Date
March 03 2014
Written By
Barbara Karnes, RN
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Let's Talk Poop--Bowel Movements and End of Life Care


Comments

Barbara - October 10 2018

Hi Susan, because your mom is receiving hospice care I would ask her hospice nurse if the laxative dose needs to be decreased. Being on high quantities of narcotics makes it very important to regulate the laxative dosage. You want to keep the bowels moving. Maybe this was a one time occurrence and she will be back to her bowels being managed on the laxatives she was on before this happened. Thank you for reaching out to me. Know that your hospice nurses are there to answer all of your questions. Don’t hesitate to contact them.
Blessings to you and your mom. Barbara

Susan French - October 10 2018

My mom (95) under hospice care quit eating for several days. Now she has started eating again and is having major bowel blow outs. She is on heavy duty pain meds accompanied by a laxative and natural fiber capsules.
Wondering if something should be cut back on due to blow outs. She has awakened and needed a shower due to feces on her.

Barbara - September 20 2018

Hi Jodi, what a mess. It is hard to believe this is happening. Get a different doctor to see her ASAP or take her to the emergency room and get someone to really listen to what you are telling them. Be fierce and get the CT Scan NOW. Obviously something is seriously wrong and needs immediate attention. She may just be impacted and need to have it removed but I’m thinking something more serious than that is happening here. Be forceful, don’t take no or later for an answer. Demand that she get immediate attention. Barbara

Barbara - September 20 2018

Hi Debbie, I just don’t have enough information about our mother’s health condition to know why she doesn’t know if she has had a BM or not. You might ask her doctor to see what he/she thinks.
Blessings! Barbara

Jodi - September 20 2018

I’m so overwhelmed and don’t know what to do. My mother is 87 and takes absolutely no medication – hard to believe but true. However, since about May 2018 she has had potty problems. It started out a little red blood in her feces that we initially thought was hemorrhoids, even though she’s never been diagnosed with them. She went to her sister for the summer and when she came back in September she was very emotional because she has not had a bowel movement since she left and has to wear pads because slime will leak out when she stands up without her knowing. Her excrement is a bloody mucus. Took her to doctor who thought she may have drank well water and have an infection but we live on city water and so does my Aunt. Then they sent her home with a stool sample kit- I explained to them once again that she doesn’t have ANY STOOL to put in the vials. They said do your best. She did – she put some slime in the 3 tubes but not enough to fill them like directed. So today I called in expecting them to say the test were inconclusive due to lack of specimen but lo and behold they said EVERYTHING was NORMAL. How on Earth can that be possible? Now she is weaker and getting dizzy, food is not desirable and still no poop. They want to schedule her for a CT scan to see what’s going on in her stomach but they failed to get authorization from her insurance so I’m still waiting to hear back on scheduling. I am a mess – I need help, answers or just someone to act like they care. Any ideas? Mom thinks it’s cancer and I’m just so besides myself with what to do next. It’s so sad to see her suffer and I feel helpless.

Debbie - September 20 2018

My mother is 92 is in stage 5 kidney failure, heart disease. When she has a bm she can’t tell if she has gone or not, she will ask me have I passed anything yet! Why can’t she feel her bowel movements?

Barbara - August 02 2018

Hi Sonia, About your question “Could these be the signs of her last days?" I don’t know your lady’s medical history so I can’t say whether she has entered the dying process but from what you have written it does not appear that she has begun “labor" (weeks to days) although the changes you mentioned could signal the beginning of “she may not be here next year at this time”. I just don’t have enough information to be more specific. I do suggest you talk with her family physician to get her bowels more regulated and tell him/her of the changes you are seeing. Thanks for reaching out to me. Blessings to you in the work you are doing. Barbara

Sonia - August 02 2018

Hi Barbara, I care for someone who has COPD & kidney disease both are stage 4. She has been withdrawing herself from going out and shopping. She doesn’t want to shower , she is extremely moody and she is either constipated or has diarrhea. We never have a good day where she goes regularly. Could these be signs of her last days? She also has been trying to reach out to her daughter whom she hasn’t spoken to in 15 years.

Barbara - July 14 2018

Hi Priscilla, it does sound like your father has entered the dying process. Withdrawing, sleeping a lot, not eating very much, losing weight, wetting or stooling himself, his age, all tell me death is approaching. When becomes the question. Since I don’t know all the medical particulars I can’t give a length of time. Actually no one can. We die in our own way and our own time but we can get an idea of how long based on the progression of the above signs I mentioned. The restlessness could be an indication of weeks but again I don’t know all the details of your father’s disease. You said your father was on Hospice. Ask your nurse your questions. Hospice is there to guide and support you, to answer your questions, to make this experience easier for you. If I can be of any help use my personal email barbara@bkbooks.com. My blessings are with you and your family during this challenging time. Barbara
I just had a thought—if you haven’t read my booklet Gone From My Sight it will be helpful in guiding you during this time. Ask your hospice if they have it or get it from my website.

Priscilla - July 14 2018

Hi. My father is 85 and he is very ill. I know for sure he is diabetic, and has copd. He is in hospice, and keeps losing weight. He is down to 83 pounds. Is having bowel movement on himself a sign that the end of life is near? He barely eats, sleeps alot, and is very restless. He also has a fatty liver, and smokes alot.

