As a CDPAP caregiver, you’re responsible for assisting your loved one with daily living activities and providing care.
You’ll come across numerous situations as a caregiver, including diarrhea. While you likely understand diarrhea in children and adults, it’s a bit different for elderly patients.
Learn about diarrhea in the elderly, including the causes and symptoms. Then, find out what you can do as a caregiver to assist your loved one and when you should seek medical treatment.
First, let’s take a look at what diarrhea is and how it forms.
Understanding Diarrhea
Diarrhea is the term used to describe loose, watery stools that occur at least three times a day. It’s broken up into three categories, which are:
· Mild
· Moderate
· Severe
If you only have a few loose stools in one day, you have mild diarrhea. Moderate diarrhea occurs when you have more than three loose stools but less than 10 in one day. Then, severe diarrhea refers to more than 10 loose, watery stools in a single day.
Medical providers also classify diarrhea as acute or chronic. Acute diarrhea generally lasts one to two days, although it can go on for two weeks.
Chronic diarrhea is a more significant program and can last for four weeks or longer. If you suffer from chronic diarrhea, you might not have loose stools daily. Instead, the condition will come and go.
Loose, watery stools are formed in one of two ways. First, your intestine might move the stool through your bowels faster than normal. When this happens, the colon can’t reabsorb the water in the stool. That means you’ll expel the excess water when having a bowel movement, causing a loose and watery stool.
Second, you can form a loose stool if your bowel lining is inflamed. The inflammation causes additional fluid to mix with the stool. That, in turn, creates the watery stools associated with diarrhea.
Now that you have a basic understanding of the science behind diarrhea, let’s look at the symptoms.
Symptoms of Diarrhea in the Elderly
Elderly patients often experience numerous symptoms when suffering from diarrhea. These symptoms include:
· Cramping
· Abdominal pain
· Bloating
· Nausea
· Mucus in the stool
· Dehydration
· Urgent need to go to the bathroom
In some cases, people also experience fevers, chills, and bloody stools. These symptoms occur when the diarrhea is a result of an infection.
With that in mind, let’s look at infections and other causes of diarrhea in elderly patients.
Common Causes of Diarrhea in the Elderly
Understanding the cause of diarrhea is important for caregivers. Then, you can evaluate your loved one’s condition to see if it needs to run its course or requires medical intervention.
There are numerous causes. Let’s begin by looking at infections.
Infections
Many cases of diarrhea in the elderly are caused by infections. Infections are divided into three categories, which are:
· Viral infections
· Bacterial infections
· Parasitic infections
While a number of viruses can cause diarrhea, the most common include:
· Norwalk virus
· Viral hepatitis
· Cytomegalovirus
· Viral gastroenteritis
· COVID-19
When seniors eat or drink contaminated food or beverages, they can develop a bacterial infection that causes diarrhea. The most common forms of bacterial infections are:
· Campylobacter
· Escherichia coli
· Salmonella
· Shigella
While less common, your loved one can also develop a parasitic infection. This occurs when he or she eats or drinks food or beverages that contain parasites. The parasites make their home in the digestive tract, causing diarrhea.
Common parasitic infections include:
· Cryptosporidium enteritis
· Entamoeba histolytica
· Giardia lamblia
If your loved one has an infection, he or she might complain of the stomach flu. The symptoms are very similar.
Antibiotics and Other Medications
Your loved one could also have diarrhea due to medications. While different medications cause diarrhea, antibiotics are the biggest culprit.
Antibiotics cannot differentiate between good and bad bacteria, so the medication kills both. Killing good bacteria causes a system imbalance, leading to diarrhea.
Cancer drugs have also been known to cause bacteria. Also, magnesium and antacids can cause loose, frequent stools.
Food Intolerances
Food intolerances are also common in elderly people with diarrhea. This includes an intolerance to:
· Lactose
· Fructose
· Artificial sweeteners
If your loved one has diarrhea, check his or her diet. Make some changes to see if that alleviates the problem.
Digestive Disorders
Your loved one might have a digestive disorder that is causing loose stools. Numerous disorders can cause diarrhea, including:
· Crohn’s disease
· Ulcerative colitis
· Irritable bowel syndrome
· Celiac disease
· Microscopic colitis
Alcohol Consumption
Consuming alcohol is dangerous for the elderly population for numerous reasons. First, it can cause drowsiness and confusion while increasing the risk of falls. It can also interact with medications, making side effects worse.
