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

Let's Talk Poop--Bowel Movements and End of Life Care


Comments

barbara - October 25 2020

Hi Sonu, I am sorry your doctor is not understanding of the difficult situation you have regarding transporting your mom. Have you considered having hospice services? They will come to your home, and can provide medical care without you leaving the house. About the burning and rectal pressure; it could be the irritation of the catheter but it could also be a bladder infection. If hospice is not an option ask the doctor if you can bring a urine sample to a lab and have it tested. If she does have a bladder infection an antibiotic is appropriate.
My blessings to you and your mom. Barbara
If I can be of further help use my personal email barbara@bkbooks.com

Sonu - October 25 2020

My mom is at advance stage of Lung cancer and now completely on Bi-pep. She has Catheter for urine and given morphine for pain. Even though she has 3-4 times normal bowel movements in a day, she still feels something stuck in rectum and burning burning at the urine place.
Doctor has asked us to take her home and not able to help with her symptoms on phone and ask us to bring her to hospital but her condition is not like to be taken to the hospital. She becomes breathless even if she changes her side to left or right.
Is this common symptom with cancer patience or could be something else?

barbara - August 27 2020

Hi Tamela,
I am disappointed your mother’s doctor didn’t offer you more help. Not controlling your bowels is not necessarily a part of aging, although having 9 children could mean that the muscles in that area are not as strong as they once were. You might ask her doctor if anti-diarrhea medication would help as I’m thinking the increase in fiber did not help. I’m sorry to say that adult diapers might be in your future. My blessings to you and your mom. Barbara

Tamela - August 27 2020

My mom is 88, and other than arthritis, and Afib, she is relatively healthy. However, the past few months she has started getting diarrhea, and many times she doesn’t make it to the bathroom in time. Is this just part of aging? Her doctor doesn’t seem too concerned about it, and has told her to up her fiber. She is depressed and keeps talking about wanting to die. Side note: Not sure if this is important, but she has given birth to 9 kids.

barbara - August 07 2020

Hi Kim, I do not have enough medical history or information on your mom to say why she is not aware of pooping. Is dementia involved? If the stool is very loose then maybe too much fiber and poop inducing foods but most likely it is just her mental state declining. If she hasn’t had a doctors appointment in a while it might be time for a physical or just call her doctor and ask what could be happening. It might just be time to get the adult diapers out. What about urine. Does she know when she is peeing? If she knows when she has to pee then not knowing when she poops is something for the doctor to know about. Also any medication changes that could be affecting this? So many questions, so few answers. . Blessings! Barbara

barbara - August 07 2020

Hi Kim, I do not have enough medical history or information on your mom to say why she is not aware of pooping. Is dementia involved? If the stool is very loose then maybe too much fiber and poop inducing foods but most likely it is just her mental state declining. If she hasn’t had a doctors appointment in a while it might be time for a physical or just call her doctor and ask what could be happening. It might just be time to get the adult diapers out. What about urine. Does she know when she is peeing? If she knows when she has to pee then not knowing when she poops is something for the doctor to know about. Also any medication changes that could be affecting this? So many questions, so few answers. . Blessings! Barbara

kim michele - August 07 2020

Hello:

I happened upon your website today, searching for answers. My mother just turned 89. She has recently had quite a few poop issues. Most recently not feeling when she is going. Having several accidents due to not knowing when she is going. She is frail, has loss of sight, we have a daytime caregiver for her. She is doing all I feel that is necessary for being able to poop. Forcing fluids, tons of fiber, walking with her walker around the house. Is this common for end of life ? We have not had this issue before. Thank you for your time,

barbara - April 14 2020

Hi Mary Ellen, about your mom’s persistent diarrhea and could it be a sign she is beginning the dying process. At 99 years old anything is possible. Obviously something is going on inside her body that is not normal or healthy BUT if she is comfortable (not in pain) and reasonably happy I’d say just love her, enjoy her and let her body do what it is doing. At her age anything out of the ordinary can be an indication her body is beginning to activly shut down. Old age is a way of dying gradually without a specific disease process to speed it along so from that stand point she has entered the dying process. It will just take her longer than if she had a detectable disease.
My blessings are with you both during this gift of time that you to have. Barbara

Mary Ellen K - April 14 2020

Mom is 99 and has had persistent diarrhea and intermittent vomiting for the last month. All tests come back normal and all agree she is too frail for a colonoscopy, One nurse indicated this may be the beginning of her body shitting down. I can’t find any other resource that confirms that – in fact only the opposite, that constipation can be a sign. Her appetite is not what it once was but she is still eating and enjoying food, or as much as one can on a BRAT diet.

Can you tell me if this may be a possibility?

Barbara - November 27 2019

Hi Sherri, you asked how much longer your mom can go on not eating, agitated, falling; I don’t know. I really don’t have enough medical history information on your mom to make any predictions. Dementia just doesn’t play by the “rules” of dying from a disease. Not eating or drinking anything for 5 days would indicate she has entered the dying process. How long depends on her body size but probably weeks (since you said her vital signs are normal). Watch for her blood pressure to get lower and pulse faster. Look for bluish hands and feet.
Do you have my two booklets Gone From My Sight and How Do I Know You? They will be helpful during this time.
My blessings are with you and your mom. Barbara

Sherri - November 27 2019

My 90 yr old mother with Alzheimer’s and has had 3 strokes this yr is under Hospice care. Hasn’t eaten or drank anything fr 5 days. Yet her vital signs are all normal. She is very pale and not coherent. She fell 3 times in one week. Before hospice started the morphine for pain. Now adderall for agitation that was really bad. How much longer can she go on like this

Barbara - November 18 2019

Hi Lisa, I do not have enough medical information about your father in law to know why he hasn’t had a bowel movement in so long. Have you talked with his physician about this? What does he think is happening? This situation does not sound normal. I would hope the physician has some ideas. Blessings! Barbara

Lisa - November 18 2019

My father in law fell about 6 weeks ago. He was in a rehabilitation facility for a month and had one bowel movement due to an enema. He’s now home but has no physical activity. He’s in a hospital bed in his living room. Hospice comes in 3 times a week. They have been giving him suppositories and laxatives. He is eating small amounts of food, but has not had a bowel movement since he’s been home.(He has been home a week.) He says he is not in pain, and has no urge to go. The hospice nurses push on his stomach and check for pain, but he’s not hurting. He just doesn’t go. How is this possible?

Barbara - October 02 2019

HI Debby, about your dad’s foul smelling and continuous poop— I don’t have any of your dad’s medical information to know why he is having this bowel problem. Have you talked to your hospice nurse about this and what are her explanations and recommendations? I can say that when a person is in the dying process nothing in their body works right, nothing functions are it normally would. Diarrhea can be from the actual disease and how it is affecting the body. It can be caused by medication your father is on. This is why I encourage you to ask your hospice team not only for why this is happening but to address it and try to stop it. My blessings are with you and your father. Barbara

Debby - October 02 2019

My dad is 92. He won’t eat. All he wants is ice water. He is so weak and confined to a hospital bed. He soils himself multiple times a day with the must foul smelling BMs. The entire house smells I have candles lit, door open, spraying disinfectants! How can he go this much with no food in his body? He’s on hospice
Is this an end of life smell?

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?

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