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 - June 16 2019

Hi Judy, when we are sick and more so when we have dementia we don’t necessarily know what we need or what is “best” for us. Our body needs to poop. It is that simple. 7 days is too long to go without a bowel movement. The longer she goes the harder it will be to get the stool out and the more painful it will be on her to remove it. You must insist that she take the senna (although I am not sure at this point that will be strong enough). An enema may be in order. Good luck. Barbara

Judy - June 16 2019

My mom is 90 years old. Hasn’t been eating much this past 2 weeks…just picking at her food. She does like milkshakes and will drink them. That’s about all she will eat. She has diabetes, 20% kidney function, and moderate stage dementia. She hasn’t had a bowel movement in 7 days. She refuses enema’s and laxative (senna). What to do? I respect her opinions and decisions, but I worry she will get sick without bowel movements. Thank you.

Barbara - June 04 2019

Hi Patricia, what a mess. Your dad has to be so uncomfortable. At this point I wonder about impaction, even obstruction. Has anyone checked his rectum to remove stool that way? I would really have to be there to see his entire chart to have a more reliable opinion. Before you just take him to the ER call his doctor directly, by pass hospice and the nursing home, and tell the doctor your concerns. See if you get results that way. Yes, you can always sign yourself off of the hospice benefit. You can also talk with other hospices in your area to compare notes and see if you will be happier with a different one. My thoughts and blessings are with you. Barbara

Patricia - June 04 2019

My Dad has poor circulation to his left leg, dementia, stenosis of the aortic valve (congestive heart failure). The vascular doctor will not agree to do the bypass surgery on Dad’s left leg. Daddy was willing to take his chances on whether he ran the risk of dying. But Doctor will not do surgery.
They told us to go home or a nursing home on Hospice. We went to a nursing home. Now Daddy’s biggest problem has been not his leg pain—but Constipation! Hospice has given Colace, now they give Senna. Added Miralax—he pooped once on May 26th and once again on May 28th but not enough to clear out the Days and Days of Food—He was eating double sized portions. Still hospice was not concerned about no BM. May 31st Dad went into a weird wacky state of confusion. We were thinking maybe it was a UTI infection from Foley Catheter. Someone mentioned that it looked like he was suffering from High Ammonia. I googled and he had all the symptoms. But his is from CONSTIPATION not liver disease. Very concerned I contacted his Hospice caseworker nurse. The weekend nurse came. Dad woke up Saturday June 1st with an injured left arm from apparently hitting it on the bed during a confusion episode. Hospice ordered Lactulose for the constipation—will not do any test to see if it is high ammonia—says the remedy is the same: Lactulose. Today is June 2, 2019, after 2 doses of Lactulose, Senna, Miralax and prune juice—still no Bowel Movement. Hospice tells us to wait. AT what point do we say the heck with Hospice and take Daddy to the ER??? Also note: Nothing has been done to address his injured left arm/wrist. It is painful to Daddy when he moves it. Hospice finally told me 30 minutes ago that it will be up to the nursing home and not Hospice to exam the injury and or get exrays. Again, I am left wondering, do we leaving Hospice and go to the ER?

Barbara - May 18 2019

Hi Patty, with your mom having colorectal cancer her bowel activity is not functioning as a normal intestine would. That is probably why you are seeing all the “brown, odorous liquid”. Did you ask your hospice nurse what she thought? Just know your mom’s body is shutting down and nothing works the way it normally would.
My blessings are with you and your family. Barbara

Patty Petruzzelli - May 18 2019

Hi. Mom is in her final hours or days before her passing; we are receiving Hospice care; mom was diagnosed with stage 4 colorectal cancer with lung matastisis, last June. She had radiation and chemotherapy for a combined 7 months. Her bowels have been distressed the entire time. Re: bowels at this time: mom’s bowel movements have been brown, odorous, and liquid for some time; she has not eaten in two weeks; how can she still be having bowel movements? Is her body getting rid of itself? Thanks for your consideration and expertise in responding to our question.

Barbara - March 18 2019

Hi Alma, I do not have enough knowledge of your mother’s condition to make any comment about her bowels. I suggest you talk with her hospice nurse about what you see and your concern. That is what hospice is there for, to support and guide you through this challenging time. Don’t be afraid to call them and ask questions. Blessings to you and your mom. Barbara

Alma Pineda - March 18 2019

My mother is 97 years old , she has dementia and also has cervical cancer. She eats well , sleeps a lot, but is more or less aware. She went through radiation treatments to stop the bleeding and it worked, the tumor shrunk but it didn’t go away. She is in hospice but she seems to be doing well. Her bowel movements are a lot, we are wondering if this is normal, it is sometimes very watery and a dark brown color and it’s a lot for what she eats, lately it’s been very watery, but also sometimes it comes a little more dense. She drinks ensure , one to two cartons, and some yogurt. Is that normal?

Barbara - February 15 2019

Hi Shalinda, Oh my goodness! Not having a bowel movement for two weeks is not okay, no matter how close to death a person is. Well, that is not exactly correct. If she is days from death (non responsive, has start and stop breathing, no eating, no drinking) then don’t put her body through the ordeal BUT if she weeks (1 to 3), is eating a little, drinking, a little, even picking at her bedclothes, rambling verbally she should be helped to have a bowel movement. Contact your hospice nurse, now (don’t wait until Monday) if your mom is in the weeks category. Have you read my booklet Gone From My Sight? It gives some guidelines and where your mom is in the dying process. I am sorry your mother has this problem. Her body must be very uncomfortable. Even when we don’t eat very much our body still makes waste and it has to come out. If you have further questions please use my personal email barbara@bkbooks.com
Blessings! Barbara

Shalinda Theress Cochran - February 15 2019

My mom is on hospice she has anaplastic thyroid cancer and she hasnt had a bowel movement in 2wks !!! Is that close signs to death?

Barbara - December 17 2018

Hi Karen, about your mom’s declining condition and should she be on Hospice care: it would seem to me if she continues as she is doing her body will not be able to sustain itself. You have nothing to lose and a lot to gain by getting a hospice consult. Ask your doctor for a referral. If he says no, your mom is not appropriate, you can call a hospice yourself and ask for an assessment visit. Taking care of anyone in a life threatening situation is difficult and you need all the guidance and support you can get. If I can be of further help email me at barbara@bkbooks.com. My blessings to you and your mom. Barbara

Karen - December 17 2018

My mom has stage 4 lung cancer. She has been on a cancer medication that has cause severe diarrhea. She refuses to shower and get up to go to the bathroom but will get up to get food when needed. She has psoriatic arthritis and lives on pain meds. Her feet swell and are black and blue some days. She was just diagnosed with colitis and is on steroid but still has diarrhea issues. She has made numerous trips to the hospital but they cant seem to get it under control. She is getting very weak and still no resolution as they sent her home from rehab and said its up to her to keep up treatment. Some days she just refuses care. Should she be on hospice? Is this a sign her cancer has moved to another area and they are not seeing it? How much longer can mom go on like this.

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

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