Bowel incontinence severe pain, comfort care

Jennisme

Hello all, I’m wondering if anyone else has witnessed extreme pain with moving bowels? My mom has been bedridden in hospital for 2.5 months. Aside from dementia and reoccurring UTI’s, she has no other diagnosis yet (BPD tho). After a few bout of screaming, crying, and moaning “it hurtttts”, I asked the doctor to switch her to comfort care (Canadian term). Laxatives and stool softeners were not helping. She would be mid conversation and tense up, ask me to make it stop, and just scream with pain. Today, when it began, I quickly grabbed the nurse and he gave her an injection of hydromorphone. I haven’t seen her that happy in months. We talked for 2 hours about anything and everything, all signs of frustration gone, not one zone out period, zero screams. Comfort care means no more procedures, antibiotics, and much more than Tylenol for pain. And yet I am curious…pooping in bed would be uncomfortable, but what would cause the severity of pain? I’m told “sometimes that happens”, and Google is not cooperating. Any thoughts welcome, including how to help her through those moments. And lastly, as I left today, mom asked “did I get a shot of something? I feel good”. Short term memory gaps won’t allow her to ask for pain meds, so I am unsure how to approach the staff. Is “as needed” enough to keep her comfortable?

towhee

I am not sure if my experience relates, my LOs pain was actually caused by the laxatives, she thought she was giving birth again, it was so bad. However, having had my own problems with constipation and stomach cramps I am not surprised that a PWD was screaming in pain. As for the "as needed" if she is screaming it should be enough, but you might want to gently ask the CNAs to notify the nurse if your mom starts screaming, and gently tell all he nurses how well the medication worked and how relieved you are.

Jennisme

Thank you. That is very helpful. The unit is understaffed and over capacity, which adds to the overall stress. I worry she is laying there screaming with no relief until someone has time. I will speak with them today, gently:)