Bowel problem in elderly; Dr. believes Dad is simply obsessed. I'm at a loss as to how to help him.

I think quite a few older people grew up obsessing about bowel movements. I worked in London in the 70s with an American Jewish girl whose mother sent her suppositories in the post! Perhaps follow the recommendations for coping with constipation, and then divert the conversation. Perhaps you could try to tell him that obsessing about this is actually a sign of dementia (true), and he wouldn’t want people to think that, would he?

I never met an elderly person who isn't obsessed with this topic. It can be harrowing. This sounds over the top though. Professional intervention sounds good. I wouldn't engage in the conversation though, I'd redirect him or ignore it--he's too focused on it,

I will tell you this. From friends dealing with elder parent issues and here on this forum. Some elders just become obsessed with a bowel movement. More important than an orgasm. What to do, I don't know. But I feel for you, if any help or solace.

And here's the thing, I wrote colace and had to fix.

My mom is in an assisted living facility and she seems to have this same obsession. I think she always has to some degree. She has recently begun to experience some bowel incontinence due to diarrhea, yet if she misses one day of having a bowel movement she says she is constipated and she needs to make things start moving and then she takes the miralax and the cycle gets repeated. Anyone else?

Obsession about bowel movements is often a part of regression, which is common among the elderly. It would be good to rule out physical etiology though. They could measure his output, check for signs of distention by palpating, etc. If it is a genuine problem which is not uncommon then a gastroenterology consult is needed. Well, that should be done in any case to determine the extent of the issue, which probably does have some truth to it. Then let the gastroenterologist make suggestions for remediation.

Constipation caused by meds can be helped by drinking Juicy Juice Cherry juice. It can be hard to find, so even the mixed fruit Juicy Juice can help. My m.i.l. had constipation from her meds, was taking stuff that barely helped. I started cooking for her after f.i.l. passed away, and I cook with ONIONS. We had to stop her from taking her poop pills cause it was causing diarrhea. She hasn't had to take a pill for over 4 years now. So, Juicy Juice CHERRY juice and ONIONS are 2 natural ways to fix the constipation problem

This man obviously has dementia and is certainly lacking social skills. This is horrible. If I were in the room with him and he started with his talk, I would immediately look him in the eye and very firmly and strongly tell him HE IS NOT ALLOWED TO DISCUSS SUCH A PRIVATE ISSUE. YOU, nor anyone else in the room, does NOT want to hear this and he is to stop at once or everyone will leave. And if he starts up, ALL OF YOU GET UP AND LEAVE AT ONCE. Do this a few times and it may sink in. Try to change the subject but don't expect it will work.

i get a poop report every morning, rain or shine.

My mom who has passed used to be obsessed. I would just say can we talk about something else besides poop today?
DL

Omgosh....this was my mother! First she wouldn't dare take the Immodium (and she needed to!!), then she would get blocked up (and she wouldn't take anything to help that). She was undergoing a colonoscopy - but didn't because she had a stroke.

Thanks Ahmijoy for replying. He is 93 and at this stage on respite. The NH raised the issue with me as they are leaving his medical issues up to us at stage as his dr is not a local once he becomes permanent they will be able to manage it with a local doctor easier. That will be happening in the next few weeks. Your words have however given me a little reality check it that is not up to me to obsess over his obsessing. Cheers

Thanks Ahmijoy for replying. He is 93 and at this stage on respite. The NH raised the issue with me as they are leaving his medical issues up to us at stage as his dr is not a local once he becomes permanent they will be able to manage it with a local doctor easier. That will be happening in the next few weeks. Your words have however given me a little reality check it that is not up to me to obsess over his obsessing. Cheers

Was your dad one of those people, I think men in particular, that had a morning constitutional (not the walking one)? Many active people particularly of his generation stick to a routine when it comes to bowel movements most of their adult lives (you might be surprised how often heart attacks happen early in the morning in the bathroom) but when they age and become less active all kinds of things contribute to the need lessening. Sometimes medications affect the bowels but simply less activity, eating less, drinking less water and maybe not eating as much fiber will all contribute to less bowel movements and often constipation. For someone who went every morning like clock work it must be a big and concerning change and for someone with any sort of dementia it's probably even worse because the comforting pattern of routine isn't there.

