My elderly mom who lives with us suddenl

This is a "get her seen today" level, not a "watch it for two days" level — so call her doctor's nurse line at 08:30 tomorrow morning, and tonight the thing that matters is not how many times she goes, it is whether she stays sharp and keeps passing urine.

But check these five things first, right now — if any one of them is true, do not wait for 08:30: call your local emergency number now. (I can't give you the digits for her country from memory; tell me where you are and I'll bring up the right one.)

• She is confused, muddled, unusually drowsy, or drifting in and out — not her normal self.
• She has passed almost no urine, or hasn't passed any since this started.
• Hands and feet are cold, skin pale or blotchy/mottled, or she faints or nearly faints when standing up.
• She cannot keep any drink down, or refuses fluids entirely.
• Blood, black tarry stool, or mucus, or severe belly pain, or a swollen or hard belly.

Why an elder's diarrhoea is worth more attention than a three-day bug in someone else

1. At her age, dehydration shows up as confusion before it shows up as thirst. The clinical material is blunt about it: reduced drinking and passing little urine over a day or two, with drowsiness or confusion, is an emergency in an older adult, not a home-observation plan.
2. Infection in an older adult often arrives without a fever. "No fever" is genuinely not reassurance here. Confusion or just "not right today" can be the first sign of something serious.
3. A new bowel symptom can also be a medicine effect. Diarrhoea is on the list of common side effects in older adults, and she takes more medicines than most people her age. A sudden change like this is a reason to have someone review the whole list — not something to work out at home.

Tonight, about 20 minutes of work

• Oral rehydration salts: this is the main thing. Use the sachets you already have, mixed exactly as the packet says, with clean cool water. Small sips, spaced out, only what she can keep down — do not hand her a full glass and do not push if she feels sick. I am not giving you a millilitre count on purpose: the packet is the right source for that, and the goal is simply "it stays down."
• If she is drowsy or confused, give nothing by mouth at all, not water, not food, not tablets. That's the one hard rule tonight.
• Keep her eating what she already eats. Rice, congee, bananas — all fine, all already in the kitchen. Small and often beats three big meals. If she only wants fluids for a while, that's fine too; the goal is not an empty stomach.
• Start a one-line log on the fridge or your phone. Time, what came out (watery / formed / any blood or colour), what she drank, and when she last passed urine. This log is the single most useful thing you can hand the nurse in the morning.
• Pads and hygiene. Gloves on for each change, hands washed with soap straight after, and a bleach wipe over the toilet seat, flush handle and bathroom door handle. Give her her own cup and her own plate; the kids don't eat from her bowl tonight, and nobody tastes her leftovers.
• Make her comfortable to go — a night-light on the way to the bathroom, a firm hand on the way up, and don't let her hurry. A fall in the middle of the night is how this turns serious.

1. What you already did vs. what I'd change

You gave her an anti-diarrhea pill without checking her other medicines. Here is the honest version: that medicine isn't hers, it wasn't prescribed to her for this, and no more of it is to be given — the same tablet is not something you keep giving on a long night. What you do with it now is paperwork, and it's important paperwork:

• Put the box on the table, not back in the drawer. Note the name on the label, the strength printed on the box, how many she had, and roughly what time — her own words, no arithmetic needed.
• Do not change any of her regular medicines — not one, not the timing, not a half dose. Anything that gets stopped or altered is a decision for the clinician who can see the whole list; stopping a drug can be as dangerous as continuing it.
• Say this to the nurse line as the first thing, not as an aside: what you gave, when, and what her full medicine list is.
• The same goes for anything else non-prescription in the house — anything bought over the counter, anything a friend or relative brought. Bring the containers, not the names from memory.

What was missing alongside it: the salt-and-sugar fluid, the log, and the nurse call. Those three do more overnight than the pill did.

