Friday, 7 August 2015

Constipation in the Elderly... STINKS!

When Bowels are All Show but NO GO.

There’s nothing funny about Constipation.  Nobody likes talking about it - let alone having to suffer from it.  In fact to tell the truth, similarly to being constipated, I’m finding it quite hard work squeezing out a blog post concerning it!  

Distasteful as the subject is though, and as much as we poo-poo it, as human beings, sooner or later we all have to ‘go’.   The problem is of course when you CAN’T go.  And although we are all different… and what’s normal for one isn’t necessarily normal for others… most doctors generally consider that three days or more of NOT being able to evacuate your bowels, means you have become Constipated. 

Unsurprisingly, I’ve found during my employment in the Aged-Care industry, that just mentioning the word Constipation makes most elderly people screw up their faces and clench their teeth.  And if there’s one thing ‘bunged-up’ older adults don’t need – it’s MORE clenching!  Because unfair though it may be and for a whole toilet-load of reasons, chronic Constipation becomes more prevalent the older we get.

Oh, Joy!

Constipation in the Elderly
oh WHY can't I go?

10 Reasons why Elderly are more Prone to Constipation:

  • An ageing colon, as per the rest of a Senior’s body, is just not as peppy as it used to be
  • Some medications (eg: pain meds) mean Constipation as a pesky side-effect
  • Diuretics cause people to wee more resulting in an increase in fluid loss ie: dehydration
  • Retirement and leading a more sedentary lifestyle: slow down your life = slow down your bowels
  • Dietary changes (eg: during travel) or a loss of appetite mean a lack of nutrition (fibre, fibre, FIBRE!)
  • Drinking less allows for more chance of the dreaded dehydration
  • Digestive issues mean the likelihood of Constipation is increased
  • Various medical conditions are symptomatically liked to Constipation – MS, Diabetes, Parkinsons
  • Being sick and/or bedridden for long periods encourages a lower metabolism rate
  • Depression, anxiety, stress, lack of sleep all contribute to a sluggish bowel by upsetting bodily functions and throwing hormonal balances out of whack

But it’s not just our sacred Seniors who battle with the anguish of infrequent faecal elimination.  Most of us have been lucky enough to experience the gassy smelly delights associated with Constipation at some stage in our lives.  And we recognise how it greatly disturbs our quality of life; that we have little energy and how it leaves us feeling uncomfy, bloated, perhaps in pain and… well, just blah.

Unfortunately, it is the elderly in our lives who seem to suffer more frequently from bouts of chronic Constipation - and usually it's found to be a symptom of an underlying health condition.

That's nice Dollie, but is it story time yet?

How about the time I helped an old lady write in her Poo Diary?

Arriving at 89 year old  Annie Turdsworth's house one afternoon, I found her deeply engrossed with a pile of paperwork on her kitchen bench.  I’ve helped the quietly charming Mrs Turdsworth for several years now and she is the gentlest, most kindly person you could ever meet – real Grandmother material in fact.

Unfortunately though, she’s put up with a lifetime of suffering from various ongoing gastro-intestinal complaints.  Long story short Annie since the day she turned 65, has been diagnosed with the crappiest lot of bowel disorders imaginable - ranging from IBS, Diverticulitis until now most recently, they have decided she may have Colon Cancer.

Oh, Poo!

And being that the specialist needed to know what her bowels were dishing out, she was instructed to keep a record of every time she ‘went’; how her stool looked, its colour, texture and shape etc. Good lord, can you imagine - the modest and deeply private Annie Turdsworth felt mortified with the thought of it all!

Luckily, her doctor also had a copy of the Bristol Stool Form scale (BSF) to present her with PHEW.

A simple user-friendly chart, the BSF enables people such as Annie (who would rather DIE than discuss their bathroom habits to another living soul) to use a picture-type rating system to best match up with the appearance of their own stools.  So rather than having to write horrific words like “runny” or “hard pebbles” Annie only has to work discretely off her BSF guide and record the corresponding number of the day... into her Poo Diary (once she got brave enough to actually start looking into the toilet bowl first that is!)

Elderly people with Constipation
What kind of STOOL am I?

“I think today Dollie, I’m more of a 2 than a 3” Annie always likes to update me when I see her. 

And we mark it off in her book along with the food she’s eaten in the last 24 hours, all nice and neatly, for her doctor to peruse later.  Annie then pops the diary into an empty chocolate box, twists a large rubber band around it and then tucks the whole sordid package away out of sight in a drawer beside her bed. 

I thinks it's actually quite sweet that she feels brave enough to talk to me, her visiting Home-Carer and confidant, about something as personal as bowel movements (or lack thereof). It took us a while though.  In fact, I'm pretty sure Annie Turdsworth would most likely trust me with anything now - seeing as we are such intimate poop-buddies and all!

*** To see how your own poo measures up (and to win a prize) - feel free to click on this link

(go on, you know you want to...)  

But before we go, here's Part 2 of the story (of the No.2...)

At the other end of the Constipational spectrum, I should definitely make mention of another of my cherished clients, Mrs Maggie Cementballs.  Not only does 91 year old Maggie NOT require the Bristol Stool Form chart to categorise her Constipation, but because she is deaf (and refuses to wear hearing aids) – we get to discuss it LOUDLY. 


You have to laugh – and thankfully, we do.  All kidding aside though, it would be fair to say dear old Mags suffers with the most crippling bodily waste elimination problems I think I’ve ever been privy to.

Ha ha… Privy!

Throw in the resulting haemorrhoids, colon surgery and a couple of rectal prolapses - there’s not much poor Maggie hasn’t experienced when it comes to digestive complications and the painful impaction torture her bowels insist on putting her through. 

And she is more than happy to give me the full detailed account on her Constipation problem o' the week.  I recall last week’s Poop particulars went something like this (and remember, this is in SHOUT format):

“Well I don’t let it go ON AND ON, or I END UP in agony - I CAN ONLY PUSH FOR SO LONG!  AND FOR ONCE THE problem IS NOT WITH THE ACTUAL GOING… it’s the finishing off bit that’s ALL TOO hard AT THE MOMENT”

“but I HAVE TO get it out!  I can’t walk round with THE THING HALF hanging out of me, CAN I?” 

“CRIKEY MAGGIE, YOU JUST CAN’T!”  i bellow back, with my fully concerned face on.

Unfortunately, there’s not a lot that I or anyone else can do for the long-suffering Maggie Cementballs (AND her recurring rock-hard cement balls).  Due to her age, doctors have advised that yet more surgery just isn’t viable (ie: it would kill her) and therefore all they can do is pump her full of drugs, top up her pain-killers and assist her to manage the condition at home as best she can. 

Which is hardly much fun when you're a frail old girl of 91 and, much like every other Constipation sufferer in the world, all you want from life is a happy ending. LITERALLY.




  1. Helping the elderly when they are constipated is something that you just have to do when you work for an aged care center. What I didn't know though was that they had to identify it and they even had charts for it too. Now that is very interesting and is not something that you would think to see at work. They even call it the Bristol Stool Form and that is a very interesting name title.

  2. Hey Chris, admittedly Ive never worked in an actual Aged Care facility - instead I deal with elderly in their own homes. But constipation is constipaton wherever you are.... and it still sucks! Bristol comes from the hospital in Bristol, UK where the chart thingy originated from (cheers Google). Oh and Id love to see the looks your residents give you with that big hole in your ear! Thanks for stopping by mate, Cheers Dollie