Some good suggestions here about making sure he isn't in fact constipated or even impacted/becoming impacted and beyond that making sure he is drinking plenty of water, get's a pro-biotic and/or pro-biotic foods each day, takes fiber (my mom now takes "triple" fiber capsules which are primarily psyllium husk I believe) daily and gets as much exercise as possible. Mom had a bout with constipation and was impacted just not fully and we added Metamucil (turned into the capsules because just about the time I got a mega size she stopped enjoying drinking it, lol) and have been really on top of her water intake and it's helped straighten things out. But I would suggest that you have a doctor, a professional other than you, who is looking into any possible problems and cares so not sure if the one you mention is the right one or not, let him know that they have checked everything out and found the issue is that his system has slowed down, not eating as much, not as much exercise and that's normal, he might not have a BM every day and that's normal now but it is important he let someone know if it's been (whatever time determined...3 days?) and that he drink X amount of water a day, get X amount of fiber...the things suggested for helping his intestinal system straight (fermented foods especially if he likes any) so he has an investment and responsibility for keeping himself regular it's just adjusted a bit from what he's used to. I'm hoping the ability to focus on the things that will positively affect his plumbing along with a new baseline might help shift his obsession or anxiety.

Maybe even once this discussion has taken place and you can then be on the same page as the doctor when reminding him it will give you an acceptable (to both of you) way to divert the conversation if he starts in on the BM topic. So when he starts bringing it up you can ask, When was your last BM, yesterday oh remember doc said...how much water have you had today, you took your fiber, what have you eaten today, yesterday? Maybe we should go for a walk...that sort of thing. There is of course a good chance it is an obsession you just wont be able to break with reason and distraction or his system feeling better in which case a geriatric psychiatrist or specialist of some sort might be able to prescribe something that can help calm the obsessive thinking and it's not uncommon for an elder to just use the medication through the particular obsessive behavior and once it's broken they can come off it, not all the time but a fair amount of time. The trick of course is the be vigilant with making sure they try to take them off rather than just take the path of least resistance and leave them on a med that may no longer be necessary.

Good luck!

This is my father. For years he was obsessed with getting cancer then it switched to BMs. I miss the cancer obsession. He would graphically describe it to me in the middle of a restaurant no less! I asked him why he was telling me all about his BMs and he genuinely thought I would want to know. This man would buy fleet enemas by the case. I just don’t get how he thought this was proper dinner conversation.

This reminds me of my Mom a couple of years back. I was able to take her out to dinner many nights, and invariably the waitress would come by and ask if we wanted desert. My Mom would say yes and would ask what was available. Inevitably the waitress would mention Creme Brulee to which my Mom would explain (pretty loudly) that she couldn't eat it because it gave her gas. Ugh.. I got to the point where I just had to laugh. Good news is she is no longer doing it because she has since forgotten. See... there are some benefits to dementia!

I have an old and I mean OLD book on child rearing---probably published in the 20's--the 1920's--more time is spent on making sure your child had regular bowel movements I couldn't believe it.

I guess "science" has begun to prove that fecal matter was poisonous to the body and you needed to get that out ASAP. The thinking was that you'd sit the child on the potty first thing, everyday and they could not get up until they had had a BM.
It went beyond obsession, really. That's how my dad was raised and I know he stuck by this principle of 'health' all his life.

He was also administered a 'glob' of Vicks VapoRub when he had a cold (put in the mouth and let it slowly melt) and when he had a sore throat grandma swabbed his throat with Mercurochrome, which I believe had mercury in it.

In his later years he was pretty much immobile and on large doses of Percocet. He HAD to take laxatives and MiraLax both, everyday, to ensure having a BM. Opiates will slow you down very quickly. Aging doesn't help, and yes, many elders are chronically dehydrated. My mom withholds fluids as much as she can, but I don't think she drinks more than 24 oz in a day.

We struggled with this with my FIL too. He'd be backed up one day and we'd hear about it all day, then he'd have these blowouts and --oh well--he wore thong underwear. I. Just. Can't. It was the grossest thing in the world. He WOULD NOT wear briefs, not for anything. When I threw out the thongs--he went commando. Oh well, one less thing to wash.

So I guess that generation came by the regularity issues naturally--obsessed mama's wanting to be the best, most 'scientific' mamas they could be.

We never did get dad to a state of 'normal' for him. He would have a BM and begin worrying about the next one almost immediately. He wasn't bad with anyone but mom. He spared us kids such intimate stuff, until the very end.

