Posted in Aged Care, Working with Elderly

Elderly Constipation – the In’s & Outs

“And it’s a Pain in the Butt!”

Being constipated STINKS.

Certainly, nobody likes talking about constipation out loud, let alone having to endure the often excruciating pain associated from suffering with it.  In fact truth be told, and much like being constipated… I’m finding it hard work bearing-down to squeeeeeze out my thoughts and write about it.

Let’s face it, as distasteful (and smelly) as the subject of constipation is… and as much as we might poo-poo it, the fact remains that as human beings sooner or later, we all have to ‘go’. 

The problem is of course when you CAN’T go.

Waiting…. waiting…

And although we are each so physiologically different (and what’s normal for one isn’t necessarily normal for another) most doctors generally consider that five days or more of NOT being able to evacuate your bowels, means you pretty much to some degree, have become constipated.

Unsurprising to me, is how merely mentioning the word constipation in the presence of many of my elderly clients, can result instantly in a frowny screwed-up-nose face or clenched teeth.  Which is a worry because if there’s one thing bunged-up people of advanced age don’t need – is MORE clenching!

Sadly, and unfair as it may be however (and for a whole toilet-load of reasons), it is becoming typical that chronic constipation is more prevalent the older we get.

Oh, the joy!

10 Poopy reasons why Seniors are prone to Constipation:

  • Some medications (eg: pain meds) have constipation as a pesky side-effect
  • An ageing colon, as per the rest of an elderly peep’s body, may just not be as peppy as it once was
  • Dehydration from diuretics can cause people to wee more, resulting in an increase in fluid-loss causing stools to solidify
  • Retirement for some elders can mean a more sedentary lifestyle (ie: slow down your life = slow down your bowels)
  • Dietary changes (eg: during travel) or a loss of appetite mean a lack of proper nutrition involving ample quantities of fruit n veg.  You can never have too much fibre, Fibre, FIBRE!
  • Drinking less fluids allows for more chance of the dreaded Dehydration
  • Frequent digestive tract issues or the development of diseases can mean the likelihood of constipation is also increased
  • Various medical conditions associated with ageing are symptomatically linked to constipation – eg: MS, Diabetes, Parkinson’s
  • Being sick and/or bedridden for long periods encourages a lower metabolism rate.  You can’t remove it – if you don’t move it!
  • Depression, anxiety, stress, lack of sleep can all contribute to a sluggish bowel due to upset bodily functions and a hormonal balance that’s thrown everything out of whack
  • Blockage in or around the bowel/colon regions can physically prevent the elimination process from occurring…  an indication that something medically sinister may be afoot (a-bottom?) 
OUT, damn plop?

Mind you, it’s not just poo-less pensioners who battle with the anguish of infrequent faecal evacuation.  Most of us at some stage in our lives, have been ‘privy’ to the gassy, smelly delights associated with constipation.  And we know only too well, how much it can disrupt our quality of life by zapping our energy levels and leaving us feeling uncomfortable, bloated and… well, just SHIT really.

Sadly, it’s the older generation who seem to get struck more frequently with ongoing bouts of chronic constipation – and often it’s a symptom (or a stinky side-effect) of an underlying age-related health condition.

CONSTIPATION STORY TIME!

I’ll never forget the time I arrived at the home of one of my loveliest clients for the very first time.  A charming and gentle lady, Annie Turdsworth was the most-kindly person you could ever wish to meet (her Cream Cheese & Banana Nut loaf is pretty fabulous too).

Mmmm creamy, bananery, nutty goodness

On this particular day, I found her pouring over a pile of paperwork at her kitchen bench. 

It turns out, Annie has put up with a lifetime of suffering from various ongoing gastrointestinal complaints and long story short, since the day she turned 65, has been diagnosed with the crappiest lot of bowel disorders imaginable.  Ranging from IBS to diverticulitis and now most recently at age 87, they have decided she may have colon cancer.

And being that the specialist needed to know what her bowels were dishing out, Annie was instructed to keep a Poo diary of every time she ‘went’ to the toilet; how her stool looked, its colour, texture and shape etc. 

Oh lordy, you can imagine… the demure and deeply private Mrs Turdsworth was appalled!

Luckily, her doctor had a copy of the Bristol Stool Form scale (BSF) to wave in front of her and put her mortified mind at ease.

As a simple user-friendly picture rating system, the BSF enables people like Annie (who would rather DIE than discuss their bathroom habits) to utilise the handy-dandy illustrations to match up the appearance against their own stools.

So rather than having to say horrific words like “runny” or “hard pebbles”,  Annie could instead work discretely off her BSF guide and record the corresponding number of the day into her diary (once she got over the terror of looking inside the bowl, that is!)

I’m actually flattered that Annie feels brave enough to confide in me about something as personal as bowel movements (or lack thereof)…although it took a while for her to gain confidence.

“I think today Dollie, I’m more of a 2 than a 3” 

Now when I visit, we fill in her ‘log’ book together, along with the food she’s consumed in the last 24 hours all nice and neatly, for the doctor to peruse later.  Annie then pops the diary into an empty chocolate box, twists a large rubber band around it and then tucks the whole sordid package away out of sight in a drawer beside her bed. 

If we can’t see it, then does it actually exist?

What kind of STOOL am I?

At the other end of the Constipational spectrum, I should definitely make mention of another of my cherished clients, Maggie Cementballs.  Not only does the brazen 94 year old Maggie NOT require a picture chart to categorise her faecal formations, but because she is deaf (and refuses to wear her “posh” hearing aids in case she loses one) – we get to discuss it LOUDLY. 

“JUST SO YOU KNOW, DOLLIE… I HAVEN’T BEEN TO THE TOILET SINCE 1973!”

And we have a good laugh.

All kidding aside though, it would be fair to say dear old Mags suffers with what must surely be some the most crippling waste elimination woes in the entire universe.

Throw in a blossoming set of haemorrhoids, ongoing colon surgery and a couple of rectal prolapses – there’s not much poor Maggie hasn’t experienced when it comes to digestive complications and the torturous impacted-ness her bowel insists on putting her through. 

And she is more than happy to give me the full detailed account on her constipation problem-o-the-week.  I recall last week’s pooping particulars went something like this (note: this is in SHOUT format)- – –

WELL, I DON’T LET IT GO ON AND ON, OR I END UP IN AGONY – ONE CAN ONLY PUSH FOR SO LONG!  

AND FOR ONCE, THE PROBLEM IS NOT WITH THE ACTUAL GOING… IT’S THE FINISHING OFF BIT THAT’S ALL TOO HARD AT THE MOMENT.

…BUT I HAVE TO GET IT OUT, DOLLIE!  

I CAN’T WALK ROUND WITH THE THING HALF HANGING OUT OF ME, CAN I?” 

“CRIKEY NO, MAGGIE, YOU JUST CAN’T!”  I bellow back, with my super-concerned face on.

Unfortunately, there’s not a lot that I or anyone else can do for the long-suffering Maggie.  Due to her advanced years, doctors have advised that further surgery just isn’t viable ie: it would most likely kill her.

And therefore, all they can do is pump her full of pills, top up her pain-killers and assist her to manage the condition at home as best she can. Not much fun when you’re a frail old girl in your nineties and much like every other poor soul having a crappy time in the bathroom – all she ever really wants from life is a happy ending. Literally.

HAPPY CARING!

Cheers,
Dollie

Author:

Dollie Dogood: Professional Carer & Elder Enthusiast. Assisting older adults to remain living happily ever after in their own homes - DIGNITY INTACT. Jotting down the good bits.

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