Need Advice on how to handle not wanting to bathe or change

Tluton

My father is in late stages of dementia. His demeanor has changed so much. Issues arise now that he doesn't want to bathe at all and gets very agitated. It's now been a month since he has bathed but has had a kind of sponge bath. Today he had an "accident" and refused to be changed. When this happens most times it becomes a mess. Any on else had these problems and how did you handle. I know deep down he might not be able to stay at home much longer. My step mom is is care giver and it is weighing her down and she doesn't get alot of sleep.

May flowers

My FIL hates being bathed and changed. Was to the point of hitting and cussing at us every morning and evening. For us, medication was the key (and it is a trial and error which med works best for each LO). 

Placement is another option, but if it were me, I’d work with a geri psych doctor first to see if the agitation can be managed medically.

harshedbuzz

Tluton-

Hi and welcome to the best space nobody wants to join. I'm glad you found us.

This is a difficult, but all too common, dementia behavior. How common? Common enough that there's a dedicated selection on bathing in the "Solutions" tab at the top of this page.

Bathing | Alzheimer's Association

Teepa Snow (you tube sensation) has some excellent videos on the topic as well. Some folks find working the shower into what was previously their custom- on waking up, before bed, after breakfast- as some PWD time-travel to periods when they were employed and had more structure to the day. We could usually get dad to shower ahead of a doctor appointment or sometimes dinner out. A few times she allowed/helped him to spill things on himself which made him cold and uncomfortable after which he'd agree to fresh clothes at least. Dad hated being cold. 

Fair warning. Depending on your LO's personality, the dynamic of the relationship and phase of the moon even these expert tips might not ensure success. 

Resistance to care is a deal-breaker for many families. It might be better to hire in a HHA to take over this after establishing a relationship. If that doesn't work, sometimes placement is the better option if the PWD is care-resistant around this he may not be eating, hydrating or taking meds as prescribed for her. If she's older, isolated and/or has her own health issues it may be time to look at a MCF. We found dad got much better care once placed as he respected the staff as medical professionals and allowed them to do what needed to be done freeing mom up to enjoy their visits as husband/wife and not adversaries. 

HB

ButterflyWings

Hi Tluton - You got some great advice here. And I just tried to do a 'search' here to share my post on the same topic a few years back...did not find it yet but there were pages and pages of threads about not bathing or showering that could have been written by you or me (!) 

So, as the others said, this is a very common problem. I wish I could share "what worked for us" but it is sadly one area where I had to just relax my standards significantly and go for good enough. DH still does not bathe or shower. Nope. We keep him clean and smelling fresh through sponge baths and that's it. Skin condition is great and he is not getting UTIs or other issues that could be related to poor hygiene. So, the biggest change was an attitude adjustment for me, regarding how to get him clean. 

Showers and for sure a bath...for this PWD anyway...no longer a good thing. The last attempt took hours and almost injured both of us. Not wise on my part to keep trying. I hate the saying 'there's more than one way to skin a cat' (where did that come from anyway?) but you get my drift. The standard of showers and baths is not necessarily the only way to be acceptably clean. And if it causes major upheaval and distress (his and mine)...then why insist? I sought advice and found other ways to accomplish the same thing. He and I are both much happier. One less battle to deal with. With his meds that were needed for major agitation and wandering, I am able to get him to tolerate me changing his wet incontinence briefs several times a day. 

So far, urinary incontinence is all I have to worry about. Will have to see what happens when bowel incontinence starts. I am not looking forward to it, having dealt with a couple of stomach upsets in the last 6-7 months that were messy, smelly, and just not easy to deal with while also trying to keep him from falling or spreading stuff everywhere as he resisted my help. I do hope you can figure out a workaround soon for what's happening right now. So sorry for what you and your LO are going through.

*Adding this old thread. Has lots of great tips I had not seen! Good luck to you.

 https://www.alzconnected.org/discussion.aspx?tid=2147561202&g=posts&t=2147503091

Rescue mom

I’m with Butterfly in that many of our LOs can go longer than we think without baths, and/or  with wipe-downs.  

Also, there are personal cleansers that work on body and hair, and do not have to be rinsed off—which can often help. You just wipe it off. Or you can rinse if you want, but not needed. Just may make things easier.

With fecal incontinence, shaving cream is a good, quick cleanser. Most of those do need rinsing.

I also found that an “outsider” or trained home health aide, often gets better results. You can usually hire them with this as the priority.

brodiegirl

In the last 2 months, I have started my mother on Doterra oils to help with her mood swings, calming, depression and her overall quality of life.  They have truly been amazing!!! However, any thoughts on how to get my LO to get up out of the bed??  Suggestions????

NuttyProfessor

Has anyone here tried installing a bidet toilet seat?  My mom has been using one for years, so she's familiar with this and lets me help her use it when she goes to the toilet.  It feels refreshing and does a good job cleaning.   That way she's not too gamey when she goes a week without showering.  If your LO hasn't used one of these before, you'll want to get a high quality one (Toto) that lets you warm the water to a comfortable temperature, and use a low pressure stream at first.

I also have my mom using D-mannose instead of sugar with her coffee in the morning.  It supposedly helps prevent UTIs, and it's certainly been working well for us.

​fesk

Tluton, everyone has given good advice. I'd try the behavioral management approach and, if there are still issues, consult with a geriatric psychiatrist. 

brodiegirl - which essential oils have you found to be helpful?

NuttyProfessor - a urologist my mom went to also recommended D-mannose.

QuincyLF

Tluton - i could have written your post verbatim.  i am in the exact same boat!  dad is in stage 6-7, mom is caregiver and at her breaking point.  dealing with this the past 4 years has taken it's toll.  we interviewed a caregiving service this week - and hope to have someone placed 5 hours a day (8am-1pm) 2 days a week to start.  we were very specific with his bathing and incontinence issues (and refusing to change when he soils).  i mean it's a battle.  it takes 2 to hold him down and remove his soiled clothes.  once they are off - he is okay with  mom cleaning him thoroughly - but only with towels & wipes.  he refuses to step foot into a shower or tub.  we also have him on meds (lexapro, galantamine and namenda).  we tried donepizil for a few years and that made him more agitated.  galantamine seems to work better for him.  best of luck to you and your step-mom on this journey.  i will follow this topic to see if anyone has a miracle cure!