My dh is bedbound and incontenent. He sometimes has hard bms but with Miralax it is better. Then he goes the other way and has many soft, mushy ones and I add benefiber to help that. However, it is nevery just right for any length of time. He spends so many nights and days without sleeping (even with an anti anxiety pill) trying to have a bm. I can hear it all over the house and so cannot get much sleep no matter where I lay my head. DH does not know to use his stomach muscles so thinks blowing through his nose and wringing his hands is the trick. The nurse said it helps to have him lay on his left side (the bowel area) but after a few minutes he has moved from that position (even with pillows under him). Any suggestions?
unfortunately this happens when they become bedbound and no exercise. we give stuff to help them go and then once they go we cant just turn it off. and it becomes messy. i am unable to get DH to go without a suppository which has helped more than anything else. bisocodyl and i get it from the hospice dr. once its in i find it works usually within a short time and then we are good for another 3-4 days. miralax didnt work for us as with swallowing issues it usually needs a lot of fluids to follow. its a balancing act for sure. i think we just have to go with what works for each of them. the less they move the more this becomes a problem
if hes constipated i can see where he thinks he has to breath harder. wringing the hands could mean hes anxious but you say he is using antianxiety pill. sounds like i would be reevaluating the pill for another to see if it works better.
Does he sleep with his head elevated? This always helped my husband (with the breathing sounds). He would go 5-6 days without a BM, and Hospice would have to give him an enema to clean him out. The medicines (towards the last, he was on THREE) didn't make him go. It was as if the colon muscles stopped working.
It is so hard to know what to do once they reach this stage. I just did what the Hospice doctor told me to give him. And then they still had to come and give the enemas.
Is he on a sleeping pill? If not, that might help with his breathing - if it relaxes him.
Divvi, if this "bigger bowel movemen" is a result of being less mobile I may have a HUGE problem once my dh becomes bedridden. He paces a bout 20 hours of the day every day. His movements got bigger about 2 months ago and I was astonished when they first started. He grunts and growns like he is in labor. I pick at him about what is going on and he laughs. But really on a serious note, what is the poor guy gonna do when he can't walk to the toilet anymore? What do I do? Will using Benifiber make them smaller? or just more often. Do the questions ever end or are we always gonna have new issues....... this is quite mind boggling but it really is a great topic.
Mammie, I givd dh stool softners, allplsaucr, mashed prunes in applesauce, suppositories like divvi said, enemas, you name it and we do it! Oh did I mention "praying" yep everything! Also na/ural laxatives sencot mixed in applesauce. The days revolve around him and poop! Nellie
Brindle, as you can see you are not alone in this. (forgive me Lynn, for I am once again going to talk about your BM's lol) Lynn too is bedbound, on pureed foods, and has trouble now having BM's. I do exercise every joint daily, but it isn't the same as real exercise. Even when he was healthy he would only go every 2 days, he had a powerful metabolism and would just burn up everything he ate. Now though, I think the poor bugger is just bound up because of the pureed foods, the nutritional drinks and lack of exercise.
No offence to anyone who has ever worked in a nursing home, but I do think the aides just get lazy. They don't do anything natural, they don't help him to use the toilet and they push the suppositories. The problem with them with Lynn is that it must make him have to go VERY badly, because the only time he ever attempts to get up is after they give him one. The poor guy forgets he can't walk and tries to get to the bathroom. Like I say, it must be pretty harsh for him to even attempt getting up. Most, if not all of his falls are after he is given a suppository.
So after much anguish and talking til I was blue in the face, we have finally come up with a game plan that works for us. On day two I give him warm prune juice. If this doesn't prompt a movement then on day three he is given warm prune juice with some milk of magnesia in it. If this doesn't work, we go the suppository route. The nursing home doesn't let anyone go more than 4 days before the suppositories are used.
Now though I insist that I am there before it is given to him. That way when he has to go, and he does let me know! I am there to make sure he gets to the bathroom safely and sit with him until nature takes it course. The suppositories have always worked. And so far, it hasn't caused loose stools as a result.
I never dreamed I would be doing this, much less sharing it with people.... but other things I do is make sure he is given a chance to sit on the toilet every day. Just because he is incontinent, doesn’t mean he enjoys messing in his diaper. So, we try. I also put pillows behind his back to help him with the pushing motion. I put a pad on the toilet wheelchair as well to cushion his bottom. I rub and gently push the right spot on his tummy to try to help him... and I try to explain what he needs to be doing...... It is so hard to find ourselves at this juncture in our journey. My brave, strong husband, now having to be told to push.... *sigh* but, I am determined to help him and let him keep as much dignity as possible.
