Hello- my first question here. I will be caring in my home for my 90 year old MIL who has dementia. She's in reasonably good shape physically for her age- she does walk with a walker though because of balance issues. She's in memory care right now, but has to leave because they feel they can't help her any further there. It's the nursing home or my home, so I want to try and see if I can care for her here. She's not a difficult person but has trouble following directions, and I know she's going to need assistance with cleaning herself. Am I correct in thinking that a walk-in tub would be easier for both of us rather than a walk-in shower? In a shower situation- (of course she would have a shower chair) it seems I would have to actually get in there to assist her, which seems messy and uncomfortable. Any insights are welcome. I'll be having a new bathroom put in just for her, so of course I'd like to get it all right. Cost is not really an object. TIA :)
My reasoning:
there may come a point where she needs a wheelchair
she will likely need assistance doing the actual washing, and soaping up and rinsing off someone will be easier in a shower than reaching down into a tub, especially one of the high walled walk in tubs
once urinary and fecal incontinence become a problem it will be more hygienic to rinse off in a shower that to sit in a bath
Since you are renovating I'd also plan for a bidet sprayer or bidet toilet seat as well to help with toileting
Don't forget lots of properly anchored grab bars. And don't let anyone talk you into a shower unit with a built in bench, they are not adequate for accessibility.
Oh... for safety and accessibility plan for a curtain not an enclosure
As for the how to - try searching shower assistance for elderly on YouTube for videos
I have a 99-yr old aunt with mod/adv dementia who is barely mobile but aids get her to the shower with her walker and a belt. The bathroom is very small and so is the shower, which has a 1" threshold height, but the seat is right there and the adjustable height, handheld shower head helps control the spray. Best if you get a showerhead that has all the controls on it, not the wall (on/off, temp). If modesty is an issue they can cover her with a thin terry towel, it will act like a giant washcloth and then put a dry terry robe on her right after. People who are soapy are also very slippery, so it may be safer to handle her with the help of towels during the process. Also, my aunt only needs a shower 2x a week. Those tubs are incredibly expensive and then would need to be removed when you eventually sell your home.
A former poster offered good insights into bathing: make it a pleasant ritual, with her favorite music, a treat before or after (flowers, or the music) and guide the experience into something positive, as well as one that's more safe.
If you do stick with the shower remodel, make sure you find a carpenter (and ONLY a carpenter) to install grab bars, on all sides, at low and medium high levels. They're lifesavers.
Contact your local aging service program - the Senior center, Board of health, county social services can tell you who to call. See if she will be eligible for help with bathing, as it is much easier to let a trained aide to help with the shower or bath. Also, that person can show you how to help her.
There are plenty of businesses that offer home safety services for elders - ramps, rails, bathrooms, etc. They will have ideas...
If she was not, then it won't be worth putting an expensive walk-in tub in.
How much space do you have for the shower/tub? Because there are some really great shower configurations for ease of access and assistance. A good contractor should be able to help you with the ideas.
I, highly recommend, heat lamps for the area, showers are cold and need to be heated up before she gets in and when she gets out.
Do a Google search for wheelchair accessible showers, it will give you some ideas.
Putting in a walk in tub is very expensive. We had a walk in shower. Mom used a shower bench. I installed a handheld shower head. I kept the room warm with small heater. I would wet her down and turn off the shower. Then soap her down and rinse. Have a towel nearby and dress her as much as I could. Bathroom was small. I eventually placed Mom in an AL and eventually LTC. At 68 I could not do the showering and the toileting. And the accidents. One being a "blow out" that took 3 hrs of cleaning up. The bathroom first because she needed a shower. I had a small table outside her bathroom door. I caught her using it as the toilet.
I hope your husband is going to be helping in her care. You will have sleepless nights because she is roaming or trying to get out of the house. Just as you sit down, she will want something. Its like having a toddler again.
I do suggest that you try a commode over the toilet. There are splash guards that take the place of the bucket. This will give MIL the arms and legs for stability.
Good Luck if you go ahead with this. If you find that her care is beyond you, please don't feel guilty. I personally could not do it because of the unpredictability. I like knowing what comes next. I like organization. Don't do well when a ball in thrown into the mix.
