How to handle bowel issues? A story that leads to questions! A caregivers life: if you don’t laugh, you’ll cry!

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Sorry for the long post, but I must set the scene... WARNING! Poo filled post here!
Mom isn’t having moving her bowels at all without medicinal intervention. When I tried giving her the smallest dose of Miralax, it caused uncontrollable diarrhea. She just stood in the shower with pure liquid running down her legs. She was miserable and so was I!
She doesn’t become bloated or uncomfortable for WEEKS. I honestly don’t know where she is putting it! The nurse and I tried to see if she would move them herself without the laxative. She went almost 3 weeks before we intervened!!! No bloating, no discomfort. She was still eating well and no vomiting, etc. We didn’t DARE go any longer. One senna tablet and 20 minutes later, she went uneventfully. Normal size and consistency. She continued to go throughout the day until her system was emptied.
This lead me to my routine of once per week, I would give her a senna tablet. (More often made the stool far too loose and caused uncontrollable bowels.) With this routine of once per week, she would go between 20 minutes and 2 hours later. We were prepared and I was able to get her to the bathroom where she could go on the toilet easily. I have a bidet sprayer that hooks the the faucet so I could wash her with warm water to keep the area clean. (UTIs are a major issue). Then she was done and all was well.
This week, I gave her a tablet on Tuesday. NOTHING HAPPENED. I chalked this up to her system not working as well. I planned to try again the next day, with perhaps 2 tablets. The max dose is 4. At bedtime, I took her into the bathroom and let her go before showering and changing for bed. She had a bm! I was so happy that things were moving. I got her all ready for bed and she fell asleep. Mother Nature had a surprise for me. At 2 am, my dog woke me begging to go out. I could smell a foul odor in the room. I thought perhaps something happened and he had an accident. This has never happened, but there is always a first time.
Instead, I opened the hall door to find my mother, sitting in the bathroom, covered in poo from the waste down. IT WAS EVERYWHERE! Piles, smears, and no surface unaffected.
I checked the bed alarm. I apparently forgot to TURN IT ON! I have no idea how long she had been sitting there. She had fallen, slipping on the mess.
It took me 30 minutes of cleaning before I could even reach her.
Only people that have been in the caregiver roll will find this next part funny...
The entire time I am spraying, wiping, cleaning to get to her feces coated body, she keeps perseverating on a tiny dot of poo on her pinky. “I need this off, I need this clean!” Imagine the scene. Brown from the waste down. Poopocolypse.
And all she can worry about is a tiny dot on her pinky! There was poo on the rest of her hands too, but only the pinky was a problem for her!
After an hour and a half of washing, scrubbing and disinfecting, Mom was again ready for bed. I continued to clean and then shower after I got her back to bed.
In the morning she was fine. No effects from her fall even. We went through Wednesday with no problems. I thought we were back on track. Wednesday night I was woken by the bed alarm. I had watched her until after midnight. She seemed solidly asleep. Sometime after midnight she woke up. At 12:40 she decided to stand up to remove her diaper. This is when the alarm woke me. By the time I got into her room we had Poopocolypse the sequel. Just like in the movies, the sequel is never as good.
I only had to get her cleaned up, scrub the floor and change the entire bed (she managed to sit down off of the waterproof mat that we keep under her.)
So here is my question.
Has anyone else faced this type of situation? What do I do? The nurse was no help. She said that she seems cleaned out now and she should be ok.
I just don’t know how to time medicine. I am not worried about my convenience, but I am worried about her safety and health. She doesn’t understand to call for help, and I can’t stay awake 24 hours a day watching her.
What
Do
I
Do?

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Thanks!
I’m glad to know that once a week has worked for others. I feel so guilty going that long between, but she isn’t in any discomfort!
It isn’t that she needs a softener. It’s that she needs a stimulant to actually activate the muscles to make her go.
She isn’t mobile any longer. She can stand to pivot from bed to wheelchair, to toilet, to sofa... walking isn’t an option.
She will only drink water and refuses any liquid medicine. I don’t know what she will do when it comes time for morphine. She won’t eat anything that I can mix it in!
I can’t even imagine trying to convince her to let me insert a suppository.
Thank you all for letting me know I am not alone!
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Reply to anonymous814887
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BTDT. Seriously. Mom's bowel dysfunction was one of my major stressors, we tried every laxative and combination possible and just when I was relieved we had something that worked it would stop working. I can't imagine going 3 weeks between BMs, I was pulling out hair and in tears after 2, once a week was our "normal". And yeah, when the end of week 2 rolled around and she STILL didn't go and I finally had to use a bisacodyl suppository we would have a sh*tpocalypse. And the smell, OMG it was indescribable. The funny thing is that since mom has been in the NH they haven't really reported any problems to me, she seems fine so I'm not sure how they are managing that and I find that don't really want to know.
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Reply to cwillie
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This is probably a stupid question but how mobile is she?

