On-going hygiene issues

Belle

My DH won't shower unless he had to go somewhere which is now once every week to ten days. I can try all the tricks I've read about setting up the bathroom or offering to help and it doesn't make a difference. He doesn't want to go out to eat, or shop, or for a drive so bribing him with those events doesn't help. He may change his clothes after 4 or 5 days if I insist but for the past week he has on the same clothing right down to his underwear. He is still continent, thank goodness.

I've been on his case for last two days and yesterday he slept all day and today he was going to shower but just laid down for a nap instead. It seems to be more apathy than not understanding how to shower. I'm not ready for 'in house' help quite yet since this is the only issue I have not resolved. So my question is what products do people like that helps someone just clean up outside of the shower?

Katielu

Belle,

there are adult wipes, some even have different frangrant smells, some for sensitive skin etc. just like soaps.

They work well and can be thrown away. Gentle wipes for the face can be used, the other, all over the body.

Most the time when I get them out, DH will get in the shower, but he has used them on occasion.

Kibbee

Shaving cream is a must have. I just glove up, rub a dab over the area that needs cleaning, and then wipe off with a damp microfiber cloth. Follow with lotion, since shaving cream may dry the skin a bit.

Sweetwater

There are no-rinse shampoos and body washes available that work quite well.

ButterflyWings

@Belle Welcome to the no-shower, no-bath club! I am a card-carrying member for several years now. DH is an "absolutely not, under no circumstances, no-go" on that front and we have used the sponge bath process exclusively with almost no issues once I shifted my brain to realize it is actually fine. He is clean, smells good (better than me most days since I spend more time cleaning and grooming him!), and no skin breakdown.

I focus mainly on the hot spots, and ensure he is gently cleaned every single toileting or change of incontinence briefs. The large, unscented adult wipes are our favorite, and these may have aloe. Provided by hospice so I don't know the OTC cost. I only use the no-rinse body wash or shaving cream, etc. when a real mess has been made. That is mainly because DH's skin is really sensitive.

I am changing him at least every 2-3 hours due to full incontinence both ways. The extra pad inserted into his pull-ups helps a lot with easy access and quick changes without having to take shoes off and feet out of pants legs, etc. Which can take hours lol! So I just change that pad, wipe him well (dabbing works too, so as not to overly irritate skin), and always use a moisture barrier cream or zinc ointment (like Desitin). That was the focus of a recent thread on what happens if your LO eats the butt cream 😏- so, as your LO is showing progression this is a reminder to lock up and really keep products like this out of your LO's reach. Another thing I learned the hard way is, never flush the wipes — even if they say you can. And if your DH is like mine, keep the wipes out of his reach too. Unless you like reaching in after them to avoid hundreds of dollars in plumbing repairs, fishing them out along with whatever else may have made it into the toilet. IJS

Try not to sweat it. Some have had luck with a CNA getting their LO to shower or bathe but my DH has remained pretty protective of his physical privacy and knows I'm his person - the strangers are not - even though my name (and often our relationship) escapes him.

You and your LO are in a VERY big club. If you Search this forum using Won't Shower or Bathe you will find lots of company. Hang in there.

ImMaggieMae

Do you do the sponge bath while your LO is sitting on the toilet, or in bed? I do cleanup on the toilet when changing his pull-ups or the pad inside of them. I wouldn’t know where to begin doing it in a bed, but I guess I will have to learn at some point. He will still do showers with me in the shower with him but it’s a very big ordeal getting through it. It usually takes close to an hour.

I do like the added pads as a way of often avoiding having to remove sweat pants and shoes. Getting feet through long pants without much help from him is such a pain. I love when warm weather comes and he wears shorts. His caregiver who comes for 4 hours 3 days a week can get a pair of pull-ups on him without removing his sweatpants. She starts by putting the pull-ups inside the pants and pulling half down through one leg, out and over one foot. Then she pulls the other half up inside the pants and the other half down through the other pants leg and up over the foot. I think. I’ve watched her do it but when I get to the second leg I somehow always end up with a tangled mess or something backward or inside out, and then my patience is gone. Has anyone else mastered this art?

charley0419

https://alzconnected.org/discussion/69097/on-going-hygiene-issues

I was wondering why not when he goes to sleep put all new clothes where old ones were and maybe he won’t realize.

Belle

@charley0419 He doesn't take off his dirty clothing to sleep either. So no opportunity to change out the options he has while he sleeps.

Thanks for the tips everyone. I will start looking for the bathing products that were mentioned. Maybe buying them and starting to use them will motivate him to cooperate (ha!).

ButterflyWings

https://alzconnected.org/discussion/comment/207983#Comment_207983

You made me laugh. We have both ended up in a tangled mess, more than once hahaha. It only gets goofy when nature starts taking its course before I can get the pull-up or pad on. Being sprinkled more than once (more than sprinkled!) actually made me switch to diapers for a time, but they don't stay in place well enough and he fiddles with the tabs and, well…that was way worse especially in the middle of the night. Wet DH, wet blanket, every layer of his clothes, etc.

