could it be as follows;

He has a BM. he forgets, therefore he hasnt had one, therefore he is
constipated?

For some reason, folks that age seem to think that they *have* to
have regular movements, regardless of what they've eaten!  One
time after my mother had a several-day bout of intestinal flu
where she couldn't keep anything down for two days, she still
expected to have to crap even though there was no food in her
system!  Toileting habits become very ingrained, and folks born
in the 20s and 30s were brought up to believe that regularity was
very important.

Second, I think you may be right that it *feels* like he has to
go --- perhaps his horrible diet gives him gas, or perhaps
whatever is causing the dementia has also miswired the part of
the brain that makes him feel that he has to "go".

My mom would save food that was spoiled, eat it, get diarrhea,
take something that would stop the intestine cold, then eat stuff
like cheese with no fiber (salad, crackers, veg) with it, get
constipated, take a laxative & stool softener, have diarrhea...
like a bad bowel endless loop.  If she had just eaten a bowl of
oatmeal and good sized salad every day, everything would have
kept moving.

Hey Dave, I've got a sneaky thought. If you read the label on most
stool softening meds, it says to take it with water (no surprise, since
that is how they work - by causing the stool to absorb more water). Why
not ditch the stool softener, and tell some little white lies. Go get
some fiber capsules (you can get psyllium fiber capsules from any
pharmacy), and substitute them for the stool softeners, and then insist
he does "what the label says" and have a big glass of water with each
capsule.

If he asks why they look different than the previous brand, tell him
its a new kind of stool softener the doctor wants him to try, but he
has to take them exactly as prescribed!

You can also buy unsweetened psyllium fiber in big containers,  and
just sneakily add a spoonful here or there to whatever he eats - he'll
never notice, but that won't help with the water intake issue.

He likely doesn't remember having had a movement. He's not
"constipated" in terms of not going, but they may be hard, and this is
for sure related to lack of water and fiber (the fiber causes the stool
to hold more water and thus be softer). Softeners work by causing more
water to be absorbed into the bowel - but if there ain't enough fluid
in the first place, they ain't gonna work anyway.

You have to work on cooking up ways to get more fluids into him. Is
there a way to schedule drink breaks hourly? I dunno, buy some of those
no-cal flavoured waters, and insist on even half a cup an hour because
the doctor says so (I suggest those because they aren't fizzy, but they
are sweet, and might be more palatable)? Older people often don't feel
thirst properly. You know him better than anyone. Be creative. You
can't reason with someone with a dementia, irrespective of the type, so
use whatever weapons you can hone, and be single minded about it.

Mary
(Evil sneaks perfected between mother in law and three kids...hmmm, how
to get someone irrational to do what they need to do????)

Hi David,

My father has vascular dementia in its very earliest stages, but that is not
from strokes in his case, it is from clogged arteries.    He has a total
blockage in the artery supplying blood to the brain on the one side, and the
one on the other side is partially clogged so they put a stent in there to
give him some better blood flow.   So you can get vascular dementia without
having a stroke, all that has to happen is for the arteries to become
clogged with cholesterol.

The other issue about your dad imagining he is constipated may be coming
about because he forgets he has gone to the toilet already.   The sad truth
of the matter is that they forget that they forget.

As an analogy, I recall giving my mother in law a jar of nice face cream.
She would wash her face every night and put cream on it for all the years I
remembered her.   Well, that jar disappeared at a phenomenal rate, and
finally we figured out that she'd forget she'd already washed her face and
creamed it, and go back and do it again, and again, and again!

Needless to say, I then realized that we had to give her more help and
supervision when she was getting ready for bed at night.   She repeated many
different kinds of actions over and over, unable to retain the memory for
even one minute that she'd just done that before.

So I think your dad is forgetting that he went to the bathroom already that
day and thinks he is constipated when he is not.