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LJCHR

My husband was diagnosed with dementia concerning Alzheimers August 2021.  I am his sole caretaker.  We have been married 13 years (I was a widow and he was a widower).  I have been reading every book I can get my hands on to try and educate myself to meet his needs.  I would say he is in early middle stage.  

In the last few months there have been hygiene issues - he has an iliostomy (he had stage 4 colon cancer 20 years ago).  He has become very sloppy with tending to his appliance and I have to remind him constantly to wash his hands. 

I need reassurance that I am doing the right thing by telling him to wash his hands with soap.  His senses have been affected; sight, hearing, smell so he doesn't realize when he needs tending.  

I don't want to demoralize him but I know he has to maintain his cleanliness for both of our sakes.

Any suggestions on how to approach this?  I thought about putting up a sign on his mirror "Wash Your Hands" but I don't want to embarrass him.

M1

Welcome to the forum, though sorry for the reasons that bring you here.  this is a tough one--but just like all medical issues that our loved ones have previously been able to handle but gradaully become unable to.  At some point, you will probably have to take over handling the ileostomy as well as washing his hands for him.  Signs will probably not help, or if they do, for a short period of time--you have to have an intact brain to recognize that the sign is giving you an instruction.  

I think I would put hand sanitizer and/or wipes all over the house, and use it with him.  There might be a way to make this a fond shared ritual--you rub his hands for him.  But the day will probably not be far behind that when you or a hired caregiver has to take over handling the ileostomy, period.  Very tough, and depending on his personality, may be hard to get him to buy into that he needs help with it.  

I wonder if a discussion with his gastroenterologist would help?  Just because they have probably dealt with other patients with cognitive impairment and may be able to give you some tips.  the ostomy nurse would likely be the best source, even more than the doc.  

Good luck....

Berryette

I am right there with you on this.  My husband has an ileostomy as well.  His hygiene is very poor.  I have to tell him to change his clothes.  I am the same as not wanting to embarass him- but finally I started saying- "you are getting ripe"- better change.  He thinks it's a joke, even tho it isn't.  I had not luck with getting him to brush his teeth and we ended up at the dentist Monday where all his teeth had to be pulled.  Now, to getting his gums healed.  I tried signs.  They didnt work.  As someone said- he just didnt realize that it was meant for him.  Looked right over it.  I will be watching your post for advice myself.  But I do want to tell you that I hope you dont take on all the pressure and guilt if/when you can not get him to do the things he really should.  I may not be saying this well- but after making myself sick from the stress of thinking I was failing when he didnt brush, didnt change, didnt wash, etc.  And oh the arguments that each time brought!!  I finally allowed myself to say- I am doing the best I can.  If anyone thinks they can do better- bring it on.  I asked DH to show me how to change his ostomy in case there was a time when he couldnt do it himself.  He said ok- but we still havent got that done.  If your husband will show you- that would be a good thing!  I am sorry you have to be here, but so thankful for this forum!

Ed1937

I'm so sorry anyone has to deal with this. When my wife became incontinent, it was a battle when I had to help her. I can't imagine what it would have been if I had to take care of the bag. If it gets too bad, you might possibly have to consider a SNF.

Iris L.

Berryette wrote:

   He thinks it's a joke, even tho it isn't.  

These PWDs have anosognosia.  They don't really understand what you're talking about.  You have to figure out a work-around to accomplish what you want.  They cannot show you what to do because they are losing their executive functioning abilities.

Iris L.

LJCHR

Thank you to all the responses.  I can already see that this discussion board is going to help me cope much better - getting responses from people in the same situation as me. I am just learning how to use the site,but appreciate all of the responses - they have truly helped me.

LJCHR

Thank you for your response.  I have to put my husband's clean clothes out for him - and sometimes he puts his dirty ones back on.  So far he is still showering, shaving and brushing his teeth.  I have had him show me how to change the appliance but have not done it so far.  Thanks again and good luck to you.  Sounds like we have very similar situations.