Since YOU are at your wits end and to soothe your mind, ask your dad’s doctor to do an abdominal X Ray to prove there is no impaction. (I’m assuming that the doc has already done a digital (finger) exam rectally.)

If the X Ray comes back negative then all is well. The radiologist is the one “reading” the X Ray and has the final diagnosis. Ask for the radiologist’s report. If everything is not OK, then steps will need to be taken to remove the impaction (Enema first, hopefully that does it.)

Its easy to “dismiss” older people’s idiosyncrasies but you need to make sure nothing is wrong before you write off their complaints.

After everything has been checked, things you can do to encourage your dad to keep his bowels moving are;
1. Drink more water (or non-caffeinated drinks). Elderly NEVER drink enough.
2. Eat prunes or drink 4 oz. prune juice/day.
3. Walk as much as possible-even if it’s only up and down the halls of the facility.
4. Eat fruits and vegetables every day.
5. On the advice of his doc, add Miralax to his medication regimen. (I believe it’s over the counter but you would need the doctor’s approval first.)
6. Also ask if he can start stool softeners. Do not confuse these with laxatives-they are not! Stool softeners just keep more water in the stool, making it easier to pass.
7. Check with the doc to see if any of dad’s other meds cause constipation.

Now, I’ll agree that lots of seniors are bowel obsessed. Many were told as kids that they would get sick if they didn’t “go” every day. Many poor seniors are straining to push out something that isn’t there or ready to come out. Bowels, like many other body functions don’t have a built in clock for when to work.
He’s NOT going to stop talking about it, so, after he’s been thoroughly checked and cleared, you will need to acknowledge his concern then turn off your listening. Do NOT continue to engage him on the subject-redirect the conversation. If necessary, get up to go get a drink of water (and get him one too) or go to the bathroom. If it won’t stop, you’ll need to politely excuse yourself and leave. You must take care of your sanity too.

Good luck. 😌

I give my wife Clearlax from the Supermarket. One cap full a day in her water which I top off with apple juice to hide the taste. The method was doctor suggested the apple juice was an RN's idea. I believe the equivalent to Clearlax is Metamucil. Works very well with daily results.

Another thing that causes constant issues with constipation and Bowel irregularities is that they don’t drink nearly enough water! we went thru this with MIL in the past couple of months. Ended up at the ER with severe impaction. She has incontinence issues so she’s convinced herself that drinking less water will fix that. *sigh* she probably takes in 12-20 oz per day MAX-many times less. That issue however did convince my FIL of the need to up his water intake.

I agree with PCH111 about Miralax or the genaric brand. Given every 2 days was better when it was needed. Prune juice seems to work better when it is warmed slightly. Many things cause the bowels not to work properly, lack of movement, meds, hemorrhoids, etc. Most people know if they do not go, toxicity will cause problems. If LO is obsessed with it, give them a large calender. Tell them to put an "X" on everyday they go. If there are 3 days that they haven't gone(not checked), they need to take Miralax or ask for help. Stomach massages help, too. Go to www.youtube.com & watch a few. Some massages are on self, while others require a caregiver.

For those who say don't worry, let the nursing home handle it as they are experienced with it....not necessarily true. About a month ago my mom was in SEVERE pain when I got there, actually screaming in pain...I heard her when entering door of building. Nurse's ignoring the screams from her room. I ran down the hall, saw her, and demanded to see Dr. He was out of town for several hours. They had no suggestions. I made them call an ambulance and take her to hospital. She had bowel impaction and had a large buildup. In hospital for 3 days. She in not mobile. Had been complaing of pain for weeks from developing hemorrhoids.

Hospital prescribed the Miramax and prune juice daily regimen, with suppositories every day for the hemorrhoids. WE had been asking for weeks before this that she get prune juice every morning, but it did not happen. We even took prune juice up there and put cans on the dresser the prior week, but by then it was beyond just prune juice.

Then last week one day, she started complaining of the same hemorrhoid type pain. I had the aide change her in front of me and I checked her bottom....hemorrhoids again. I went out and asked whether she was still getting the suppositories for them..and the nurse said, well no, we didn't know she still needed them. Well, I wonder, do your aides not report this when they change her ? As my brother says, nursing homes are just warehouses for the elderly. There is little or no compassion.....and not just in this one. I talk with several friends who either have family or friends in a NH in this county...and all the same problems. Sorry for the rant, but I am sooooo frustrated. She does not deserve this.

