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LBD & Laxatives

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I'm looking for information about laxatives as well as feeding information for

my mom.

Mom, Louise, 86 yo, was dx w/LBD 7/2007, and has been bedbound and immobile

since 1/2008.  At this point she is consistently disoriented as to person,

place, and time, but still talks and has an occasional " notebook moment " . 

Meanwhile, we're so profoundly grateful for Seroquel which keeps her

hallucinations to a minimum and keeps them happy (last week she said she took a

cruise and today she thinks she's at a party).  The problem is her growing

constipation.

Her prescription meds are:

Coumadin 3 mg daily (history of A Fib)

Seroquel 25 mg @ 9AM

Seroquel 62.5 mg @ 3PM

Seroquel 100 mg @ 9PM

Laxatives:

Lactulose 30cc daily

Glycolax 17 Gms daily

Senna S 4 tabs @ 9AM and 4 tabs @ 9PM  (these are the senna with the

Docusate        sodium)

Applesauce w/pureed prunes daily

She truly loathes milk of magnesia, but once in a while I give it to her

anyway.  All this to only go once a week, but the last two weeks all this has

not worked and she has required Dulcolax suppositories and/or enemas.

Any suggestions will be considered.

Regarding feeding issues:  since her GI tract is slowed should we change her

meal plans?  At this point she's been eating a " mechanical soft " diet, but

within that, she enjoys a very wide variety of foods. 

Mom has had a few minor incidents of choking, but (so far) no aspiration

issues.  Still, which method is safest for liquids at this point?  Straws? 

Sippy cups?  Regular cups?

We have hospice helping us here at home and they have been wonderful, but they

tend to be nonjudgmental when I would like more specific directions.  Do any of

you have experience with these issues at this stage of LBD? 

You all have taught me so much along the way here.  Thank you for your help,

Sheila

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