Supporting Bowel Fixation in Elderly Dementia Patients

Why Bowel Fixations Occur in Dementia

There are several reasons people with Alzheimer's disease and related dementias may develop a fixation with their bowel movements:

Loss of Inhibitory Control

Dementia damages areas of the brain responsible for inhibition and impulse control. This causes patients to act on urges, thoughts, or behaviors that they would have previously suppressed.

Declining Memory

Short-term memory loss means patients quickly forget they have already discussed their bowels or used the bathroom frequently. To them, each trip feels like the first.

Medication Side Effects

Some medications like cholinesterase inhibitors used to treat Alzheimer's symptoms can cause diarrhea, gas, or constipation as side effects.

Anxiety and Discomfort

Bowel issues may cause physical discomfort. Patients also experience anxiety over losing control of their bowels. This brings bowel movements to the forefront of their mind.

Reduced Communication Abilities

Declining language skills make it hard for patients to articulate needs and experiences. Talking about bowel movements may be one way they try to express themselves.

Signs of Bowel Movement Preoccupation

How might this fixation manifest in your loved one with dementia? Watch for:

Frequently Discussing Bowel Movements

They may regularly report on the timing, consistency, color, volume and other details regarding their bowel movements or repeatedly ask about when they can go to the bathroom.

Disrobing

In their urgency to use the toilet, patients may start removing clothing items prematurely or in public places.

Repeating Trips to the Bathroom

Every trip may feel like the first, leading to frequent unnecessary visits just minutes apart.

Interrupted Sleep

Bowel fixation can disrupt normal sleep patterns, with patients waking frequently to use the bathroom - whether they need to or not.

Agitation Before or After Bowel Movements

Frustration surrounding bowel movements may lead to outbursts, agitation, or other behavioral issues.

Incontinence Accidents

Despite repetitive bathroom trips, incontinence is common. Lack of inhibitory control plus declining mobility makes it hard to get to the toilet in time.

Coping Strategies for Bowel Fixation

It requires patience and compassion to care for someone fixated on their bowels. Try these strategies to ease challenges:

Rule Out Underlying Causes

Discuss any major changes in bathroom habits with their doctor. There may be a treatable underlying infection or new medication exacerbating issues.

Stick to a Schedule

Establish a regular toilet routine at consistent times of day. This provides structure and assurance that bathrooms trips will be predictably periodic.

Provide Reassurance

Offer frequent reassurance that the bathroom is easily accessible whenever needed. This helps ease anxiety.

Use Tracking Charts

Keep a daily log of bowel movements and any notable characteristics. Checking this helps reduce repetitive questions and trips.

Simplify Clothing

Opt for easy pull-on garments and avoid complicated belts, buttons and zippers to empower independence.

Watch for Non-Verbal Cues

Be alert for physical signs they may need the bathroom like fidgeting, pacing or facial expressions.

Schedule Check-Ins After Each Trip

Briefly check in after bathroom visits: All done? Feel better? This acknowledgment helps calm the mind.

Provide Comfort Items in the Bathroom

Consider keeping favorite music, photos, puzzles or snacks in the bathroom to make repetitive trips less distressing.

When to Seek Medical Advice

Consult your loved one's doctor if you notice:

• Blood in the stool
• Black or tarry stool
• Drastic change in bowel movement frequency or consistency
• Pain or straining when trying to use the bathroom
• New fecal incontinence

Any of these may indicate an underlying gastrointestinal issue needing medical treatment. The doctor can also check for side effects of medications impacting bowels.

Consider Incontinence Products

Despite your best efforts at scheduled trips and reassurance, incontinence accidents are likely. Incontinence pads, underwear and moisture-wicking bedding help manage accidents discreetly and comfortably.

Choose high-absorbency overnight pads for maximum protection during the day. Look for pads contoured for a good fit and designed to draw moisture away from the skin.

When to Consider Professional Help

If bowel fixation behaviors escalate and start severely impacting daily life even with these management strategies, consider:

• Adult day programs - Socializing and activities can provide a helpful distraction during the day.
• In-home care assistance - Additional support relieves strain on family caregivers.
• Memory care facilities - 24/7 supervised care may become necessary.

Seeking professional help allows you to maintain your own health and wellbeing as a caregiver.

Stay Patient, Positive and Proactive

Bowel fixation challenges caregivers to stay patient, compassionate and solution-oriented. Communicate with health providers, establish bathroom routines, provide reassurance, simplify clothing, watch for non-verbal signs, and use tracking charts. With understanding and proactive planning, you can thoughtfully support your loved one's needs.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.