You can't watch television for more than 5 minutes these days without hearing a commercial for something to cure your "irregularity." No wonder our elderlies are fixated on the issue. As a group they watch more television than anyone. As a group the ones we care for also have more time to think about their aches and pains, too, which doesn't help.

While just about everyone has felt constipated now and again, it is a real documented problem for as many as 35% of people over the age of 65. Some sources say that as many as 75% of patients in hospitals and nursing homes use laxatives regularly.

Ask many of our seniors how often they should have a bowel movement and almost to a man they will say "every day." This is the myth that leads many to believe they are constipated when, in fact, they aren't. It is perfectly normal to visit the bathroom anywhere from two or three times a day to every second or third day. If your senior's pattern is regular for him or her, even when he or she can't "go" for a day or so there is probably no real cause for concern.

If things regularly stretch much more than three days, or if your elder has symptoms such as pain or cramps, unusual gas, bloating, loss of runny stool, vomiting or unusual loss of appetite it could be cause for concern and should be checked by a medical professional.

Why do our seniors tend to feel constipated more often than younger people?

• They tend to get little exercise. Movement on the outside can get things moving along on the inside, too. Less than 30 minutes of movement a day can increase constipation;

• They don't drink enough fluid (6 to 8 glasses a day is recommended). Water is needed to keep moisture in the colon so things move along smoothly and don't harden;

• Their diet tends to be low in fiber. Many of our seniors eat easy-to-prepare microwave meals, which are almost all low in fiber. If they are choosing soft foods because of dental or denture discomfort, these foods are also more often than not low fiber. Fiber helps retain the moisture that our bowels need to work effectively;

• They take medications that can cause constipation: antihistamines, some high blood pressure medications, diuretics, antidepressants, some cardiac medications, antacids with calcium or aluminum, and many pain medications can cause constipation;

• They have a medical condition that can contribute to constipation such as Parkinson's Disease or Parkinsonism, under- or over-active thyroid, stroke, scleroderma, diabetes or colon cancer, among many;

• They have become dependent on laxatives, which often causes  "rebound" constipation. 

What to Do About Senior Constipation

Before turning to laxatives or enemas, which are often our seniors' immediate treatment of choice, most medical experts believe that diet and exercise changes will usually be the biggest help. Check with your parent's doctor before making any changes, just to be sure. Then, with the doctor's approval try:

• Increase the amount and selection of high-fiber foods. The old tried-and-true whole grains, nuts, fresh or dried fruits, and raw or cooked vegetables are the gold standard. If you can't get your elder to eat these, try adding high fiber bran flakes, cooked in or sprinkled over just about anything. Proceed cautiously with adding high fiber foods. If the body is not accustomed to fiber it can cause uncomfortable gas and bloating.

• For many people cheese, dairy products, eggs and foods high in sugar can be constipating. Try to reduce the amount of cheese, beef, and other rich high-fat foods.

• Increase fluids. 24 ounces a day of liquid is recommended. Soup, sherbets, gelatins, frozen juice bars and popsicles also all contribute fluid, so it doesn't have to be just liquid in a glass. Remember that milk and milk products can be constipating, and coffee, tea and other drinks with caffeine can dehydrate.

• Try to get your senior moving (often easier said than done, but give it a shot).

• As best you can, make sure your senior has time to use the bathroom without feeling rushed at his or her usual optimal time. Simply feeling rushed can lead to shut-down.

When Should You Turn to Laxatives?

If dietary changes, increasing the amount of fluid and getting some exercise aren't helping enough, then your doctor might recommend starting with a mild laxative. Don't turn to laxatives without consulting with the doctor, because you want to rule out any potentially serious medical issue.

Your doctor will probably recommend that you start with a natural fiber laxative. Psyllium, which Metamucil contains, is a natural fiber laxative. Start with the smallest dose your doctor recommends and do not increase it beyond the maximum the doctor recommends. More is not always better.

For anyone who does not have renal failure Milk of Magnesia is often effective.

Mineral oil, which our parents and grandparents often used to use, is not recommended today. Mineral oil can interfere with the body's absorption of certain vitamins, and it can reduce the effectiveness of certain medications including blood thinners. It can also cause a nasty pneumonia if it is accidentally inhaled (how one would do that I don't know, but the warning is there).

Unless directed to them by a doctor, do your best to help your parent avoid the siren call of "stimulant" laxatives that cause the intestinal muscles to contract. These medications, which are not always as "gentle" as advertised, can cause serious cramping and vomiting. They can also cause dehydration, which is the last thing your senior needs. These laxatives can also create chronic dependence, which might ultimately only make things worse.

Remember that if your parent complains of a sudden change in bowel habits, blood in the stool, stomach pains or a sudden loss of weight without trying, see the doctor. Otherwise, try to convince him or her to try increasing fluids, eating more fiber, and getting more exercise. These changes won't offer the instant "cure" or the nice visit with the doctor that many seniors crave, but they are a much better place to start than laxatives.