When should we feed mom during the day now? (3 or 2 times a day?)

Tony11: Imho, continue with regular small amount meals. As well, perhaps your mother should take a daily probiotic.

Constipation is also a sign of dehydration. Make sure she drinks enough fluids. Elderly lose their sense of thirst and you have to make sure she is drinking enough before kidneys get damaged from dehydration. Of course there are other considerations such as congestive heart failure you have to watch fluids but talk to her doctor since he knows her better.

I’ve personally had this issue. Since I control my blood glucose with lower carbs and eat no cooked veggies, I have a glass of “prune punch” everyday ..half low-sugar prune juice with diet sprite or ginger ale.

For low-carb bread-lovers, I use a microwaveable mug to make a 1-minute flax muffin (after I turn it out and let it cool for a few minutes, I turn the muffin on its side and make 3-4 round slices. Freezes well. Eat plain, top with cream cheese, peanut butter, or whatever. Over a day’s time, I finish off the muffin slices. Helps tremendously with constipation issues, as flax is fiber.

recipe: in un-greased microwaveable mug, mix well: 1/4 cup ground (not whole) flax seed, 1/2 tea baking powder, 1 tea cinnamon, 1 packet Splenda, 1 tablespoon low-sugar or unsweetened applesauce, 2 tablespoons cream (or oil+water combination equivalent), 1 egg. Microwave 1 min plus 15 seconds on high. Note- applesauce can be omitted and cooking time is then just one minute. Sometimes I sprinkle with just a bit of Swerve powdered sugar. This is a very tasty low-Carb bread substitute packed with fiber.

My husband and I lived with mom for 8 months and she was taking pills for gas and pills for constipation……the gas was because she was sucking on mouth lozenges for dry mouth and drinking through a straw so we stopped the gas x. Then, the constipation was an issue….since mom wanted to control her weight and she had a sweet tooth we purchased dried figs….she loves them and dried apricots. She would not eat prunes because she eats too many since she likes them so much….not a good thing to over-indulge. This has solved her problems. She does not eat much and does not drink between meals so the dried fruit has solved her constipation issues. She also does not exercise except when she has PT 3 times a week.

Continue to feed her regular times and 3 meals a day.

It is better to look more closely at what she is eating and drinking. Try to avoid caffeine which dehydrates and leads to constipation. Try to incorporate more whole grains, produce (fruits and vegetables), and less processed foods (white flour, white potatoes, starch, white sugar). Give her plenty of water to drink, fruit juices, and even Ensure-like supplemental drinks. If need be, give her fiber tablets (I like the sugar free gummies).

See if she will "dance" or do "chair exercises" in her chair to increase her activity.

If constipation, less than 1 bowl movement in 3 days, is becoming more of her usual, then talk to her doctor. There are a couple of disease processes that can cause constipation too,

I would go with smaller more frequent meals or snack size portions.
I also dealt with my Husbands constipation. I would give him prunes several times a day then had to switch to juice. As I had to thicken liquids I could not add Miralax to a glass that had Thickit in it as that Miralax would counteract the thickener. So Miralax went into soups and cereal like cream of wheat or oatmeal.
A puree of Pineapple and Papaya was also good
A herbal tea called Smooth Move helped.
Hospice suggested what they called "the bomb" 1/4 Cup each of Milk of Magnesia , Orange Juice, Prune Juice heated up to about body temperature. That typically worked in about 30 minutes.
Suppository when needed
And lastly we started with a prescription Lactulose daily.
It is always going to be a problem you just monitor it and there is always the Enema and Magnesium Citrate but these 2 I would have left to the Hospice to either administer or suggest.

Tony, I am with the others on more frequent smaller meals.

Not all food items create bulk, that's part of flushing. Lots of high protein foods can take days to produce a bm. High fiber foods create bulk and with enough fluids produce bm. Some are natural flushers, raisins, dates, figs, pears to name a few. Watermelon is a great source of fiber and fluid. You can blend food items and make smoothie type drinks that you give mom drinks of throughout the day.

She probably eats sweets more readily then anything else, so let her. At this stage it is about getting fluids and calories in them really. Of course nutrition is important but, not as important as keeping her hydrated and fed.

You are doing great and they are blessed to have you.

At this point she is going to be eating and probably drinking less. Unless she is interested in food it might be worth switching to liquid diet which should be available from your pharmacy or blending meals down to soup consistency with the addition of some fluid to make swallowing easier and also to get the fluid in which is just as important and the "food". She will probably not want a lot at a time, so I still think you should offer little and often. Something that can be taken / eaten cold or just warm will make your preparation easier as you can do a whole day in one go and just use as needed. In the UK we get mixed vegetable juice which tastes like tomato juice really that would be a ready made option to buy (or make), and the ready made liquid diet comes in both sweet and savoury flavours. I am sure you can also buy online. Don't worry about meal times or having a proper meal, just what she will "eat" when she will. xx

Tony, in case no one else has told you, you are a really good, thoughtful and caring son.

Tony, is someone regularly listening to mom's bowel sounds?

Tony, here is a resource on eating and drinking in late dementia:

https://www.scie.org.uk/dementia/advanced-dementia-and-end-of-life-care/end-of-life-care/eating-drinking.asp

It seems like offering small amounts of foods mom likes throughout the day would be a better idea than regularly scheduled "meals".

I don't think the timing of her meals is something that would make any difference, when it comes to diet it's more dependent on the types of things she is eating and the volume of fluids she's taking in.
Constipation means different things to different people, what exactly do you mean by it? My mom routinely went 7 days between bowel movements (and often more), an yet when she did go the stool was never dry and hard. In retrospect I spent way too much time and energy fussing with bowel care and worrying about the possibility of fecal impaction, once mom was in the nursing home nobody seemed concerned and bowel dysfunction wasn't what caused her death 🤔.

A buffet of choices of items that she likes, offered frequently, that contains foods that may help promote evacuation, would probably be what I’d try first.

Mashed Berries, Canned Baked Beans (drained of most of the sugary goop and lightly mashed), soft oatmeal cookies (perhaps sandwiched with sugar free fig jam), prune/fig puree, stews containing bits of meat.

How much trained medical advice are you receiving? It sounds as though you might benefit from some specific suggestions regarding her overall care. You are obviously willing to experiment in order to help her live more safely and comfortable, and some ideas from an outside source who can see her may be helpful to you.

I’m not sure what you see as a potential benefit of decreasing her meals? Sometimes people in advanced dementia “forget” the sensation of hunger altogether, and if that!s the case, she may need to see and smell her food to increase her interest?

Here is a resource on end of life constipation

https://www.crossroadshospice.com/hospice-palliative-care-blog/2017/august/08/understanding-end-of-life-constipation/

Make sure she's not dehydrated (a big problem with older women). If she has no teeth she's no doubt not getting enough fiber. Our hospice recommended a stool softener for my mom, which worked too well, so start small if you go that route.

Tony, has mom been evaluated for hospice services? I seem to recall that you are not in the US, but please find out from her doctor if there is hospice service available.

Hospice is not a place; it is an level of service provided by a hospice organization. Please call mom's doc and get a referral or look up hospice organizations in your locale.

Tony, is mom on Hospice? If so, the nurse should be guiding you here.

How about you ask her????

Or maybe smaller meals less often.

As you are saying nothing about her medical state apart from her bowel movements it is hard to know if she can tell you what she would like, and harder still to know why you think cutting her meals down in number - which goes against how our digestive system works - would be a good idea. She is not a dog/cat she is more like a child - little, often and varied to assist digestion would probably help. Speak to her dietician and get some sensible advice - some foods aid bowel movement some should probably be cut out.