Many people don’t realize this, but alcohol can also cause diarrhea. First, it can irritate the digestive tract, leading to diarrhea. Also, it prevents the colon from reabsorbing water in digested food. That means the water remains in the stool and is expelled during bowel movements.
On the other side, alcohol is also known to cause constipation. Drinking leads to dehydration, making it harder to pass stools.
Malabsorption
While not as common, malabsorption can also cause diarrhea in the elderly. Children with this condition are more prone to diarrhea. However, some elderly patients experience diarrhea as a side effect of malabsorption.
Partial Bowel Obstructions
While anyone can develop a bowel obstruction, seniors are in the high-risk group. Risk factors include tumors in the digestive system and previous pelvic and abdominal surgeries. By the time people reach their 70s and 80s, many have at least one of these risk factors.
If your loved one has a complete bowel obstruction, he or she will be constipated. However, a partial bowel obstruction can cause diarrhea. It’s often accompanied by bloating, vomiting, and extreme pain.
Nausea and vomiting with a bowel obstruction can be so severe that your loved one might not be able to keep anything down. Also, the pain is significant enough to make sleeping almost impossible.
Helping an Elderly Person With Diarrhea
Providing the proper care for a loved one with diarrhea is critical. Let’s go over some strategies to reduce symptoms and prevent additional issues.
Replace Lost Fluids and Nutrients
Diarrhea causes people to lose fluids and nutrients. As a caregiver, you need to help your loved one replace what’s been lost.
While some caregivers provide water, that’s not enough to replenish the system. Instead, you need to provide clean water, electrolytes, salt, and sugar.
Begin with clean water and then add electrolytes such as magnesium, potassium, calcium, and sodium.
You also need to include some sugar and salt. Salt prevents the body from expelling as much fluid. Then, sugar makes it easier for your body to absorb the salt.
If you don’t want to make a solution, you can buy one. Choose something with electrolytes, such as Pedialyte. This will help your loved one get the fluids needed to prevent dehydration.
Best Foods to Serve
Many elderly patients stop eating when they have diarrhea. However, this can cause their health to get worse. Thus, feed your loved one bland, easy-to-digest foods to soothe the digestive tract and replenish nutrients.
First, you can start with a BRAT diet. BRAT stands for:
· Bananas
· Rice
· Applesauce
· Toast
Each food is easy to digest and will help your loved one get nutrients. Also, the foods reduce stool production, which helps with diarrhea.
Your loved one will probably tire of a diet that only contains four foods, so you can add some other things as well. Slowly ease in foods like skinless baked chicken and chicken soup. You can also serve peeled boiled potatoes.
Remember to add new foods slowly and watch to see what your family member can tolerate. Also, your loved one should eat slowly to prevent overwhelming the digestive tract.
Foods to Avoid
While providing food is important, you do need to be careful what you give your loved one to eat. Some foods will upset your loved one’s digestive tract, making diarrhea and associated symptoms even worse.
First, be wary of high-fiber foods if your loved one is experiencing bloating. While fiber is an important part of the diet for all ages, it can increase bloating. This can cause your loved one to feel even more uncomfortable.
Spicy foods are also a poor choice for people suffering from diarrhea. These foods contain capsaicin, which irritates the digestive tract. That, in turn, can cause your loved one to feel worse than before the meal.
Foods that contain artificial sweeteners aren’t well tolerated when people have diarrhea. Remove them from the diet and slowly add them back in after your loved one feels better. However, if the sweeteners were the cause of diarrhea, leave them out permanently.
Also, restrict caffeinated beverages when your loved one is suffering from diarrhea. Caffeine can stimulate the digestive system, causing people to go to the bathroom more often.
Finally, your loved one should not drink any alcohol while dealing with diarrhea. It is often the cause of diarrhea and will make the problem worse.
Use Probiotics to Reduce Symptoms
If your loved one has diarrhea due to antibiotic use, probiotics can help. Probiotics rebalance the bacteria in the digestive system. They can reduce the symptoms and severity of diarrhea.
You can choose from foods and supplements that contain probiotics. If you decide to give your loved one a supplement, consult with the doctor first. You don’t want to administer any pills without the doctor’s approval. This is always true, but it’s especially important when your loved one is ill.
Keep the Rectal Area Clean
Runny stools can burn the skin, causing discomfort with each bowel movement. As a caregiver, you can limit discomfort by cleaning the rectal area after each trip to the bathroom.
