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Constipation

Constipation can occur when the stools are unusually dry and hard or there is a longer than usual period between bowel movements.  For the terminally ill individual, many factors can increase the likelihood of constipation. 
These include:

  • Increased frequency of pain medications

  • Decreased fluids

  • Diet changes

  • Decreased physical activity

Manage constipation and encourage bowel movements:

  • Talk to your hospice team nurse or physician about laxatives, stool softeners or other bowel medications.Discuss discontinuing calcium and iron supplements.

  • Encourage doctor-approved physical exercise.

  • Serve foods high in fiber such as bran cereal, whole grains, fruit (pineapple, prunes and raisins), vegetables and nuts, but avoid high fiber foods if dehydration, severe constipation or obstruction is anticipated.

  • Increase fluid intake (fruit juices, prune juice, hot lemon water, cider, apple juice).

  • Offer a cup of hot tea, coffee or other warm beverage to your loved one when he or she awakens.

  • Limit consumption of cheese.

  • Try relaxation techniques before mealtime.

  • Provide an attractive meal service.Remove bedpans and other less-than-appetizing items from the room before the meal.

Suggestions for constipation relief

Laxatives

  • Metamucil – Fluid intake of 8 cups per day is needed to help the fiber do its job.

  • Milk of Magnesia

  • magnesium citrate

  • Chronulac or Cephulac

  • Stool softeners:Colace, Pericolace, Senekot-S, Surfak

Lubricants

  • Mineral oil – Give plain mineral oil at bedtime and on an empty stomach or try mineral oil Milk of Magnesia emulsion (purchase at any pharmacy).
    Do not offer a mineral oil product if your loved one is vomiting, as he or she may accidentally inhale it.

  • Stimulants: Pericolace, Colace, Senokot, Ex-Lax, castor oil, Bisacodyl

Enemas

  • tap water

  • saline

  • soap suds

  • Fleet

Fruit Bar Laxative

  • 8 oz. Figs

  • 8 oz. Dates

  • 8 oz. Prunes

  • 8 oz. Raisins

  • 2 oz. Senna leaves (available at health food stores)

  • 1 pre-made graham cracker crust or homemade 8 x 8 graham cracker crust

Mix first four ingredients together.  Cover with water.  Steam for 20 minutes.  Drain off all the water.  Break off senna leaves and mix into the steamed fruits.  Run this mixture through a grinder, blender or food processor.  Pour fruit mixture over crust and refrigerate. Cut into one-inch square bars and eat one every morning or as directed.

Blended Meals

Blended meals can be a helpful treat for your loved one if he or she is finding eating difficult due to dry mouth, fatigue, sore mouth or throat.

Tips for Creating Blended Meals

  • You’ll need a good blender or food processor.Talk to your hospice team social worker if you can’t get one.

  • Use plastic freezer bags to store small amounts of fruit or juice for shakes.

  • If milk is poorly digested, liquid non-dairy creamer can be used instead.

  • If milk and fats are well digested, use half-and-half or whole milk.

Liquids to add when blending foods:

Add cold milk to:

Add warm milk to:

Add warm gravy or soup to:

  • puddings
  • yogurt
  • cereal
  • sandwiches
  • ice cream
  • cake
  • eggs
  • toast
  • hot cereal
  • muffins
  • macaroni
  • hot main dishes
  • potatoes
  • meats
  • poultry
  • rice
  • noodles

Recipes

For any of the following recipes, place all ingredients in a blender, blend until smooth and thin enough to sip through a straw.  Pour into a chilled glass.

Sherbet Shakes

Apricot Raspberry Shake

Pineapple Lemon Shake

Banana Grape Shake

  • ½ c. apricot nectar
  • 4 apricot halves
  • ½ c. raspberry sherbet
  • ½ c. pineapple juice
  • ½ c. lemon sherbet
  • 2 pineapple slices, chopped
  • ½ c. grape juice
  • ¼ c. whole milk
  • ½ banana
  • ½ c. lemon sherbet

Milk Shakes

Mock Orange Julius

Tropical Soda

Peanut Butter Cup Shake

  • ½ c. orange juice
  • ½ c. whole milk or half-and-half
  • ½ c. vanilla ice cream
  • 2 tablespoons instant custard mix
  • ¼ c. crushed pineapple, drained
  • ½ c. pear or mango nectar
  • ½ c. whole milk or half-and-half
  • ½ c. vanilla ice cream
  • ½ c. whole milk or half-and-half
  • 3 tablespoons creamy peanut butter
  • 3 tablespoons chocolate syrup
  • ½ c. vanilla ice cream

Beverages

Peach Shake

Tropical Float

Mocha Frosty

  • ½ peach (canned)
  • ½ package vanilla instant breakfast
  • ¼ c. vanilla ice cream
  • ¼ c. milk
  • 2 tablespoons frozen tropical juice blend concentrate - undiluted
  • ¼ c. lime sherbet
  • 2 tablespoons vanilla instant breakfast
  • ¼ c. milk
  • 1 c. milk
  • ½ package vanilla instant breakfast
  • 1 tablespoon instant coffee mix
  • 3 ice cubes, crushed

Tips for Making Mealtimes Better

Convenience foods can make mealtime easier: 

  • snack packs of pudding, yogurt and applesauce

  • canned peaches

  • instant custard mix

  • Carnation Instant Breakfast

  • prepared gravy and sauces

  • frozen malts

  • pints of ice cream or sherbet

  • small cans of apricot nectar, pineapple, V8 or grape juice