1.

What preventive measures could you recommend to older adults to

promote bowel elimination?

Constipation is an issue that many older adults deal with on a regular basis. And this
chronic digestive discomfort can seriously affect your older adult’s life. It can cause them
want to eat or exercise and can make them cranky and uncooperative.  It could also cause
unwanted behavior in people with Alzheimer’s or dementia like taking off their incontinence
briefs at inappropriate times.

1. Avoid constipating foods like:

 White rice and other refined grains

 Unripe bananas
 Tea
 Cheese
 Chocolate

2. Regularly eat (and drink) foods like:

 Beans
 Whole grains, especially bran
 Vegetables
 Fresh and dried fruit
 Nuts
 High-fiber foods
 Water — softens stool and stimulates the bowel

If their doctor says that constipation is caused by a nerve or muscle problem, they may
recommend that your older adult eats less fiber and instead, use medication that adds
water to the colon to soften stool.

3. Exercise regularly and as vigorously as possible

Exercise and regular physical activity is great for overall health, so it’s no surprise
that it also helps regulate the digestive system.

4. Establish a regular bathroom time and also respond immediately to the urge to go
It’s a good idea to have a daily routine where your older adult at least “tries” to go at
the same time every day. But anytime they feel the urge, they should still go immediately.

5. Take a daily soluble fiber supplement

Add a soluble fiber supplement like Benefiber or Metamucil to beverages. Today’s
formulas are easier to take because they dissolve completely, aren’t gritty, and don’t thicken
beverages. They also come in flavorless options that can be added to any beverage.
 If their doctor says that constipation is caused by a nerve or muscle problem, they
may recommend that your older adult eats less fiber and instead, use medication that adds
water to the colon to soften stool.

6. Use laxatives properly

Long-term use of stimulant laxatives like Senokot or Dulcolax shouldn’t harm the
colon or cause dependence if they’re used in recommended amounts. Of course, it’s
essential for your older adult’s doctor to approve the laxative, recommend an appropriate
dose, and continue to monitor your older adult as long as they’re taking it.

2. What age-related changes affect bowel elimination?

As we age there are a number of things that just aren't what they used to be. In other
words, we can't or don't perform at age 70 like we did at age 30. One of those many things
that age tends to change is our digestive system. It has been estimated that 40 percent of
the elderly will have an age-related digestive problem each year. We don't have space to go
through all the things that change with age in the digestive system, but we will focus on
something that tends to go unmentioned in polite company your bowel habits.
Nevertheless, sometimes socially uncomfortable topics must be addressed. Constipation is
usually defined as less frequent bowel movements (two or fewer per week), straining at
time of defecation at least 25 percentage of the time, often incomplete evacuation
(meaning returning to complete the process in an hour or so), and a hard stool (Bristol Type
1 or 2).

This happens due to a number of factors related to age. These include: lack of muscle
tone in the bowel and abdominal muscles, slowed peristalsis (involuntary contraction of the
intestinal muscles), lack of exercise, immobility (sedentary life style or travel), inadequate
fluid intake, too many dairy products, lack of dietary fiber (fruits and vegetables), and many
medicines. Some of the medicines that predispose to constipation are calcium channel
blockers, narcotic pain meds, antacids containing calcium or aluminum, iron, anti-
depressants, and overuse and/or abrupt stoppage of laxatives. The home treatment of
constipation is to tend to any of the known causes, for example, if one is not staying
hydrated by drinking eight glasses of water a day, then do so. Eat foods rich in fiber
including the old stand-by prunes. Consume bread with whole grains and cereals. Eat dairy
products in moderation, and avoid fried fast foods. Exercise more than usual and even try
some sit-ups to improve abdominal muscle tone. Stool softeners may be used as
recommended. It is also normal as we age to have diarrhea from time to time - not because
of aging per se, but because we can eat foods that "disagree" with us, ingest some infected
food product, contract a "GI virus" or the intestinal flu, perform extensive exercise with
rampant fluid consumption, or due to food allergies.
 3. How will you promote rest and sleep in older adults?

Sleep is a vital mechanism, regardless of your age. It has the ability to restore energy
levels and heal both physical and cognitive damage. A regular sleeping pattern of 7.5-9hours
per night is recommended to help people function at their best. However, as we get older, a
number of factors combine and make this harder to achieve. The most notable change is a
decrease in the levels of melatonin- the hormone that our sleeping patterns- within our
bodies. Elderly people are most likely to be woken up by health complaints or minor
disturbances, and often have trouble falling asleep at the desired time.

Disrupted sleep often leads to older people spending longer in bed, or sleeping at intervals
throughout the day to catch up.

 Promoting an active and regular daily routine that includes both physical and social
activities
 Ensuring the bedroom is quiet, dark and cool (removing or restricting audible or
visual distractions)
 Optimising melatonin levels by getting adequate sunlight, using low wattage bulbs
(where safe) and switching off all non-backlit screens one hour before bed
 Sticking to a regular sleep schedule, waking and going to bed at the same times each
day
 Limiting use of stimulants (caffeine, sugar or alcohol
 Trying a soothing pre-bedtime routine, such as bathing or reading

Managing an elderly person’s sleeping pattern takes time and a certain level of expertise. By
ensuring a good and regular day time routine, an active lifestyle.