Has anyone had to deal with their loved one having to have a colonoscopy but being immobile? - AgingCare.com

Has anyone had to deal with their loved one having to have a colonoscopy but being immobile?

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Not able to get to use a commode at all? How can any prep be done at home? I can't see how that is possible! Right now a caseworker is trying to get the insurance company to approve a stay at the facility to get the job done. If they don't approve this, I just can't see how this can happen here at home!! Help!

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No, not really. Home health doctor was here this week and she said she is going to contact the case worker again about a GI consult. We are kind of on hold about the whole decision to go ahead with colonoscopy until further notice from the doctor. It really is frustrating to have to wait so long to hear from the health care professionals. We of course will stick with our decision to NOT be responsible for the prep here at home. Just cannot do that especially with my 92yr old father living here too. I guess my brother can refuse the procedure and accept what goes along with that decision. I am just trying to get through each day with no major trauma from both guys in the house! Thanks to everyone for your advice and comments. It really does help to hear what others have to say that are in the same situation.
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Anything new with your brother?
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Saturn, my mom recently went 2 weeks before having a BM. I had to take her to the ER where they gave her lactulose (go figure!) and she went the very next day.
There was a little blood in her stool and some of the health care people involved were all up in arms, worried and all. But it didn't happen again. Sometimes, when I am constipated, there might be a bit of blood on the tp. It doesn't repeat and I've never worried about it.

I am also an RN and in school and in practice, we didn't really worry about blood unless it was obviously blood that had gone through the alimentary canal for some time, maybe from the stomach or upper intestine. But that blood isn't bright red and it has a terrible odor.

There are little cards with reagents that you can use to see if there is blood in the stool BEFORE you and he go through this ordeal to make sure there is something to investigate. A lot of times hemorrhoids or just overstretching and trauma related to the size of the BM after being constipated for so long can cause a little blood, But the thing is, if the blood is bright red, it is not from deep in the body but right inside or outside. If it doesn't repeat or doesn't show up on the little cards (ask the dr for an Rx to get some), then I would either talk to the dr about alternatives and/or get a second opinion!

It seems unnecessary unless there is good reason to suspect something going on. And from what you've said, I think there is more investigation that should be done before having to suffer the prep and aftermath of a colonoscopy.
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if your brother is of clear thinking ability it is his decison. But that he was impacted for 2 weeks without intervention is unfortunate. Yes I think a trip to er is in order. What pain that must be causing him. Let us know how it works out.
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Boy, I dont know how I feel about some theses responses. As I noted above my father was same situation. If he hadnt had this I know he would of passed from the cancer they found, At 78 they were able to get it all out (colorectal) and he lived cancer free for 8yrs, He died from other problems. I am so thankful to have had him around those extra yrs. I think decisions should depend on situations,and of course individuals health and decision of treatments if something were found.....It is a shame Medicare wont pay for short stay for these pts, our Dr would of admitted dad if so. but they woudnt pay for admit for "diagnostic or exploratory procedure" ,at least that was our situation
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Many great comments here - most of all consider how all the drinking/flushing etc. will affect your brother. Can he handle it? Kudos to the family who shared the task by all being there...you are awesome! I would sure be asking more questions of his doctor: Will the test enhance the quality of his life? What will the treatment be if it is cancer? Can your brother withstand the chemo/radiation if it comes to that? My husband at the age of 84 had to have a colonoscopy to check for polyps(sp) - I would never do that to him again. He was uncomfortable the whole time and he drank all the solution, but it was not easy for him. He has Alzheimers and now a brain tumor so for sure he won't have another. It took away his dignity too, not only the constant bathroom runs but the actual procedure. We have a wonderful doctor and she did not push it. We made the choice. Has your brother agreed to this/does he actually understand what will be happening? The bottom line - what is his prognosis? You have lots to consider in this situation. If I had to make the decision for him as my brother, I would not do it - but that is my own personal opinion. I would say call in Hospice and see what they say about his condition before I'd proceed with any rectal testing. The best to you - I hear the caring and concern for him. All caregivers have to make decisions that we don't want to sometimes, but our loved one is top priority and their comfort is what we're about. Sometimes our heart says differently - we've all been there. Know you are loved and we care. Blessings on all caregivers everywhere!
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If nothing else the risk of dehydration should justify hospitalization for the procedure and prep. I too would question if this is worth doing,
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Unfortunately, It is common for those bedridden with MS [or some other ills or meds] to have bowel impactions.
Preventive measures/regular bowel care regimens are crucial to preventing or reducing episodes of this, but measures do fail to do the job sometimes, no matter how well instituted..
Also, paralyzed persons could have parts of intestines twisting or telescoping into itself, which can cause blockages.
But impacted stool is most usual culprit.

