My child is mentally challenged and always had a problem with constipation to the point of impaction on several occasions. It was eventually resolved while in a nursing home. Now that he is at home, the meds, colace and dulcolax?, aren't working. I hate to do it, but I think I may need to resort to giving him an enema. This was always traumatic for him, but I don't know what else to do. I can't let this go on it only gets worse. What is the best enema to give and how do I do this now that he's an adult?
One of the biggest causes of conspitation in the mentally impaired or elderly is dehydration. They may not realize or remember to drink constantly. The feces gets stuck because there is not enough lubrication so it makes it difficult to pass the stool. Encourage him to drink a glass of water or juice at least every hour. Avoid drinks with caffeine. Grapes, raisins, prunes, flax and bran are great to add to a diet to help promote regular, soft bowel movements.
To rid the bowel movement that may be lodged inside, it is much less invasive to give a suppository (instead of an enema). This is a small pill that you insert in the anus (make SURE you lubricate your fingers and that you are gloved). The enema is more invasive and causes more discomfort. As a personal support worker in a nursing home, we always try to give suppositories before an enema.
I really don't think there is a particular enema I would recommend, they are pretty much all the same. Same goes for suppositories.
I definetely recommend increasing his fluid intake, and try hard to give flax and bran with cereal. You can even bake all sorts of goods (cookies, muffins, bread) with flax seed and bran. Best wishes!