So, once the CNA heard my frustration about ALL the laundry and multiple times waking up (2-3 times a night at one point!) to have to stand him up and wrestle him out of wet clothes, sponge him down and then re-dress him…she mentioned the pads (duh, why did we not get those sooner?!!! I did not know to ask aarghh). Anyway…

YES! If your LO is cooperative and has pretty good balance, it is easy to do the pull-ups change sitting or even standing, only removing one pants leg. I don't know how your aide does it, but my trick is while he's sitting, one fully clad leg goes into the pullup (even shoes on is OK). Leave the other pants leg off, and that whole other part of the pants needs to go through the same pull-up leg that you just put on your LO. Leave pants down, for now — the priority should be getting those pullups all the way up, in place and pad inside. (Avoiding the sprinkler risk I mentioned earlier 😁😅). Then once the pull-up is on, you can put the other pants leg on, and pull the pants up. I hope that makes sense. We perfected this when he was cold during winter changes and really did not want to be naked. So, at least one pants leg on at all times, was comforting and the ONLY way I could get him to let me undress him. We still play the game of I pull pants down and he pulls them right back up and often he has a death grip on the pull-up even though we've done this hundreds of times by now. I may sing, chit chat, hand him something to hold, anything to distract him and stop the tug of war if it gets too serious. Worst case I just rip the side seam of the tear off pull up, but that's only been a few times and was urgent to avoid getting poop everywhere! Hang in there. The things we never imagined, right?

As for sponge baths, I clean whatever skin I can see, almost any time. Hot spots every time he does #1 or #2. I may do his legs while he's standing and brushing teeth (sort of) or otherwise distracted. Arms and torso when I change his shirt after a meal, or hands and arms and feet while we are reclining watching a favorite oldies sitcom. Wipe down, lotion up, keep it moving. Yes, mind numbingly redundant if you think about it (I don't any more except to feel accomplished when we get this kind of basic, necessary care done without too much stress.) And omg yes, it takes forever doesn't it? You/we all deserve a medal even though it is the right thing to do — it feels like life is going in slow mo, most days. Other times it feels like it is speeding by and I am totally behind on all the laundry, basic housekeeping (let's not even discuss that for now lolol. It is on hold here.)

There must be a video tutorial on how to help a PWD LO changed quickly after toileting without them feeling rushed or threatened. I'll look and if so will post it.

ImMaggieMae

@ButterflyWings thank you, thank you, thank you! Your instructions were perfectly clear, but the first dozen times I read it I just kept imagining half of the pull-ups on the outside of one leg and the other half on the inside with the crotch mixed up somewhere on top of everything. I was seriously starting to question my executive function. Lol! I had to go in the bathroom and try putting them on myself. Simple as pie, while reading your instructions. And it alleviates the tugging and stretching of the method my aide uses. Your method is brilliant!

I had to laugh at your comment about your husband’s death grip on pants, trying to pull them up while you pull down. Whenever I doubt his strength, I just think back to that. If I can’t distract him I just walk outside the bathroom door and within a minute or two he starts to get up to follow me and I rush in and grab the forgotten pants.

Do you do pull-ups changes in bed as well? We use pads inside the pull-up both night and day and he can get through the night without changing anything. He does get up early in the morning for me to change him and then goes back to bed for another hour or more. I was hesitant about keeping the same pad on all night, but they do a really good job of wicking the moisture away from sensitive parts. We haven’t yet had bowel incontinence during the night yet. That would be a game changer. I’ve posted before about using a sticky backed pad and poking 5 or 6 small holes in the bottom at night only so as not to have much overflow on the sides of the pad. There have been suggestions of pads without the sticky backing but the ones that I’ve tried don’t hold the moisture as well as the ones I use. He woke up with pull-ups more soaked as well as the pee pad on the bed quite wet where now there is usually only a few wet spots. I guess they don’t like us posting links to specific brands here, but if anyone knows a good one, a pm with a link would be appreciated. The only time I might want to change to a non sticky overflow pad might be during the day because sticky backed pads often tear at the top layer of the pull-ups when I go to change them. I change them every couple hours during the day.

Spot cleaning other body parts outside of pants changes is a good idea. Life feels like it’s moving in slow mo most days here too. Feeding and changing move at a very slow pace. Everything takes so long! Basic housekeeping? I pick up the big chunks. Lol! As long as it’s not a tripping hazard. The dishwasher and laundry appliances are the most used appliances, next to the coffee maker. The dust on the furniture is a good place to write reminders.

White Crane

there is a product called Scrubzz. They are bath sponges that foam up really nice and don’t have to be rinsed off. I used those for several months before my husband went into memory care. I also got out clean underwear for him every other day, and gave it to him while he was on the toilet along with wipes. when he took his T-shirt off, I would rub his back and arms with lotion, and he seemed to enjoy that. Once he was in bed, I put the dirty clothes in the hamper and laid out fresh ones for morning. He never seemed to notice.

ButterflyWings

@ImMaggieMae asked "Do you do pull-ups changes in bed as well? "

He is not too cooperative at that. When he was really out of it a couple of times, for a few weeks each time, yes I changed him in the hospital bed which we do not always use but hospice has it here. When he is not strong enough to stand for 2 minutes while I change his pad quickly, I have learned to use the tabbed diaper and it takes a bit of technique to roll part of it in the chux pad, slide that partly under him and then roll him a bit one way while cleaning that cheek, and then the other way, repeat and then back to his back and fasten everything up. In that case, I don't pull pants up. Just lots of covers.

Not ideal, but he is not too cooperative when lying flat in a bed and especially if struggling to breathe or other downturn. He "planks" or stiffens legs and it is really a task to try and get him to roll just a bit to one side. I'm really winded and tired after 20-30 minutes of trying to get him changed in bed. Maybe 1 time in 3 years he has actually lifted his hips up long enough to help me help him get some thing soiled off, and clean pullups back on when in bed. He just doesn't understand what I'm asking him to do, and why I'm pushing and pulling him. I'm happy to say he's back to sleeping semi-reclining on the couch right now and I can get him to a standing position easily, changed, and tucked in - back to sleep in MUCH less time. Better for both of us. If I let him sleep through the night, it is wet chux, clothes, etc, so more work in the end.