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I don't know what it is, but I'm convinced that after a certain age, seniors become obsessed with their bowels. So Dad has had a rough couple of days... (and so have I). Between diminished breathing due to his COPD progressing and the resulting anxiety which makes the breathing worse, he's now saying that he hasn't pooped in two weeks. I find that hard to believe, especially since he's on daily Senna and Miralax PRN. I spoke with his hospice nurse who said he's checking his bowel movements and Dad has complained lately of being constipated but they're on top of it. Unfortunately, I've missed 5 calls today (I try to leave the phone alone because this type of thing wrecks my productivity at work... should be working but typing this question...) 2 from Dad, 2 from the AL and one from the transportation person for the Adult Day Center dad visits three days a week. I've also been texting with the Adult Day Center director who's stating that Dad is saying that he hasn't pooped in two weeks and that I need to drive the hour to pick him up. It's times like these I don't know what to do. I'm thinking Dad just may not remember that he's gone to the bathroom. I'm sure it hasn't been two weeks. We're guesstimating about three days. I know this is uncomfortable, but I don't want to take Dad to the hospital for this (we went through this a couple years ago and there was a LOT of wasted trips to the ER...). The hospice guy keeps trying to keep me calm, but now I'm worried. My creative flow has been completely destroyed (again) so I might as well just go pick him up, but I will be REALLY ticked off about this. This will be my THIRD time leaving work over something (sorry to sound mean) so petty. Clogged ears and clogged bowels are beginning to cost valuable work time and productivity. AAAAAARRRRRRRRRRRRRRGGGGGGGHHHHHHHHHHHH!!!!!!!!

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Constipation is very common with later states of Alzheimer's. Part of it they don't drink and exercise enough; another reason can be due to sluggish bowels OR it may have to do with hypothyroid (get that checked periodically which is a simple blood test). .and it can be deadly because not only can a person get IMPACTED as little as three days (will require Emergency Room visit and the nurse will dig it out with their finger). Constipation is deadly because they will feel uncomfortable and unable to communicate what is wrong--the result is WANDERING which can lead to catastrophic falls. You must be extremely careful with Miralax and other laxatives such as MOM, Mag citrate, even Fleets enema because you MUST know their kidney function. Poor kidney function giving these will cause kidney damage (they form crystals in the kidney and can kill the person). Ask the doctor for LACTULOSE which is designed for long term use--and is kidney friendly. It's not really a laxative, but an indigestible sugar which accumulates in the large intestine which will draw water into the bowel.  These people require around-the-clock supervision because they are unable to tell you if they went or not--and may or may not flush the toilet and can't give you a straight answer if you ask them. So someone has to monitor them.  If they do flush, TURN OFF THE TOILET. You must keep a diary when they had bowel movements.. For the caregiver your entire life will be center around the bowels.  It's so sad but true.  Been there..doing that.  That's one reason if you are confronted with being caregiver vs. nursing home--you are better off going the nursing home route because your life will become one living purgatory...how would you feel to live your life centered around an old, confused, feeble person's bowels. But do not take constipation lightly. It can turn serious due to them wandering because they feel uncomfortable with a gut full of backed up stool.  

PS: Good lucking giving them the medication.  Some Alzheimer's people refuse to take their meds because they taste bad. Giving my mom medication which is three times a day is a major ordeal for me.   I have to use every psychological trick in the book to get her to take them.  The moment I wake up I know this special purgatory of mine starts and try doing this every single day--seven days a week. With no help.  NO relief. But when she has her bowel movement I get a sense of relief because at least I won't have to deal with that..for another day.  Like I said if you can get them in a nursing home..do it.  
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"I spoke with his hospice nurse who said he's checking his bowel movements and Dad has complained lately of being constipated but they're on top of it."

Is there any particular reason why you will listen to your Dad, to the day care director, to your innermost fears... to anybody *except* the person who is in charge of your father's daily welfare AND knows what is actually happening with his bowels?

Stop this, Tiny. Listen to the hospice nurse, and faithfully repeat his/her EXPERT opinion if the Director calls you talking - for want of a less vulgar word - sh*t.
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UPDATE: So Dad didn't even GO to the Adult Day Care Center today! When I got the message from the director, I assumed he was there. The transportation person just called me back (two hours of phone tag -- YAY) to let me know that she left him at the AL.

Is it bad that I don't want to have to deal with any of this and just do my job? So now I feel like I have to figure out what the HE** is going on. How is the Adult Day Center involved? Why am I always stuck in the middle of this stuff?

It's like a catch 22. Dad really loves the Adult Day Center, but I'm starting to think that he may not be well enough to keep going with the incidences of him losing his breath trying to get back and forth and the new revelation from the driver that she has to go inside and pick him up because he gets his time mixed up. This would devastate Dad, but that may be my only option.

and it's really a toss up on whether Dad needs Memory Care. Honestly, he's not that far gone. Hospice has classified his dementia as "Pulmonary Dementia" so he's not THAT bad compared to what I've seen in memory care facilities. To top that off, it's about $1K more a month for memory care. I just don't have that kind of money.

