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My mother who is almost bedbound and very, very weak, cannot have bowel movements as she has no strength to push. We use enemas every other day, but even then, she can't push at all and we end up having to take the poop out for her which is a concern as we could hurt her without knowing.
Any tips to help her?

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My first reaction is that every other day is much too often, no doubt her diet is also quite small so the need to go so often is not as acute. My major regret in the time I spent caring for my mother was the time I spent obsessing about her bowel routine. We tried every diet, laxative, stool softener, enema and even digital stimulation and I know I must have caused her both physical and mental pain in attempting to keep her on some kind of schedule, and I didn't begin to freak out until day 5...( as advised by our palliative care nurse).
What I discovered after she was in the NH was that she obviously didn't need all that fussing, they even discontinued the stool softeners and laxatives she had depended on for decades to no apparent ill effect. She lived another 18 months after moving there and I gradually learned to stop obsessing about her bowels.
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Unless you are finding that the poop is staying in the bowel so long that the bowel is removing so much fluid that the stool is going cement, there is little reason for doing this. Poop is like a train, add another car and the first car will move forward. Use stool softner daily to keep it from going hard as cement, and needing disimpacting. You are correct that disimpacting is dangerous, and digging about in the bowel can actually trigger reactions that cause heart problems. Get the advice of Mom's doctor.
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Great advice below but my dad's palliative care team suggested 1 tsp of olive oil orally and it worked amazingly well. It provided moisture to the dry fecal contents and he was able to expel with very little effort. Try to push drinking water.
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AlvaDeer Aug 2020
Great if this worked. What else can help is a bit of a fleets oil enema smeared about if stools are overly hard. It can be messy, but it works well. Pushing fluid is only good if there is no congestive heart failure. The weakening heart pump has a hard time with too much fluid.
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I am not obsessed. She is. She wants to poop and can't. There is hard stool there thatvshe can't push out.
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cwillie Aug 2020
Ah I see, with my mom the stool wasn't hard there was just very low motility. Use lots and lots of lubricant when inserting the enema, something like KY jelly. A lot is going to depend on her diet and health condition, with hard stool I would be trying something to relieve that and you will find that everyone has different ideas on that score. #1 is adding fluids and fiber (prune juice?), then gentle laxatives like pectin based benefiber, then something like miralax (this really was very helpful for my mom), moving on to the big guns like stool softeners and laxatives. If you can get her up to a bedside commode at all that may make it easier for her to push.
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Hospice recommends using smooth move tea, you can get it at most grocery stores. It is senna and works really well. Usually without a lot of effort needed.

We let it brew for 10 to 15 minutes and then you don't have to drink but about 4oz for results.
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