You can clean the area with wet wipes or warm water and a washcloth. After cleaning, give the skin time to dry before pulling up the pants. Wet skin can rub and get irritated, which can cause an infection.
Treat Sensitive Skin
Irritated skin is common with diarrhea, even if you keep the rectal area clean. If your loved one has irritated skin, soothe it by applying a diaper rash cream. A cream can provide instant relief and help the area heal.
Use Diapers As Needed
Getting to the bathroom in time can be difficult for elderly patients with diarrhea. If this is an issue, consider using adult diapers.
Your loved one can still attempt to use the toilet. However, if he or she doesn’t make it, the mess will go in the diaper instead of on clothes and the floor.
If you use diapers, make sure to change them after every use. Your loved one may be able to handle this task. However, be available to provide help if needed.
While adult diapers are a good solution, your family member might be resistant at first. Many seniors view diapers as embarrassing and a sign that they’re losing independence. Thus, you might need to have a discussion with your loved one beforehand.
Explain that this is a temporary solution to a short-term problem. Assure your loved one that once the diarrhea is gone, the diapers will be a thing of the past.
Maintain a Germ-free Environment
Make sure that you maintain a germ-free environment when dealing with diarrhea. Wash your hands with soap and hot water throughout the day, including after changing diapers or assisting your loved one in the restroom.
Also, keep the home clean and use disinfectant wipes on surfaces. Your loved one could transfer germs and bacteria to surfaces in the house. By keeping your hands and surfaces clean, you will prevent the spread of viruses or infections and also help your loved one recover.
While diarrhea often goes away on its own, your loved one might need to seek medical help. Find out when it’s time to take your family member to the doctor.
When to Get Professional Help for Diarrhea
When working as a caregiver, it’s important to look for signs that you need to take your loved one to the doctor to treat diarrhea. Always err on the side of caution when it comes to seeking medical treatment. If your loved one doesn’t need medical help, the worst that will happen is he or she will get sent home with a clean bill of health. However, if he or she does need assistance, going to the doctor could be lifesaving.
First, you need to schedule an appointment if your loved one has severe diarrhea. Let’s take a closer look at that and then the other signs that indicate a trip to a physician is in order.
Severe Diarrhea
If your loved one has had 10 or more loose stools within 24 hours, go to the doctor immediately. This is referred to as severe diarrhea and can lead to issues such as:
· Dehydration
· Electrolyte imbalance
· Kidney failure
· Organ damage
The doctor needs to diagnose and treat the cause of diarrhea and provide fluids. Quick medical intervention can prevent your loved one from experiencing serious complications.
Dehydration
You also need to take your family member to the doctor if he or she is dehydrated. Common symptoms of dehydration include:
· Little to no urine production
· Dark urine
· Weakness
· Dizziness
· Fatigue
· Confusion
· Trouble speaking
· Dry mouth and skin
Your loved one needs fluids immediately, so don’t hesitate before calling the doctor.
Diarrhea That Lasts Longer Than One Day
Younger people don’t need to go to the doctor until they have diarrhea for two days. However, elderly people should seek medical attention for diarrhea that lasts longer than a day. Your loved one could be experiencing a drug reaction, infection, or another problem that needs medical intervention.
Blood in the Stool
When you serve as a caregiver, you should check the stool when the patient has diarrhea. If you notice any blood, contact the doctor to schedule an appointment.
Often, blood in the stool is caused by hemorrhoids or skin tears around the rectum. However, it can also be a sign of a serious medical condition, including colon cancer. A doctor can run tests to diagnose the cause of the blood and then provide treatment options.
Antibiotic Usage
Many people develop diarrhea after taking antibiotics. The problem usually resolves itself after the bacteria in the digestive tract rebalances.
However, people experience an increased risk of developing a clostridium difficile infection when taking or after stopping antibiotics. In fact, the risk for developing the condition increases by as much as 10 percent with antibiotic use, according to the CDC.
If your loved one was recently on antibiotics and now has diarrhea, talk to a doctor. The physician will likely want to see if your family member has a clostridium difficile infection.
Severe Pain and Fever
If your loved one complains of severe stomach or abdominal pain, is vomiting, and has a fever that’s higher than 100.3 degrees, it’s time to go to the doctor. Your loved one might have an infection or another medical condition that requires immediate attention.
Caring for a loved one with diarrhea creates some challenges. However, understanding the cause and knowing how to help will allow you to navigate the process. Keep this guide handy, so you can refer to it if your family member develops diarrhea.