Best of luck in finding what helps your husband. Have the doctors said he was in pain? I know just 3 days and it does affect Lynn.. his poor tummy gets rock hard. It has to hurt I imagine. I hope they are able to give him something to help bring him comfort and you some peace. ((hugs))
i dont know if the load gets 'lighter' with fiber, i'd think the opposite helps bulk it up and movement. if its in there its gotta come out, and its from foods and probably diet would help some. try to eliminate foods that cause constipation and substitute natural fiber foods like apples, and fruits aka stewed prunes,papaya is excellent too etc. you can google which fruits are better and worse. we do not give bananas now- but its good for clogging effects. :) ok ok. i know its not a fun subject but we gotta say it. stool softeners are an important part of controlling patients who have bm issues. most of the problems arise from constipation. if not controlled it can cause fissures and or tears which can result in infection and pain. the pacing can actually help with the bm but it can also be a sign of stress due to constipation. when mine starting the nonstop pacing, he would usually have a bm sometime soon after. the walking seems to help. mammie when they cant walk to the toilet anymore, you can try the bedside toilets that are easy to maneuver and closeby. if that gets to hard then you just have to go with the flow and then nature takes over, they go in the depends. there is nothing in my opinion about it, its nature at work, and we have to be grateful they have bodily functions at all by this time of the disease. by the time this all comes to happen, you will have more experiences and it will come easier for you to deal with hopefully. many decide that the fecal incontinence issues triggers a time for placement. and its ok if thats the course. each does as they deem necessary. divvi
I agree Divvi, Lynn is on a stool softener as well. It just isn't enough most of the time.
Lynn can't walk so what we use for him is a commode wheelchair. The one they have is made from PVC; it is lightweight and works wonderful. Two people lift him to the chair, then I wheel him in and the commode sits right over the regular toilet. When he is done, simply wheel him forward, clean him up, and then wheel him back to either his chair or bed. It makes clean ups much easier. I think it is less harsh than the constant rolling him to change him on the bed. They still have to do this of course because of the urine incontinence. But with this new regimen, often he does now have his BM’s on the toilet.
We have a routine now, I pull up a chair beside him and I also turn the TV so he can watch it while on the commode. Talk about a king on his throne LOL
thanks for all the advice. It is always good to have ideas of what to do and more resources in case what you try doesn't work.
Divvi, I don't think my dh paces because he has to have a bm, but I am glad he is at least getting that exercise. I will try the stool softener and see if that helps.
Nikki, I agree with the way you are doing this with Lynn. I have worked in nursing homes and you are right, things are not done as punctual as they need to be done. Many reasons are the cause and laziness is just one of those. Bad thing is that the patients are the ones that suffer. I am thankful for the experience I got while working there as it comes in handy with this disease.
Again, thanks for all the information and I hope all of you have a great day....
the commode wheelchair sounds divine, nikki! the things they are coming up with. glad its working for you. mammie, when the time comes and you find something doesnt work, you can ask here again and someone will have more answers - we learn from each others experiences.
This may be a stupid suggestion but would possible adding some probiotics to his system help ??? I saw a PBS special talking about keeping your system balanced. Medications are rough on the system but Activia helps my hubby with the Aricept issues. Brindle I would be more than happy to give you the stats from that special. What they call for is not one of the popular over the counter ones (pretty box and all) but another. I use it when I have been on Antibotics for awhile and it mess me up and it has help to reright my system.
Wow! actually this really helps. This morning I was in tears listening. My dh has bms that are soft and I give some benefiber to bulk them up. I too have used a suppository when he has not had a bm for 3 days. I don't like the idea of a fleets! The nurse practitioner told me to put dh on his left side as that is where all the bowel is and that may help. Also to gently massage the rectal area which may stimulate a movement. I too rub the stomach. Prunes never did work for us. Before dh was bedbound, his bms were huge. I had to remove them from the toilet as they clogged it up. I don't know how he got such a big bm out of such a small outlet. It may be dh's bms are too soft or that he has learned a new habit. Even with the door closed I can hear him stuggling. The Ativan does not seem to help relax him enough to sleep. Any suggestions on sleeping aids that don't knock him out all the next day? I don't think he is showing signs of pain (grimacing). Oh, yes, the NP also said it might help to move the person from side to side which is movement of the bowels. Not successful with that either.