Bowel Elimination

Bowel habbits differ from person to person. Some people move their bowels once a day, while others may only move theirs 2-3 times a week.

Constipation

In the hospice patient, many things may cause a less frequent bowel movement and difficulty passing stools, leading to constipation. The best treatment for constipation is prevention. A plan for prevention includes:

• Try to maintain well-balanced meals

• Set aside a time each day (usually after breakfast) that the patient sits for a period of time on teh bedpan, commode or toilet.

• Maintain fluid consumption to two quarts a day (unless otherwise instructed by your doctor).

• Try to consume plenty of nectras, juices, and jellos, such as prune juice.

If prevention efforts don't work, and the patient has not had a bowel movement for 1-2 days, tell your primary nurse. Your nurse will want to know what has worked for the patient's constipation in the past, and may suggest non-prescription laxatives, which ar available over the counter.

Diarrhea

Diarrhea can also be a problem for the hospice paitnet. It is characterized by frequent watery stools, and is often accompanied by stomach cramping. If the patient has diarrhea, you should keep a record of the frequency of stools. Your primary nurse will try to find the cause for this diarrhea and will discuss with the doctor about a medicine to treat it. Some medicines can be obtained without a prescription, while others will require a prescription.

Things to Remember When a Patient Has Diarrhea:

• Keep the bedpan close to the patient to avoid accidents.

• Place a waterproof bed pad under the patient. If stool leakage should occur, the pad may help to prevent additional changes on the entire bed.

• After each loose stool, the rectal area should be washed with mild soap and water and a skin protection lotion should be applied.

• Encourage the patient to increase liquids if diarrhea occurs.

• The patient can drink juices or liquid diluted jello for both fluid intake and to provide some sugar for energy.

• If the patient is too weak and can't get to the bathroom, then it will be necessary fo rthe patient to use either a commode (a chair with a bed pan inserted in the open center), a bed pain, or a diaper.

Things to Remember About Using Commodes and Bedpans:

• Warm a metal bedpan by running warm water over it prior to use.

• Put a towel on the back side of the bedpan for padding.

• Sprinkle baby powder or cornstarch around the top of the bedpan so that the patient's skin will not stick to it.

• Keep the commode near the bed and help the patient to get on and off of it.

• If the patient is bed-bound, it is important to try and put them in a sitting position for elimination by raising the head of the bed.

• Remember to wash your hands after helping the patient with elimination and to wash the patient's hands as well.

• Give the patient time alone during elimination.