps a little bit of a Real good laxative will clean out the plumbing and correct that kind of problem also indicating the use of less paper

All of these health problems disorders in the body are a result of insufficient amount of B vitamins. People believe they are getting sufficient vitamins when taking the pill form of vitamin this includes B vitamin which is false. The vitamins sold in grocery stores in Walmart do not have sufficient vitamin in the most of them have fillers and very little vitamin. The best vitamins are sold in health food stores are by holistic doctors.

Constipation dementia heart problems all physical disorders start due to poor circulation poor circulation occurs due to lack of B vitamins. People do not understand that the type of B vitamin they take most in pill form do not suffice and preventing the poor circulation. They should either see a doctor holistic doctor who will give you liquid B vitamin shots or you can go buy liquid, sublingual B vitamins in a health food store. Western medicine doctors are not trained about nutrition in medical school so they do not understand anything about treating your health problems other than pushing drugs on you which perpetuate your health problems. You will be wasting your time to discuss these health problems with with them. It is unfortunate that people do not understand Anatomy of the human body. The average size human body consists of 100 trillion cells that are bound together which make your up your muscles and bones and organs and these cells require the nutrients to function properly and stay healthy. Dr. Julian Whitaker a holistic MD said Every pharmaceutical drug depletes the cells in your body of at least one nutrient which causes a disorder in the cells. Some vitamins such as B vitamins or water soluble which require more frequent intake of them to maintain sufficient amount in the cells. When a person does not take sufficient amount of water soluble vitamins their body becomes deficient of this and physical problems such as the constipation dementia heart problems develop. B vitamins also Pro long the life of the cellos

Yes, it's true Tinyblu. Many elderly, if not most, become obsessed with their bowels. Many years ago when I was a student nurse doing Med-Surge clinicals, it was nearly impossible to complete my assignment with elderly patients until after they had their BM. No bathing, no history taking, no daily activities until that BM happened. It was one of the reasons I never worked the Medical-Surgical floor. This is my Mom's primary topic of "conversation" even tho she goes 3 times a day & the caregiver shows her the daily BM chart, she's still insists she is constipated. When I speak with her the very first thing she mentions are her BM's. Even tho I am an RN, I find it most unpleasant.

Yes! The #2 issue! My mother almost drove me to drink about buying prunes, prune juice, Miralax and Immodium. And using them ... or NOT!

I agree that if Hospice is caring for him than Hospice should be called by the daycare. Same with the AL. They all need to understand that your job is such you can not deal with this kind of stuff. If the DC continues to call for you to pick up Dad, you may have to give DC up. Your job is more important.

Is Dad on any kind of schedule as to when he goes? I would avoid going to see my mom at the NH early in the morning because it seemed that everyone who was going to go did after breakfast. But I know that my bedridden hubby can go any time, usually right after I’ve changed him. What about checking his diet and adding more fruits or vegetables? Also, as for the transport, could you find a personal driver for him? Maybe even a church volunteer? They could seek him out at the daycare. I know from experience that sometimes the transport schedule can be a little “off”. My hubby doesn’t have dementia, but he’s like a preschooler, trying to entertain him when the van is late! My thoughts are with you, Tiny. I know you’ve had a hell of a road to go down.

Boy, does this bring back memories. My ex-husband (one of the reasons he is an ex) was always very focused on his bowel movements. Even in his 40's and 50's he would follow me around the house discussing the texture, amount, smell, etc. of his morning movements. I would tell him I didn't want to hear it and I would walk away. He would just ignore me and keep on. I hated it. He turns 90 this year, is in assisted living and bores my daughter with the same thing. UGH!!!

I feel your pain. My father is convinced that if he’s not having explosive diarrhea that’s he’s not going to the BATHROOM. I took him to the doctor for pain in his leg a few weeks ago. When we walked in he shouted at the receptionist “I have a severe fecal impact!” I was like WOW, that came out of nowhere. We got into the room and when the doctor came in he shouted the same thing at her. She looked at him and said, “So you’re constipated?” It’s never a dull moment! He will change how long it’s been since he went several times. It will go from a few days to a few weeks within a single conversation! He recently went on a hunger strike because he couldn’t live where he wanted. He didn’t eat for about 5 days. He first told people it was a week, then it was 2 weeks and now he’s settled on 3 weeks! Sometimes he’ll say it was 21 days just to add effect I suppose. The doctor prescribed for him the same thing your father’s doctor did. Senna and Miralax. He hasn’t complained about it since. He says it’s working so that’s all that matters...until he fixates on it again and claims it’s not. I believe he just likes the attention a doctor’s appointment brings. I notice he believes time moves faster than it does. Every time he tells me the same stories the amount of days or weeks changes. I hope things get better for you. It helps me a lot to read other people’s woes as sad as that is. It lifts my spirits to know I’m not alone in this. I often say this is a club I never signed up for but I’m in it whether I like it or not! I’m praying for you.