I was ROCKING this morning at work. I was creating and really having a good day. That's been brought to a screeching halt thanks to all of this. I'm so irritated right now. I just want to work... now my head hurts in the back and I'm seeing spots. Might as well call it another unproductive day... YAY ME!!!!
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Hi everyone... I took it a step further (in the spirit of Countrymouse's advice), I spoke with the social worker on Dad's hospice team and we are working on a plan to funnel those calls other places.

Hospice now has the Adult Day Center Director's contact info so they can speak directly.

I still have no idea how the director even got involved yesterday (maybe the transportation person relayed the message -- who knows), but I can't be taken away from work for that type of thing.

As for the transportation person, while I don't like being blind sided with information about Dad not being ready or in the waiting area when she arrives, I can't worry about that either.

I've talked to the AL staff about this to no avail. I asked the hospice social worker to talk to the AL staff as well about making sure Dad stays in the waiting area (he comes down early, gets impatient and goes back upstairs) until she comes.

I am working on trying to monitor the messages that drive me bananas, but it's in my nature to worry. The easiest thing would be not to get the calls in the first place.

Let's see how things go with social worker intervention.
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My two cents...Tinyblu for what it’s worth. They do fixate on their bowels..period. They can’t recall when they had them. My dad will swear they are hard and small, when he’s on Miralax and Sennekot daily. As Cetude said, they don’t hydrate or walk enough or eat enough fiber so there you go. But they can’t remember either when they went last.
Your dad is on hospice for a reason. He's in AL for a reason. He pays good money for their care so you don’t have to. If there is truly an issue AL should resolve, then contact the Director of AL or the nurse in charge of Patient Care Coordinator duties. Regular staff is not the "go to" here. Complain loud and clear that they are not to call you for every little thing and that is why he is there for them to handle it. We had the same thing happening to me and my sister and it was wearing us out. (Mostly me since I live by dad) So I totally get where you are coming from. Here’s a piece of advice my sis gave me (she’s a nurse) "if he’s not bleeding from an orifrice, or dying, it’s not an emergency." Because I began to fret Bout every little thing. Your dad is on hospice...towards end of life and unlike Cetude, I would not be concerned with him being on Miralax due to his kidney function. That’s small potatoes right now. You can not worry about every little "what if". That will eat you up. Tell them not to call you at work unless it’s a true emergency. The director can come up with a way to monitor his bowel habits...let them devise this method. If dad is calling your cell phone...block his number while you are at work. You need to have some control and NO, it’s not selfish to want some peace of mind. 
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tornadojan your first few sentences are my life. I had to see who wrote this because i thought, my gosh, did I write this and not remember. This site has been so helpful and I am dealing with the same bowel obsession with my mom and it truly has become my life's distraction. I'm glad to see that I'm not the only one or that my mom isn't the only one with these issues. It's so sad to see our parents this way.
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Although it doesn't always resolve the issue we are having personally, it is SO SO SO SO comforting...no, helpful...., not quite right, steadying....yea that's it! to read others in the same boat, struggling with the same issues and stressed about the same things. Maybe we each aren't all on our own island afterall. Thank you for this forum all of you special, incredible and amazing caregivers in your many forms....daughters, sons, wives, husbands!!! You've been my life saver more times than I can count. God speed to all of you and we WILL get through this and be OKAY. You're doing a fabulous job!
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Call the day care and tell them to discuss with Hospice. Hospice needs to clear hospital visits.  Or tell them you'e discussed with Hospice and they tell you nothing to be done.
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Great question, especially for those of us who are working professionals. It is so hard to stay focused when you always have this background dialog running subconsciously - I hope everything is OK, is this going to be a decent day? I call my mom roughly at 9 a.m. every day. (She has a helper whenever I'm not there). I always have this low-level dread before I call. Will she be alert? Feel decent? Depending on the outcome, I then feel I can move on and hopefully have a good day at work. Believe me, I have gotten many of those calls - I am also in a creative field - and a 5-minute call can easily turn into a 30-minute side activity that can completely mess up your workday. Actually I was laid off and am now interviewing for other full-time jobs. In the back of my mind, again, I think, will a new employer be understanding? Will I start a new job and then have to deal with a crisis? What if? What if? I am single and have to work for several more years. Just another one of life's dilemmas. I feel your pain, Tiny. Listen to all the great advice on this board.
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They don't have to have dementia - old people are fixated on their bowels, to put it bluntly.

My DH can come out of the bathroom and not 30 minutes later he'll swear he hasn't gone. I learned to just roll with it.

Believe me, 2 weeks without a bowel movement and he'd be on the floor and unable to get up; rolling in pain. I've seen that at the hospital and it was never 2 weeks without. By the 3rd day I too have pain - the body starts cramping to rid itself of waste.

I still remind my DH that he has gone but I know he doesn't believe me. Now I just let him trek to the potty as often as he wants. "pick your battles"
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