Situation: Mom has one leg amputated and solely gets around via wheelchair. She was too stubborn to learn how to use a prosthetic leg. A year and a half later, she now lives in a nursing home. Admin is saying she refuses to wear pants and only has her adult diapers partially pulled up. When staff tries to help her get dressed or adjust her diapers, she gets cross, angry and refuses help. She sits on towels laid out on her wheelchair and on her bed and INSISTS she's clean and happy with the way things are. (I know for a fact, she is sometimes not completely clean.) It's unsanitary and undignified but no one (no family member, no child, no trusted staff) can convince her to wear it. I used to buy her diapers she liked despite the care home offering their own. (She wanted pull-ups. The care home has the kinds with the sticker tabs on the sides. She hates those.) It worked for a while until then she stopped pulling those up completely to cover her bum. Eventually, she asked to have me stop sending them and she'd just use the ones they offer. I don't know how to help her. She stubborn and cranky and seems to be getting worse. I'm considering buying her the ones she likes again if it helps...? Any ideas?
We even worked out a new shower schedule that works around my mom's "superstitions." (She wouldn't shower on holy days and Fridays for some reason!)
When you are sitting in a wheelchair, not the most comfortable thing by the way, and there is a cushion, then usually an absorbent pad, then the brief or pull up then clothing. That is a lot of bulk and wrinkles to sit on.
I used to cut the back of my Husbands pants out so there was less bulk and fewer wrinkles that might lead to creases on his skin. The back was cut down from about the back part of the hips to right around the lower part of his seat. The pants could be pulled on and off easily the sides of the pants could be tucked behind him to secure the pants. This way it looked like he was wearing pants when you looked at him from the front or side. I also cut the back of his shirts from the bottom to the neck so I could easily slip a clean shirt on without having to move him forward and back., again fewer wrinkles and less skin creases.
This is not just to be more comfortable - but when the needs arise, he has trouble removing the garments and the laundry truly starts to backup on a daily basis. Now I prefer him without briefs but will supply them when asked for. We live alone and rarely if ever get company. He has no incontinence to speak of, just the occasional gas-bubble (sorry if TMI) and I do have waterproof sheets on the couch and his lift-sleep chair. In the 2 years since he was sent home to die from Hospital, we have yet to have him soil the sheets in that manner. I only had to insist on his using the urinal as following him down the hall felt like I was housebreaking a puppy. We still have the occasional puddle but he throws a washrag or a tissue on it so I know it's there and can clean it up. I learned to wear slippers.
He's 96 now and every day we still have together is precious to me. All too soon I will have to let him go and I will miss his smiles.
She does sit on towels and uses a second towel to cover her lap. I've given her many pull-over dresses in pretty floral designs and colors that she likes. Even w/ those on, she'll still put something to cover her lap. Some days, she'll refuse to put a dress on and opt for a medical gown instead. :( On those days, I just grab a dress and put it on her and she won't fight me to wear it. (I learned she hates wearing them because she doesn't want her dresses to get lost in the laundry sorting. She has a hoarding issue and hates her stuff to be out of sight. So she'd rather preserve it than use it.)
Her mood shifts. She was recently documented for having memory issues and lack of capacity for decision making.
At this point, I've learned its a matter of compromise but I talk to her firmly when things start to tip towards unsanitary or unsafe habits.
(in addition, there are adaptive open backed pants etc that are designed for wheelchair users, they can be slipped on a seated person and the waist wraps around and snaps at the back)
What does your mother wear? Dresses? Would wearing much longer dresses help? Or loose skirts? They wouldn't tend to ride up as much when she sit.
Many people, men and women, used a lap blanket all the time in my mom's nh. Then it would be easy for an aide to say, "here is your lap cover. It seems a little chilly in the hallways."
There was one woman in my mom's nh who got around well in her wheelchair. She often ate with my mother, but of course then I'd see her from the chest up. I was very surprised to see her in the hall with just a very short dress or tunic, high stockings, and nothing else. This was definitely undignified, but it didn't appear to bother her and she wasn't hurting anyone else. But I hope if I get to that stage someone will prevent me from displaying my private area!
Her hygiene comes first. That could be a real problem for her. Do some brainstorming with the staff to figure out what to try. The undignified apparel is probably more of a problem for you than it is for her right now. But I think it would be a kindness if you could spare her this.
(Is anybody else thinking, "I sure hope I'm not like that when I'm old!")