April 30 2019
Written By
Barbara Karnes
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An Unpleasant Situation

An Unpleasant Situation


Beverly - May 04 2019

My dad died at home. My mother, a nurse, said he asked to be taken to the bathroom where he had a large BM. He died within a couple of hours. She said he didn’t want to leave that mess for his family. He wanted to die with dignity.

Elizabeth Bateman - May 03 2019

My mom was very uncomfortable in the last few days because of constipation. Her caregivers didn’t want to give her stool softeners because then she made a mess. When I got there, I gave her something to help her and it took a lot of her energy to clear her bowels of stool. It was her last major effort at anything before she died. I was upset that the carers had been so selfish, and I do think that this is an important, albeit an uncomfortable, topic to discuss. Thank you for raising it.

Patricia - May 02 2019

Hello Barbara, I have many of your literature and keep reading and rereading every word trying to educate my self on my husbands journey with cholangio carcinoma which is 7 months into diagnosis.Every word appears to be on point ,he is not accepting the idea of hospice yet and I can’t seem to take that dignity away from him.he is still taking care of his hygiene needs and his medication but certainly has no quality of life,he also has asbestosis which isn’t pleasant at all! I look forward to future writings from you.thank you

Barbara - May 01 2019

Hi Trace, your comments about the blog article and bowel movements: a lot of people as they are dying will have a bowel movement and also will urinate. For me that shows that the body indeed makes waste even though a person is not eating. We just don’t want all of that to build up in the intestine and lower bowel causing discomfort. The longer stool sits in the rectum area the harder it gets adding additional discomfort. It just seems so simple to give a laxative or stool softer on a regular basis as long as a person can swallow. Once they can’t swallow death is generally so close it is okay (unless the person has dementia and that is another whole blog.) Thank you for asking.
Blessings! Barbara

Terry wellner - May 01 2019

My mother passed away last month. She was 1 month shy of 107. I am a retired ICU nurse, I was ignorant to the phases of death, hospice brought me your book “Gone from sight”. Most everything was explained, I wish I’d had had it 2 months previously. I could’ve helped her so much better. I’ve never known grief as this. All nurses need to understand death , my BS degree failed me here. I hope that has changed in nursing institutions. Your books should be required reading in school and encourage as CEU’s.

Sue Blosser - May 01 2019

What a nice way of explaining the process. As a palliative NP, I see just the opposite, no one asks a patient about constipation. I had a patient in for abdominal pain and it turned out I was the first to ask if he was constipated. He had not gone in 9 days, which contributed to his pain. We were giving him plenty of pain medication, which contributed to this situation. I started out with stool softeners and moved up to suppositories and even mag citrate and then an enema. The primary was fine with discharging him without a bowel movement. The patient was really concerned about going home without having one and willing to try anything and everything. I have seen so many patients having cramping and being impacted, which is very uncomfortable.
It sounded like her dad may have been more comfortable getting a suppository in the bed but many parents are embarrassed about having a bowel movement in front of their children, even if they’re grown. I’m sorry the nurse didn’t explain the process well and know that the patient has a right to refuse, even if it’s not the best decision.

Trace - May 01 2019

Hello Barbara
I am hoping you will get more specific as to why a person must be made to have a bowel movement when they are nearing death. I was the carer of my father as he died at home. Within 2 hours of his death he had a huge bowel evacuation. We dealt with it (cleaning my father and the room). My father in law’s body did the same thing.

I suspect that the more specific reason is to avoid having feces and blood on the bed, floors, on the patient and on carers. A work health safety issue.

As a reader of your response to the writer I would say that your reason why wasn’t much different to what they were told by the hospice nurse.

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