Is it normal to regulate a loved ones bowel movements by using laxatives?

1 answer | Last updated: Sep 21, 2016
A fellow caregiver asked...

hi.........i want to know if it is acceptable practice when looking after an 89yr old female Alzheimer,with some paranoia.....to manage their bowel movements using laxatives so they only do a bowel movement once a week? or every 6 days?is it normal practice to do this?


Expert Answers

Jennifer Serafin, N.P. is a registered nurse and geriatric nurse practitioner at the Jewish Homes for the Aged in San Francisco.

One way to manage someone's constipation is to find out how often they normally would go when they were younger, and use that as a guide. For example, most people have a stool at least every other day, so that schedule is what you would try to mimic using laxative therapy. You can also use the consistency of the stool as a guide. For example, the stool should be soft, formed, and easy to pass. If it is hard and painful to pass, you may need to use more laxatives to increase the amount of water in the stool (so it is not dry), or increase the frequency of stool (i.e.: going daily instead of every other day).

When I read you question, I immediately thought to myself that 6/7 days is too long to go without a bowel movement for someone with dementia. Most people cannot go 6 days without a bowel movement, as they would be uncomfortable (bloated) and their appetite could suffer. Furthermore, I have seen demented people get more confused when constipated. In other words, constipation can increase agitation and paranoia, as the person with dementia may be uncomfortable but not able to communicate this to anyone, so they act out.

I know that dealing with incontinence by delaying the bowel movements makes taking care of dementia patients easier, but it is very risky. Being really constipated can cause a bowel obstruction, which can be life threatening. Also, being really constipated can make getting someone to eat and drink well even harder, which puts them at risk for dehydration.

So therefore, no, it is not normal to delay someone's bowel movements to once a week. It is far to risky. In taking care of my patients, we start giving laxatives by the end of the second day with no bowel movement. By 5 days with no movement, I am using all my strongest laxatives, as this to me is too long to go without a bowel movement.

Hope this helps.