Recently my Mother had a bout with constipation, and for about 4 days did not have feces. After having her drink lots of water & prune juice, and then 1/2 a dose of ex-lax one day & 1/2 a dose the next day, she finally was flushed of everything in her little system. Here we are almost a week later going through another 4 days without feces, except she seems fine otherwise. On the prior episode, she was complaining of pain when she tried to go but couldn't. I treated her for hemorrhoids on the first episode. She walking, eating, drinking, and seems normal, but no regularity as far as I have been able to tell. She has moderate to severe dementia.
However, you indicate that she is eating and drinking and moving. So, Good job with the prune juice. You don't want her to become dependent upon a laxative if at all possible. Beware of fiber supplements as they draw water from the tissues and elderly don't drink enough water anyway. You can use suppositories, fruit with every meal (I use the little cups of cut up fruit, but the seals are impossible for mom to open by herself). Miralax is a good powder to mix with juice, it's not gritty and is tasteless. I can just use a half dosage and it works to keep mom regular. A hot beverage in the morning seems to help get things moving too. As a last resort, there are premixed enemas available. But you definitely want to try to avoid getting to that point. I think, too, that the dementia kind of works against you. They seem to forget they may need to sit there for a few minutes and push a little. I know mom just expects it to fall out of her at this point.
Lots of rambling thoughts, I know, but maybe you can glean something useful out of it.
I'd also recommend high fiber foods, like beans. My 95-year old mom eats them regularly and is regular to boot! But start with a small amount, to make sure mom can tolerate them. Veggies also have lots of fiber. Good luck and keep us posted!
One funny thing is that mom's leg pains increase with reduced BM's so when she complains of leg pain I usually tell her she is full of S*** and although I mean it in joke...its true and makes me chuckle as well.
We have also used benefiber (1/2 dose in coffee every morning) but then it was not available for about 2 years...but it is back now.
We have a plan...dried fruit and pushing fluids - if daily stool, we stop there (level 1); 1/2 dose of miralax in coffee plus level 1 for up to 2 days (level 2); full dose of miralax plus prune juice and level 1 for 1 day (level 3); suppositories and phillips milk of magnesia are level 4 options but rarely used if we stay with the rest of the plan.
I try to remember to ask how the bowels are doing. Although I really don't want the details...if I don't ask I don't know how to escalate the treatment levels.
Also make sure you check with PCP as some items may not be correct due to medications and or medical problems...
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