2. Don't do

• No more anti-diarrhea pills, including leftover ones from last time, and nothing a neighbour or family member "knows works."
• No leftover antibiotics and nothing bought online — no new medicine of any kind tonight.
• Don't stop, halve, double or re-time any of her prescribed medicines because of this. Write the question down; hand the list to the clinician.
• Don't make your own sugar-and-salt solution, and don't substitute juice, soft drinks or sports drinks for the rehydration salts. Use the packet as it comes.
• Don't give anything by mouth if she's drowsy or confused — including her usual tablets. That's a choking risk, and it's the rule I'd hold hardest tonight.
• Don't wait for a fever before treating this seriously, and don't accept "it's just her age" for a new change in her alertness.
• Don't let her clean up after herself or hurry to the bathroom alone tonight.

3. Red flags — when to stop home care

Call your local emergency number now for any of the five checks at the top of this page, plus: she collapses, cannot be woken, is only gasping, has chest pain, severe belly pain, a swollen or rigid belly, or a rash that doesn't fade when you press it.

Same day, not tomorrow morning, if: blood or mucus appears in the stool; she develops a fever; she starts vomiting and can't keep fluids; the diarrhoea is still running heavily toward morning; she needs help getting up or walking; or she simply is "not herself" by morning even without any of the above. At her age, that last one counts on its own.

Call the nurse line tomorrow and ask for a same-day appointment even if the night is quiet — sudden, explosive, three-plus stools in someone her age with this medicine list deserves a look and probably a stool test, not a phone reassurance.

The morning plan, and the school run

• 08:30: call the nurse line. Have ready: her age, when it started, the number of stools, the last urine, the log, the anti-diarrhea box, and her full medicine list. Ask four questions: *does she need to be seen today, does she needs a stool test or a drip, what must we not give her at home, and which of her medicines should be reviewed.*
• Say the first line like this: "She's [age], she suddenly had three very loose stools starting [time], she's [alert/confused], she last passed urine at [time], and I gave her [name from the box] before checking her other medicines."
• Thursday 15:15 pickup: decide tonight who takes her if the nurse says she must be seen — that call will be a doctor visit, not a quick errand. If the appointment overlaps pickup, hand the school a one-liner in the morning: "My grandmother is unwell and I may be at a medical appointment at pickup; [name] is collecting today and I've told them what to tell you." One name, one sentence, no medical detail owed to the school.

Bring / have ready for the appointment

• Her baseline: what she's normally like — memory, walking, continence, how much help she needs — and exactly what changed today. For an older adult this is the most useful thing you can say.
• The log (times, stool, drinks, urine), and the anti-diarrhea box with everything in it.
• Every medicine in its actual container, including the over-the-counter ones and anything from another doctor.
• Whether she's had antibiotics in the last couple of weeks, any sick contacts, travel, or undercooked food — these change what the doctor checks for.
• Heart, kidney, liver, diabetes, memory problems, and any blood thinners.

What "success" looks like in the next 24 hours

1. ✅ The five-item check done once now, and the emergency rule understood rather than hoped about.
2. ✅ She has had small sips of properly mixed rehydration salts and kept some down.
3. ✅ The fridge log exists: stools, drinks, urine, times.
4. ✅ The anti-diarrhea box is out on the table, not back in the drawer.
5. ✅ No prescribed medicine was changed, and no new medicine was added.
6. ✅ 08:30 nurse line called, and the answer was "come in" or "here's what to watch" — not silence.
7. ✅ The 15:15 pickup has a named backup person.
8. ✅ Someone in the house knows the five red flags and would not wait for 08:30.

I can't promise this settles tonight, and I'd be wrong if I did. What I can promise you is that the things that actually change the outcome here are all free and all available to you this evening: fluids that stay down, a written record, a clinician with the whole medicine list, and a household that knows when to stop waiting.

I put the whole thing on a one-page sheet for the fridge and the appointment:

elder-diarrhoea-visit-note-3104fdf4.pdf

*Based on the family-triage guidance for older adults and for vomiting and diarrhoea: what families may do at home, what must never be done at home, and the red flags that mean emergency care. No diagnosis, no dosing, no medicine changes — those are the clinician's calls.*

One question, and it changes what I can hand you: which country and city are you in? Then I can bring up the correct emergency number, and tell you whether your service sends an ambulance or expects you to get to an emergency department yourself.