Sound like her bowel muscles are playing up. (Mine too)

I have bowels problems too and to 'help' I use a 'cat stretch' .
She can do it sitting down. Lean forward as far as she can, head down. Put her fingers on a table(or something) in front of her. A little bit of a walk helps too. With a walker or rollator is OK.

Keep up the natural food that soften the stools (mine is onions) and all the good roughage. Can she manage stairs. This works also, for me, but I can only do it once a day, and it takes me ages.
I also use Macrogol. I have found my intake to be four a day. 2 x am and 2 x pm
But they do make me feel bloated.

Life is 'crap' sometimes literally. hahaha

I feel for her and you.
When I worked in a hospital and we we at the elderly wards. We used to keep a perfume bottle in our pocket to pop a drop on the end of our noses. Another tip is, keep your mouth closed. Not because some might go in but because of the taste buds. They seem to small it.

I wish you luck
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Reply to BuzzyBee
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Thank you so much fellow caregivers! The problem seems to be the actual mechanism of going, not the consistency. If I give her any kind of stool softener, it causes her to leak watery stool. She drinks enough water and eats enough fiber to keep even week-old stool almost pudding consistency. She needs the stimulant to kick her system into actually moving the bowels.
I know her digestive system isn’t working. She isn’t pulling nutrients from the food she eats. She isn’t dehydrating the stool as it passes through the intestines and the bowel.
She is in hospice, so we see a nurse 2 times per week. We cancelled the aide for now because she couldn’t really do anything for us right now.
I think I am just tired, both physically and emotionally. Facing that much poop in the middle of the night is overwhelming.
Thanks again everyone!
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Reply to anonymous814887
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Warning another Poop story!

In the final 9 weeks of my FIL's life (post hospitalization for pneumonia, sepsis, and finding a cancerous lung mass), he was released back to our home and on Hospice, my FIL was bedbound, weak as a kitten and couldn't even manage a bedside commode let alone move himself side to side.

So there we were, him stuck in bed, and me trying to figure out the perfect formula to keep him having routine BM's, but in bed, and in a depends. It was a nightmare, one due to the fact that my husband could not stomach anything to do with personal care, esp BM's, and 2, because this was My FIL, and it was extremely uncomfortable for Me to have to take care of his backside cleanup, but eventually I was able to keep him comfortable, and I "got over it"!!! There was really no other way.

The Nurses brought me Colase to keep him regular, but the consistency was never consistent, so there was often a Mess to clean up, if you know what I mean! Yuck!😂

I think trying the more natural routes is best, try reconstituting 1-3 prunes every night, and give them to her with her breakfast, or prune juice, probiotics, and then try a low dose of Mirilax if that doesn't work, to see if you can find your perfect solution.

Ugh, it's just one more struggle us Caregivers have to face in the care of our Loved Ones! Sorry!
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Reply to staceyb
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Sorry I have no useful advice, but will say Poopocolypse is a fabulous word you should Tm and you have my empathy in spades in dealing with this
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Reply to Daughterof1930
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I certainly have encountered many situations similar to this one from working in a hospital for so long. Bowel prep can be brutal. I've had patients wandering around their room with a constant drip of stool splatting and spreading each time it hit the floor, to a patient who went so much all at once that it was dripping off of both sides of the bed. Unfortunately everyone's bowels seem to be so different from each other. I know the most common stool softener we use is Colace. We pass those out like candy and they seem to work well for most people. Have you ever tried those?
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Reply to Caregiverology
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WHEW! I think many of us have been in similar situations to varying degrees! Personally, it appears that this is too strong for her. There are GI over the counter things such as culturelle, a probiotic. Similarly, some yogurts (Dan-Active, e.g.) have strains that help build the GI lining. My husband has GI issues and can go weeks without 'going'. But there are some natural foods that assist us in going. The ever popular prunes, Juices such as Very Veggie. Herbal pills such as butternut cascara and Slippery elm (one makes you go and the other reduces stomach discomfort). Or smaller doses of the miralax or senna. (My husband's MD said he would have to play with the dose to figure out what would work.
Seniors GI systems are fairly sensitive. Good luck, Get those antibacterial wipes ready!
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