Barbara Karnes - May 12 2018

Hi Sarah, I do not know what is happening with your mother’s bowel movements. Have you checked with her physician? Could be drug side effects (check the list of side effects on all the drugs she is taking), food issues or something more serious. Blessings! Barbara

Sarah - May 12 2018

My mom has dementria
Occasionally on a given day
She has this uncontrollable bowel movement that flow like chocolate milk and smell
Awful always occurring late in the day…any thoughts on what could be the problem.?

Barbara Karnes - April 10 2018

Hi Karen, the color of your father’s stools , odor and the jaundice are indications of liver malfunctions. They are not signs of immediate approaching death but it appears the cancer is catching up with him. Blessings! Barbara

karen - April 09 2018

Afternoon -

Help me understand a few things. My 84 year father was diagnosed with liver cancer as a secondary location. (primary is not clear – no additional testing done because of age and health) December 2017.
During this time, he has not really followed the rules of what is considered normal symptoms of liver cancer. He is a strong spirited man. He has been doing really well until this past weekend – he is becoming weaker and I noticed this since Thursday evening. Even his current bowel movements have now changed in color; from a brownish/mustard color to a pale grayish color with a an odor change. Is this a normal thing? He is also showing some jaundice.

Thanks

Barbara Karnes - March 21 2018

Hi Earlier, regarding your question about not pooping yet being alert enough to talk on the phone and chew but not swallow I don’t have enough medical information to make any suggestions. It does sound unusual which leads me to think there is a medical reason for the advice you are receiving. Talk with your physician , ask your questions and don’t stop until you understand the reason for the advice you are being given.
Blessings! Barbara

Earlier tillman - March 21 2018

Can a person whom on hospice and no bowl sound but is talking on phone but can eat food he can chew it but no swallow it cause they told him not to.and he can’t poop they say an it nothing they can do about that.can we give him a suppository

Barbara Karnes - March 07 2018

Hi Samantha, about your husband’s diarrhea issues: have you talked with his doctor about this. Even though your husband’s COPD is end stage his physician can still assist with comfort care.
Something as simple as an anti-diarrhea medicine may be all he needs. However—with his history of alcoholism his liver could be saying enough is enough. Blessings! Barbara

Samantha Romaine - March 06 2018

My husband has end stage COPD for the last couple of weeks he hasn’t been able to keep anything in him as soon as he eats he’s in the bathroom Even when he drinks he is 55 year’s old and has been a alcoholic most of his life I no the end is near doctor’s can’t do anything for him because his lungs are so bad is there anything I could give him so maybe he would be going to the bathroom so much .

Barbara Karnes - February 26 2018

RM, In response to your question of why the Hospice policy requires a laxative to be administered when the conditions you described are present—I don’t know. Doesn’t make sense to me either. In end of life situations one plan fits all just doesn’t work. There has to be leeway for individual circumstances — an example of too many regs and policies and not enough common sense.
Thanks for reaching out to me. Blessings! Barbara

RM - February 26 2018

This person is in hospice care, imminent, has not been eating or drinking since last bowel movement, no BM in 4 days, non-responsive, no agitation, face relaxed, abd soft and non-tender. Any form of laxative would cause more discomfort than anything else. Why does the hospice company’s policy require administration of a laxative?

Donna - January 09 2018

Dear Lisa,
If a person with pancreatic cancer is eating very little, (a few spoons off yogurt, pudding, ice cream, etc) a day, how is it possible to produce large Bowel movements? Where is the waste coming from? I’m concerned.

Barbara Karnes - January 06 2018

Hi Carol, I think you are right about not being able to push all that stuff out being part of the problem. I have seen this inability many times with the same challenge of how do we get it all out. I think Hospice is doing a good job with laxatives, stool softeners, etc. Enemas are really the only way of getting it out when laxatives don’t force it out. You want to make sure the stool is soft enough that he does not become impacted
About your question: does this mean he is dying soon. Not necessarily. Your key factor is less food intake. Because he has dementia the sleeping and withdrawal signs of approaching death don’t count. Based on the information you have given me it does not appear that he has started “labor” (one to three weeks before death).
Have you read my booklets Gone From My Sight, The Eleventh Hour and How Do I Know You? I think they will be helpful during this time.
Blessings! Barbara

carol redelheim - January 06 2018

My husband is in end stages of Parkinson’s Disease with dementia. He is bed ridden and completely dependent for all ADLs. He has not had an unassisted bowel movement in 35 days. He has had three partial bowel movements w/enemas and the kind assistance of our caregiver. In spite of still having some appetite, a good diet,and a hospice approved regimen of laxatives, suppositories, stool softeners, including enemas, he is not producing any waste. He is still urinating. I believe the PD factors in as he is no longer able to push. His vital signs are still normal. Is there anything more we should be doing? I am very concerned about this, and worry that this is a sign that he may be nearing his end.

Thank you

Barbara Karnes - November 05 2017

Hi Lisa, I first thought you were referring to laxative suppositories but as I read this I am thinking about other suppositories—for pain, fever, agitation. Yes, you can use suppositories because we are not talking about the bowel but about absorption through the mucus membrane. Circulation as well as all bodily functions are diminishing so the response to the suppository will not be as timely as it would be a healthy body. My choice for administering drugs when the person is non responsive is suppositories.

Barbara Karnes - November 03 2017

Hi Lisa, your question about the absence of bowel sounds and using suppositories is a good one. I am not sure I have a definitive answer. I’m thinking there are variables—how far along are they in the dying process? If months it would be different than days. What is the diagnosis? To be safe I would ask the attending or hospice physician. Thanks for asking. Barbara

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