By the way, we went to NH administrator about this. When we told her about the nurses and aides just standing around nurse's station while my mom screamed and screamed, the administrator brushed that off, saying they get immune to screaming because they hear so much of it. On the other hand, I still have dreams about that.

We all talk about what is bothering us. I would frankly rather talk about this than politics!

Keep working with his doctors, nurses and aides to get him as many of those good mornings as possible— he will talk about it less. Maybe that will incentivize his healthcare workers.

This seems to be a common theme as people get older. My grandfather was obsessed and he mistakenly ate so much Ex-Lax that, well, you get the picture. Then my Dad became obsessed in his 80's and had a whole regimen of things he did every day to ensure things were moving along as they should. I think the more older folks lose control over other parts of their lives, they might feel this is an area they should be able to control and become fixated on it. The nursing home should have a lot of experience in these things as I'm sure they've seen it many times before. I wouldn't worry about them. I would make a joke about it with my Dad and then move on to other things (no pun intended). It seemed to help shift the discussion.

Let Dad Go..Many times in a Nursing Home it is Just their Way to Get through the day. He won't Change and You are NOT there Every day, Professionals can Handle Mad Dad.

I could have written this a year ago, so my empathy level is high. My father was completely all-consumed, obsessed, etc. with this, too. The moment he had success, he began to fret about the next episode. He would pace the floor and all of us were told non-stop every detail of his discomfort and concern. We were all about to walk the plank until the problem was solved. And here's the good news: this is fixable with a dose of MiraLAX every day with his meds. Instead of trying to convince him that he is over-worrying, let him know you understand this is a source of discomfort and angst, and introduce him to the new regimen. He must take it every day. Again, MiraLAX should be taken as part of his daily meds; not just when he is having a problem. You/the staff will need to monitor and skip a dose on the occasion that he is going too often. When things get this bad with a loved one we can't believe in such an easy fix, but trust me. It works. Follow the directions on the container and do not worry about his becoming addicted to a laxative. We are under the care of a doctor and he is the one who provided the solution. It was hard to get my father to believe in this. He was convinced he had a blockage and that the issue was structural. By the way, being sedentary doesn't help either. If your dad is able, make sure he gets some exercise every day. He will feel better all around. But with or without, the MariLAX will do the trick. My dad never complains anymore and if you only knew...that is nothing short of a miracle. Dry your tears, sweet caregiver. I will say a prayer for your success.

The doctor who thinks your father is obsessed did do a full physical examination, did he? Just checking.

My Dad lives relatively independently and one of the first topics of conversation when visiting is his bowel movements or lack there of. But It is not new for him, as children he asked us if we were 'regular' on a daily basis.

Let the nursing home deal with it.

It's good he's seeing doctors, to make sure that he's okay, but, mental health issues like that are pretty common, imo. People can get compulsions about certain aspects of their health and it's just as real to them as if it were a real problem. I know several seniors who are obsessed with toileting. I'm serious. I'm not sure what it is. I'd give up on asking him to stop talking about it though, because, if he's going to do it, that won't help stop him. Maybe, the doctors can determine if it's OCD and treat it.

You have arrived! The poop obsessive stage. In my experience. It happened to Grandma 25 years ago and Grandpa 2 years before. They we're more obsessed with the end result rather than if they had a bowel movement but bodily function obsessions seem to be the norm rather than the excecption. Maybe his Dr could prescribe a mild setative for when he can't calm down? At this stage please don't be worried about addiction. He may become physically dependant on certain medication that helps him. Like pain meds which if doesn't need don't start that would be really bad for his bowl movements. Next month he'll be talking about something else and you'll be like dad can we please talk about your bowl movements again? Lol

Well, to be honest, it sounds like you’re obsessing about HIS obsessing. Since he is in a nursing home, surrounded by other elderly people, the staff is well-used to this kind of discussion. They will smile, nod and if required, offer some sympathy and hopeful words for a good “outcome” if he hasn’t “gone”. They will also celebrate with him if he has gone. Then, they will simply move on to the next resident and the next discussion about bowel habits. Telling him not to discuss this with the staff is fruitless and it is obviously upsetting you. Take a deep breath and a hint from the staff. Listen, offer sympathy or congratulations and then redirect. Bowel obsessions are super common in the elderly.