Help, Personal Hygiene with my LO is becoming a battle!
Hi,
I am running into a phase where it has become a battle to have my mother with Alzheimers take care of herself in the hygiene department. It is a battle to get her to shower and change clothes. She gets very angry and then upset. She will go days wearing the same clothes. She has moved past wanting to brush her hair and teeth. My struggle is I live out of town and my father is her primary caregiver. He is tired of fighting about it so he just lets her do what she wants.
Any suggestions, ideas or support that anyone has found to help would be greatly appreciated!
Comments
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Tarad-
Hi! and welcome. I am sorry for your reason to be here but glad you found our little clubhouse.
I am amazed no one else has waded into this post. Hygiene refusal is very, very common among PWD at a certain stage and can be caused by a number of things related to dementia. It is so common, this site has an entire page devoted to bathing under it's solutions tab at the top of this page.
Bathing | Alzheimer's Association
Understanding her refusal might help your dad overcome this refusal. If it doesn't, he may need to find a work around strategy to keep her skin integrity maintained and give the rest a lick and a promise.
Sometimes PWD have anosognosia and are unable to perceive that they've had a cognitive shift-- in their minds they are same as they have always been. In this scenario, she may believe she has showered this morning as was her custom before dementia took over. For dad to tell her otherwise will likely feel like gaslighting and only serve to anger her. Ushering her into the shower first thing, if that was what she used to do, might work.
It's generally best to lead the PWD into the activity rather than ask. If dad prepped the shower/bath and took her into it, he might have better luck than asking.
Sometimes a PWD, finds the whole experience an assault to their senses, water is cold, the bath is too brightly lit, it's noisy. If you can repackage the experience as an indulgence, she might be more agreeable to it.
Sometimes it's the memory glitch in that the PWD is driving this. If she's unsure who your dad is at times, she may not relish the thought of some random guy trying to get her clothes off. Sometimes hiring a HHA for showers is useful in overcoming this.
Sometimes you need to do a work around. Taking her to a salon for a wash and styling might take care of shampooing. If this won't work, there are wet wipes that can be used in the place of a shower and dry or no-rinse shampoos to keep her hair from getting really bad. A mani/pedi can take care of nails unless you need to engage a podiatrist for this.
Another thought is that is mom will not submit to dad's caregiving attempts, she may get better care in a facility. My dad was very resistant to mom's efforts at home. He resisted hygiene, wore the same food-encrusted clothing for a week or more (mom something spilled drinks on him to get him to change), refused meds and fought her around eating and hydration. This was part of why we placed him. At MC, he recognized the staff as professionals and submitted to their care which was easier all around.
HB0 -
HB has a lot of good suggestions. My FIL he has two major agitation triggers, being cold and being naked. We only shower my FIL once a week, and it takes my husband and I to do it. The rest of the week is sponge baths in the bed before he gets up - two days head to toe and the rest of the days it is hygiene areas, hands and face. He wears nightshirts/gowns because they are easy to slip on when we are done cleaning him and changing his diaper.
We do have to medicate him to do any of this, because he hates his diaper and clothes getting changed. As HB said, he is a lot more cooperative with a home health caregiver/CNA doing these things than us (family). Some people have suggested just letting them wear the same clothes a few days, but my FIL is incontinent and requires at least one change, sometimes two.
I don’t have any suggestions with teeth as my FIL does not mind this so far.
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Hello,
I understand the dilemma which some say may be related to ALZ while others say it's common in old age. Regardless of the cause the effect was/is troublesome to me. My mom wears the same clothes for weeks and makes excuses when it's shower time.
I brought up the issue to her PCP, visiting nurses, elder service agencies and anyone who would listen and was told it is common in older adults for many reasons (fear, uncertainty...) and not to force the issue. Essentially, I was told that wash ups are sufficient while you work through how to persuade her to shower more frequently (set schedules, ensure the environment has bath mats, use hand held shower head, tub bench, safety bars, favorite scents, don't leave her alone...) make it soothing like a spa experience. It took months for mom to allow me to help with bathing, and I had to learn not to ask or demand that she take a shower but inform (something like "it's shower time, I'm getting the bathroom ready do you want to pick out your change of clothes".
It's all trial and error for me. We had a weekly schedule and now we don't. So I change the bed, keep the environment clean and wait for her to come around. As long as there is no odor and there is occasional washup, brushing teeth...I learned to go with the flow.
*We're now in week 2 so I have to suggest again today...it's an ongoing thing.
Best wishes
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Hi Tarad;
I'm glad you posted this b/c I was wanting to ask the same thing. My father is refusing showers, shaving, changing clothes, changing briefs and get more and more violent (despite premedication) each time. He is in a SNF and I go down at least every monday to get him to shower with the staff assistance. I've tried barganing with him, i.e. last time he said if we went to the park first he would shower when we got back. So I wheeled him to the park and we got back and he adimantly refused and pitched a fit and wanted to go back to bed and he said we could change him and shave him in bed. So in bed he went and was litterally trying to swing at the NAs b/c we had to change his very bad smelly briefs and shorts. This is the first time I had ever seen him be so violent. It broke my heart. When we went to shave he would only let them shave him if I gave him a sandwich, which I did and then it lasted about 2 minutes before he told them to stop. I was asking his Psych NP for ideas and resources to help family members like myself and he said "you can google it" His answer blew my mind. Needless to say, I did and found this group. I am running out of ideas of how to get him to shower without agitation and refusal. If anyone has any ideas, I would love to hear them.
Hang in there with your loved one!
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Hope- welcome to the board too!
One thing that we do, we give medication one hour before we (caregiver and i because mornings are two-person) do anything. If my FIL is still kicking, swinging, and cussing, we stop and walk away and give it another 30 minutes. If he is still agitated we will add on a haldol or something and give it another hour. At that point (with the sedative) our goal is just to get his urine soaked clothes and diaper off! If we can wipe him down a little, sometimes that’s going to have to be enough for that day. We wrap a bed pad around him and let him stay in bed. When my DH gets home sometimes we can manage the rest of it.
Fortunately, we haven’t had many days where it gets that bad, but I do know that it has to be slow and steady and walking away sometimes so they can calm. I call it the “fight or flight” look in his eyes, we recognize it from the first “good morning” - it is way beyond ornery, it is like a cornered animal. We know that those days will take a few hours for him to calm enough to get close to do anything.
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My dw started the, not wanting to shower, I found that I would just ask each night are you gonna shower first? Sometimes she does and sometimes not. She is not incontinent yet, just a few accidents.Tarad good luck just keep trying every pwd is different.0
Commonly Used Abbreviations
DH = Dear Husband
DW= Dear Wife, Darling Wife
LO = Loved One
ES = Early Stage
EO = Early Onset
FTD = Frontotemporal Dementia
VD = Vascular Dementia
MC = Memory Care
AL = Assisted Living
POA = Power of Attorney
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