IF an impaction happens higher up in the colon, out of reach to dis-impact it, other measures are needed.
Registered Nurses in Nursing Homes often get blessed with doing a "simple" [as-if!] disimpaction. But if a blockage is too high up, or too tightly packed, it requires a Doc to do it, in an acute hospital. Immediately.
And there's no way to get around it--they hurt! In hospital, anesthesia can be used, to reduce pain and relax muscle spasms contributing to it.

It's possible the process of prepping for colonoscopy could help dislodge it, but it would be very hard to pass, and would need assistance by professionals to help clear it--back to his being in an acute hospital for that!

The tools for a colonoscopy could help break it up, to assist clearing it;
but a standard bowel prep for that procedure, is ridiculous--and it still needs anesthesia!!
The Doc may think he could get off the hook if it just "happens" to pass using the prep [met a couple of those sorts!]--again, pretty ridiculous, if that has been there 2+ weeks.
Forcing an impaction to move rapidly through the colon using forceful laxatives is very painful;
IF something else causes a blockage, a colon prep is CONTRA-indicated.

Does he have an NG tube through which to pour the liquids?
Does he have swallowing issues?
Has his stomach shrunk, or have trouble processing food, related to the progress of the MS?
...then, good luck on Standard prepping.
Not even discussing how to handle effluent!
[[have had to set up trashbags funneled to trash cans in the past--DON'T let on anyone told you that solution, lest they think you could safely handle it at home]]

IMHO, DO ask the Doc:
What does Doc suspect is cause?
WHAT other tests or exams has he done so far?
Does Doc think the prep would safely move an impaction of that long-standing?
Does Doc think cancer might be growing / blocking?
Does Doc suspect the bowel telescoped in on itself, or twisted, forming a blockage?
===Those other potential causes would be surgical interventions, NOT a colonoscopy! A colon prep would be bad in those cases.

COULD a less painful prep be used, such as repeated enemas?
COULD your person have a CT scan or MRI instead of colonoscopy, to visualize what's in there, where?
HOW did Doc think This would be handled in a home-care setting, no matter what the cause of the blockage was?
IS this DOC a specialist with MS patients?
Is he up-to-date on knowledge-base regarding care of late-stage MS?
Is Doc experienced in bowel blockages and the various causes?
AND,
If this is one of the usual sorts of bowel impaction common to bedridden MS patients, why doesn't he avoid the Prep, and just go in there to help break it up and remove it, =while the person is in hospital=, instead of torturing the person with a colonoscopy prep?
MAYBE, the Doc was just not thinking clearly at the moment he recommended a colonoscopy--had too much other on his mind, and failed to consider who he was talking about?!

Bottom line, if a bowel blockage is not cleared, it can cause death.
How slow, is question.
Your brother needs fully informed about potential causes of blockage,
potential remedies of it,
choices of procedures to remedy it,
and, potential outcomes,
to give his informed wishes on this.

IMHO, that is NOT a prep or procedure to be done at home--NO WAY!
It at least needs done in the E.R., or in the Acute Hospital.

It is hard to believe a Case Worker is proceeding on seeking Insurance coverage for it; it sounds like not enough information has been gotten, specific to this person, and, that no other options have been considered.
[[Even professionals have brain farts! ]]

Bottom Line:
A bowel blockage of 1 week or more, is an Emergency,
for which a person should probably be brought to the E.R. to get help.
This is even proper procedure, if person in a nursing home had an unresolvable blockage--they get transported to get it handled right.
Make sure he gets: "admitted for diagnosis & treatment of bowel blockage"
---being admitted for that, [[not "observation"]], is one Key thing to make sure Medicare/medicaid covers stay and treatment, according to what others have posted on this site.

Advocacy by family and friends helps keep Docs and Case Workers on the right track; helps prevent some of this ridiculousness
--sometimes, they are just on overload, and are failing to consider some details that could really put them in a bad situation, if they failed to consider them!

You could use statements like:
"It is impossible to do a colon prep on a paralyzed, bedridden person, at home, for an unknown bowel blockage of 2+ weeks duration; we have no way of knowing what is causing the blockage; he needs diagnosed and treated immediately. He can be transported to the E.R. today.".

Please keep us posted!
It sounds like the System is pushing you incorrectly, and it's time to push back!
I sincerely hope it is simply an impaction and fairly easily cleared.
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To nsjmk77- Do you think that when someone has Cancer that the inevitable is death?! I know many survivors of Cancer. I know several who have healed themselves with a change in diet. I don't like the idea that just because someone is diagnosed with Cancer that that is all she wrote. Dang!
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Does your brother want the colonscopy? If not, I would suggest you abide by his wishes. Have you contacted any MS associations to see what their recommendations are, if any? I had a routine colonscopy just 3 days ago and needed a 2-day prep. It was an awful experience, and at my age I don't think I'd do it again. (I'm 71.) Other than the MS, which is serious enough, it is a pretty grueling experience for anyone to go through.
God bless your brother and you.
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