Question

I am worried about my mother and her toileting. The other day I was at her house and she forgot to flush, again. This is not the first time that I have seen what she produces, if you know what I mean, and it does not look right to me.

Her stool is very dark and almost the size of large gum balls. I wanted to talk to her about it, but did not know how to even broach the subject with her.   

Mom is 88, tiny, and not very active anymore. She does not have trouble getting to the bathroom and does live independently. I do wonder what she is eating, as I see allot of tv dinners in the freezer. 

I get the sense that she is constipated and uncomfortable most of the time, as she complains of abdominal pain sometimes. I want to help her but I do not really want to bring it up.  

I could use some ideas here and hoping that you would be willing to write about it.

Answer

Good bowel elimination is something everyone desires and almost no one talks about, which is quite understandable. Discussing it with your mother is not easy at all. We definitely agree on that.

What you have described finding in the toilet is likely the results of constipation. Waste is not moving through her system efficiently and too much moisture is being reabsorbed and yes, she is not comfortable. If the color is brown, not black, bloody, or light in color, she is likely dealing with one issue, that being constipation.  

Good bowel habits are the product of diet, activity, stress, and timing.  

Her diet needs to contain foods that add bulk and are not simply absorbed, such as a diet that is all sugar. For the intestinal track to move waste it needs something to work with. What your mother is or is not eating could be a significant factor. Does she eat whole fruits, vegetables, nuts, and whole grain breads?  If not, a change could help.

Motion is another factor in bowel elimination. Sitting all day in an easy chair does not help the body on a number of fronts, elimination being one of them. Twisting, turning, walking, lying, and a variety of motions keeps muscles working and the gastrointestinal tract gently massaged by your motion and straighten the torso.  Older individuals can be rather sedentary for a variety of reasons, which does not help with elimination.

Stress can materially impact healthy bowel evacuation. Emotional turmoil can affect the gastrointestinal tract causing constipation or diarrhea. The answer might be finding out if something is troubling your mother.

Humans are creatures of habit. Bowel evacuation is most effective if a routine is maintained. Regular meal times, the same bedtime and wake time is most helpful. Strange settings, visitors in the home, a change in sleep times, or anything that upsets our usual schedule can affect good bowel elimination.  

There are numerous factors that affect good bowel evacuation. Identifying the problem first is most helpful. Making changes in diet and lifestyle usually have the most impact.  

There is something called the Bristol Stool Scale that may help demonstrate the issue for her.  It is easily found on the internet and can be printed for mom. If she has been constipated for a long time she may believe her situation to be normal, though it is not. Presenting the chart and your ideas to help will be your biggest challenge. If your mother has chronic bloating and abdominal discomfort she may welcome some fresh ideas though. While it is a subject not commonly talked about, you could mention your own successes based on what you read and tried. You could leave an article in the bathroom and say nothing or simply leave behind a notebook of yours with some information tucked in it. You could buy her a few high fiber items and mention how much you like them and thought that she might like to try them also. You could bring her a few meals that are high in fiber. Providing your mother with information and options may be welcomed with the right approach. 

Do be aware that some medications she might be on can cause constipation and she may need recommendations from her health care provider if that is her situation.  Constipation causing medications can be very difficult to override with simple diet changes and often require another medication to resolve.  As always, it is a subject she should discuss with her doctor if she cannot improve on her own with some adjustments.

Good bowel evacuation makes quite a difference in how person feels. Helping your mother resolve this issue will improve her quality of life.

I wish you success in helping your mother find resolution.