I am reaching a point where we must start looking at some bigger stronger more competent help for me with my DH at home. I had wanted to keep him here for the duration. It is slowly, but surely, dawning on me that this is probably not a good idea.
In saying all that, Silvie, I did have the big whirlpool bath taken out and replaced with a ceramic shower with a bench. The shower itself is great, the shower-ee is the problem! As you said, if the MC can't do it, how can a person alone do it? Will your DH help in the bathroom with a naked mom?
Think this over, and I also think you are an extraordinary princess for even wanting to do this, your MIL is a very lucky woman, and you DH also. Best of luck and God Bless.
And for the in-between shower days you can use the extra large body wipes. and waterless shampoo and conditioner caps if needed. They both work really well. you can order both from Amazon or Walmart.com
I wish you the best as you will certainly have your hands full. I really hope you're thinking long and hard before making the decision to bring her into your home.
I will forever regret not going to greater lengths to keep my parents in their home a little longer.
Sitting on a shower chair being hosed off is very cold for the person being bathed. And yes, a certain amt of water gets on the helper, too. To me, it's a miserable way to take a bath. Not to mention, to really clean the private parts, the person needs to stand for a period of time - even with the safety bars, strength is an issue to avoid falls.
I installed a lift chair for my mom (w/existing tub). Chair comes over edge of tub for her to sit on, then I activate it to lift up - turn to be over bath water - then lower to bottom of tub. She was so happy to be able to get into a warm bath and soak/have the jets in tub running. I raise her up a little when done, use shower sprayer to rinse her off and wash her hair - it minimizes the amount of time she is in the cooler air and not surrounded by warm water. I'm not having to stand there and wash every nook and cranny - she can do it.
I personally hate the thought of sitting on a shower chair being hosed off. You only feel warm when the water is all around your body...instead of just certain parts being sprayed. For me, that would be torture because I'm usually cold any way.
Imagine the walk-in bathtub filled with water and the patient poops in it. Not firm poop that stays together due to roughage and fiber in the diet. No, runny poop like a baby. The bathtub water turns yellow and the dissolved poop is all over her body. YUCK!
In the shower the poop goes to the floor and the patient remains clean.
My dad would poop in the shower all the time (he was incontinent). A bathtub would have been disgusting.
We remodeled the bathroom in my parents' house from a 9-year-old tub to a large shower with a handheld sprayer. We also put in a bathtub faucet about a foot above the floor so it could be used to wash feet or fill a bucket easily if needed. There was plenty of room for a walker and a shower chair to get in there, and honestly, I wouldn't have been a wet mess if I'd had to get in to help my mom shower. It would have been much easier to clean her "bits" than trying to lean over a walk-in tub.
Unfortunately, my dad died and my mother was in a nursing home before we were ever able to use that shower. We went from beginning the remodel, to my previously-healthy dad dying, to my mom having to go into a nursing home all in a span of six months, so know that things can change very, very quickly. Your mom has already been in a nursing home, so know that most of us see this plan of yours as probably not really feasible for any period of time. I do wish you luck, though.
Three years later, it sits there unused, but it's an asset to that house and not an obvious handicapped bathroom, so we'll do fine when we sell the house this spring.
Either way, I think a handheld extension and multiple support rails -- and a heated floor if the expense is no object -- would help make her safer and more comfortable in either case.
My grandmother liked a small amount of warm water in the bottom, or in a basin, to keep her feet warm. I think she would have liked a walk-in tub but she was also fearful of things, so not sure how she'd feel sitting in water up to her chest. Can you try out a walk-in tub with your mom?
I purchased a Carousel Sliding Transfer Bench with Swivel Seat by Platinum Health, plus with a 32-inch Horizontal Extended Rails. Also, have safety rails on all three sides of the bathtub.
Turn on the bathroom ceiling heater. If you don’t have a ceiling heater use a plug in heater in a safe location.
Wheelchair her into the bathroom. She transfer to the sliding seat on the outside of the tub. Once in the seat, I slide her into the center of the tub.
Control the hand-held shower water stream to low and soft to avoid frightening her. Also, with the control hand-held shower I control the direction the water flows. Use the shower curtains for front and for back to avoid getting drenched.
She uses the safety rails to raise herself so the most odor parts get washed. The ceiling heat keeps the room warm, no problem.
With the ceiling heat on, I sweat, but that’s okay, the job gets done.