Oops I forgot professionals...you caregivers are AWESOME TOOO!!! If I missed anyone, you are included!!!

Although it doesn't always resolve the issue we are having personally, it is SO SO SO SO comforting...no, helpful...., not quite right, steadying....yea that's it! to read others in the same boat, struggling with the same issues and stressed about the same things. Maybe we each aren't all on our own island afterall. Thank you for this forum all of you special, incredible and amazing caregivers in your many forms....daughters, sons, wives, husbands!!! You've been my life saver more times than I can count. God speed to all of you and we WILL get through this and be OKAY. You're doing a fabulous job!

They don't have to have dementia - old people are fixated on their bowels, to put it bluntly.

My DH can come out of the bathroom and not 30 minutes later he'll swear he hasn't gone. I learned to just roll with it.

Believe me, 2 weeks without a bowel movement and he'd be on the floor and unable to get up; rolling in pain. I've seen that at the hospital and it was never 2 weeks without. By the 3rd day I too have pain - the body starts cramping to rid itself of waste.

I still remind my DH that he has gone but I know he doesn't believe me. Now I just let him trek to the potty as often as he wants. "pick your battles"

tornadojan your first few sentences are my life. I had to see who wrote this because i thought, my gosh, did I write this and not remember. This site has been so helpful and I am dealing with the same bowel obsession with my mom and it truly has become my life's distraction. I'm glad to see that I'm not the only one or that my mom isn't the only one with these issues. It's so sad to see our parents this way.

Great question, especially for those of us who are working professionals. It is so hard to stay focused when you always have this background dialog running subconsciously - I hope everything is OK, is this going to be a decent day? I call my mom roughly at 9 a.m. every day. (She has a helper whenever I'm not there). I always have this low-level dread before I call. Will she be alert? Feel decent? Depending on the outcome, I then feel I can move on and hopefully have a good day at work. Believe me, I have gotten many of those calls - I am also in a creative field - and a 5-minute call can easily turn into a 30-minute side activity that can completely mess up your workday. Actually I was laid off and am now interviewing for other full-time jobs. In the back of my mind, again, I think, will a new employer be understanding? Will I start a new job and then have to deal with a crisis? What if? What if? I am single and have to work for several more years. Just another one of life's dilemmas. I feel your pain, Tiny. Listen to all the great advice on this board.

My two cents...Tinyblu for what it’s worth. They do fixate on their bowels..period. They can’t recall when they had them. My dad will swear they are hard and small, when he’s on Miralax and Sennekot daily. As Cetude said, they don’t hydrate or walk enough or eat enough fiber so there you go. But they can’t remember either when they went last.
Your dad is on hospice for a reason. He's in AL for a reason. He pays good money for their care so you don’t have to. If there is truly an issue AL should resolve, then contact the Director of AL or the nurse in charge of Patient Care Coordinator duties. Regular staff is not the "go to" here. Complain loud and clear that they are not to call you for every little thing and that is why he is there for them to handle it. We had the same thing happening to me and my sister and it was wearing us out. (Mostly me since I live by dad) So I totally get where you are coming from. Here’s a piece of advice my sis gave me (she’s a nurse) "if he’s not bleeding from an orifrice, or dying, it’s not an emergency." Because I began to fret Bout every little thing. Your dad is on hospice...towards end of life and unlike Cetude, I would not be concerned with him being on Miralax due to his kidney function. That’s small potatoes right now. You can not worry about every little "what if". That will eat you up. Tell them not to call you at work unless it’s a true emergency. The director can come up with a way to monitor his bowel habits...let them devise this method. If dad is calling your cell phone...block his number while you are at work. You need to have some control and NO, it’s not selfish to want some peace of mind. 

