Strategies That Really Work
The easiest way to deal with constipation in the elderly is to understand that constipation prevention needs to be your first step.
If you are dealing with a situation of chronic constipation, my recommendation is to review all these pages first and then come up with a plan that works well for your elderly loved one AND your family.
Sit down and talk with them ... explain the rationale behind any changes you make, even if you think they won't understand. I have found through the years that the easiest way to implement lifestyle changes in the elderly is to get them on board with the process..
That is much easier than fighting your way through it. Remember, as much as you may want them to make these changes, the ultimate choice remains theirs. That is why it is so important to do your best to get them to understand what changes you are making and why.
Constipation prevention can be simple in most cases. It just involves a few lifestyle and diet changes.
Low Fluid Intake
How can you prevent constipation? One way is to make sure your loved one is taking in enough fluid every day.
Elderly adults tend to drink less than they need on a daily basis for a variety of reasons, including decreased mobility, decreased ability to detect thirst and poor short term memory, just to name a few.
Make sure they are drinking an average of eight 8-ounce glasses of water or juice daily. Although coffee and tea "count", they are both diuretics, causing increased urine output.
Try making sure there is always water available beside your loved one ... by their chair, at the table and beside the bed. Try using one of the closed lid systems to prevent spilling. A gentle reminder can help a lot ... even a few sips at a time can make a difference.
Another idea is to try making smoothies once a day. I use frozen fruits, ice, Greek yogurt and a little honey. You can even add vegetables to the mix. Smoothies are cool and refreshing, most people like then, and because they are thick it makes it easier for the elderly to swallow.
A word of caution: There are certain medical conditions that may require less than the recommended amount of fluids daily, such as heart failure, high blood pressure and kidney failure. Check with your doctor first, explaining that you are trying to prevent constipation, and determine the right fluid intake.
A chart may help as a visual reminder as to how much is taken in daily. Make the chart large enough for your loved one to clearly see.
I have found that the majority of elderly patients of mine with constipation also had evidence of dehydration. This is the one area that can make a huge impact on constipation prevention. Low fluid intake causes the stools to become dry and hard and more difficult to pass.
Simple exercise, such as walking or using a foot cycle, increase gastric motility and decreases episodes of constipation.
It may be difficult for you to encourage your loved one to walk. Arthritis pain, fear of falling and decreased coordination may all contribute to the preference to not move.
Try taking a daily walk WITH your elderly loved one. That may decrease their fear of falling. Make it YOUR idea for YOUR benefit .... and you just want their company.
It doesn't have to be a lot. You don't need to walk miles every day. But walking will not only aid in constipation prevention, it can also help relieve some arthritis symptoms.
Fresh air and sunshine is good for everyone. Do you live in an area with bad weather?? Try going to the mall a few times a week to walk indoors. Most elderly enjoy outings and the walking is just an extra benefit.
Hemorrhoidal pain can often cause elderly people to avoid having a bowel movement and thus adding to already existing constipation issues.
Treat hemorrhoids with an external cream. Talk with your doctor if there are large internal or external hemorrhoids. Once that issue is cleared up it makes defecating easier.
Bananas, one or two daily, seem to really help with the straining associated with constipation, which only makes the hemorrhoidal pain worse. They work by softening the stool. Try throwing a fresh banana into a smoothie every morning.
Add Additional Fiber for Constipation Prevention
A low fiber diet is linked to increased episodes of constipation. Add fiber to your diet in a variety of ways.
Try adding vegetables to smoothies. Provide frequent snacks with fiber, such as whole grain cereals or whole wheat breads. Look for labels that say "100% whole wheat" or "100% whole grain".
Serve a fruit salad. Provide nuts as a snack (be cautious if there are swallowing issues).
These changes are actually good for the whole family, decreasing your risks of cardiovascular disease and diabetes. Simple changes can make a significant difference.
Maintain Regular Bowel Habits
Ever wonder how to prevent constipation in a really simple way?? It's simple ... maintain regular habits daily.
Most people feel the urge to defecate in the morning and after meals. Encourage your family member to simply sit on the toilet every day at a certain time. Eventually, the bowels will begin to develop the habit of emptying at a certain time every day.
Limit Use of Narcotics
Narcotic pain medication, as well as other medications, have the side effect of being a smooth muscles relaxer. That basically means that it slows down the guts normal motility, leading to constipation.
If your loved one must take a narcotic periodically, remember that on that day you will need to increase fiber and fluid to help offset the effects of the narcotic. You may even need to resort to some home remedies for constipation.
If your loved one is on routine narcotic pain medications and is suffering from constipation, talk with your doctor. All of the remedies listed here will help, but you may need to move on to stool softeners and stimulant laxatives on a routine basis to counteract the constipating effects of the narcotics.
These are the top areas that we used for constipation prevention in the nursing home. I can't guarantee an instant cure, but I can tell you that making these simple changes can be very beneficial.
Remember, give them time to work. It takes several days, even a week or two, for you to be able to see the results from making these changes.
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