Constipation is very common with later states of Alzheimer's. Part of it they don't drink and exercise enough; another reason can be due to sluggish bowels OR it may have to do with hypothyroid (get that checked periodically which is a simple blood test). .and it can be deadly because not only can a person get IMPACTED as little as three days (will require Emergency Room visit and the nurse will dig it out with their finger). Constipation is deadly because they will feel uncomfortable and unable to communicate what is wrong--the result is WANDERING which can lead to catastrophic falls. You must be extremely careful with Miralax and other laxatives such as MOM, Mag citrate, even Fleets enema because you MUST know their kidney function. Poor kidney function giving these will cause kidney damage (they form crystals in the kidney and can kill the person). Ask the doctor for LACTULOSE which is designed for long term use--and is kidney friendly. It's not really a laxative, but an indigestible sugar which accumulates in the large intestine which will draw water into the bowel.  These people require around-the-clock supervision because they are unable to tell you if they went or not--and may or may not flush the toilet and can't give you a straight answer if you ask them. So someone has to monitor them.  If they do flush, TURN OFF THE TOILET. You must keep a diary when they had bowel movements.. For the caregiver your entire life will be center around the bowels.  It's so sad but true.  Been there..doing that.  That's one reason if you are confronted with being caregiver vs. nursing home--you are better off going the nursing home route because your life will become one living purgatory...how would you feel to live your life centered around an old, confused, feeble person's bowels. But do not take constipation lightly. It can turn serious due to them wandering because they feel uncomfortable with a gut full of backed up stool.  

PS: Good lucking giving them the medication.  Some Alzheimer's people refuse to take their meds because they taste bad. Giving my mom medication which is three times a day is a major ordeal for me.   I have to use every psychological trick in the book to get her to take them.  The moment I wake up I know this special purgatory of mine starts and try doing this every single day--seven days a week. With no help.  NO relief. But when she has her bowel movement I get a sense of relief because at least I won't have to deal with that..for another day.  Like I said if you can get them in a nursing home..do it.  

Hi everyone... I took it a step further (in the spirit of Countrymouse's advice), I spoke with the social worker on Dad's hospice team and we are working on a plan to funnel those calls other places.

Hospice now has the Adult Day Center Director's contact info so they can speak directly.

I still have no idea how the director even got involved yesterday (maybe the transportation person relayed the message -- who knows), but I can't be taken away from work for that type of thing.

As for the transportation person, while I don't like being blind sided with information about Dad not being ready or in the waiting area when she arrives, I can't worry about that either.

I've talked to the AL staff about this to no avail. I asked the hospice social worker to talk to the AL staff as well about making sure Dad stays in the waiting area (he comes down early, gets impatient and goes back upstairs) until she comes.

I am working on trying to monitor the messages that drive me bananas, but it's in my nature to worry. The easiest thing would be not to get the calls in the first place.

Let's see how things go with social worker intervention.

"I spoke with his hospice nurse who said he's checking his bowel movements and Dad has complained lately of being constipated but they're on top of it."

Is there any particular reason why you will listen to your Dad, to the day care director, to your innermost fears... to anybody *except* the person who is in charge of your father's daily welfare AND knows what is actually happening with his bowels?

Stop this, Tiny. Listen to the hospice nurse, and faithfully repeat his/her EXPERT opinion if the Director calls you talking - for want of a less vulgar word - sh*t.

I went through this with my aunt. Only in her case Her saying she had gone when she really hadn't. X-ray showed she hadn't. After two ER visits with lots of other symptoms went to a gastroenterologist who said no stool softener but miralax everyday. If stools get too soft cut back on the dosage but make it part of daily meds. After a year of this program the everyday dosage still works great for aunt. However, I think Barb was correct in advising that AL speak with Hospice before any hospital visits.

UPDATE: So Dad didn't even GO to the Adult Day Care Center today! When I got the message from the director, I assumed he was there. The transportation person just called me back (two hours of phone tag -- YAY) to let me know that she left him at the AL.

Is it bad that I don't want to have to deal with any of this and just do my job? So now I feel like I have to figure out what the HE** is going on. How is the Adult Day Center involved? Why am I always stuck in the middle of this stuff?

It's like a catch 22. Dad really loves the Adult Day Center, but I'm starting to think that he may not be well enough to keep going with the incidences of him losing his breath trying to get back and forth and the new revelation from the driver that she has to go inside and pick him up because he gets his time mixed up. This would devastate Dad, but that may be my only option.

and it's really a toss up on whether Dad needs Memory Care. Honestly, he's not that far gone. Hospice has classified his dementia as "Pulmonary Dementia" so he's not THAT bad compared to what I've seen in memory care facilities. To top that off, it's about $1K more a month for memory care. I just don't have that kind of money.

I was ROCKING this morning at work. I was creating and really having a good day. That's been brought to a screeching halt thanks to all of this. I'm so irritated right now. I just want to work... now my head hurts in the back and I'm seeing spots. Might as well call it another unproductive day... YAY ME!!!!

Call the day care and tell them to discuss with Hospice. Hospice needs to clear hospital visits.  Or tell them you'e discussed with Hospice and they tell you nothing to be done.