Mom is almost 85 and has Alzheimer's - triggered by the anesthetic during a 2016 hip replacement. She lived alone for 2+ years after that with my sister and me providing everything we could and getting her out of the house 4 times a week to eat.
We never succeeded in getting her to clean up/shower, though she desperately needed it. She got offended when we quietly, politely suggested it was time to bathe, change clothes. In her demented state, she said she had done those things, and also took care of her house, did laundry, cooked, etc. No, she did none of those things. (In a support group my sister and I attend, we learned she was "self-neglecting.")
So that and what we learned was a fractured leg bone resulted in a hospitalization, rehab and forever placement in a memory care facility this past January. It was time; we were beat. We chose a local company that operates five memory care homes in our area - 5 residents per house rather than a large, institutional place. Better caregiver-to-resident ratio, could cater more to her extremely difficult personality. This company rates very highly with the state and is subject to the same rules and regs as "brand names" in senior care.
In general, we siblings are pleased, but Mom is completely miserable. We expected this; she has no idea anything is wrong with her and understands nothing of what's going on. Doesn't even remember she broke a hip. She's miserable anywhere but home (where she was also miserable).
So yesterday being Mother's Day, we thought we'd take her to lunch and met our brother halfway - about a 1 hr drive. We asked the caregivers to try to give her a shower or get her cleaned up beforehand because she desperately needed it. They tried but Mom was having none of it. Fought so hard against it she banged her wrist against something, tore her fragile skin, and bled everywhere, which they bandaged up. We learned about that in the morning. By the time we got there to pick her up, she didn't remember the fracas, but it was obvious she had not bathed. The staff felt bad they couldn't get it done. Blood, mysterious stains, and other stuff all over her shirt. I cannot blame the staff for this - Mom is stubborn, obstinate and - I learned on this site, probably suffers anosognosia. In short, yesterday was rather miserable and we couldn't get her back there fast enough. Which is when things really went downhill.
In bringing her back to the home, she cried and had fits that she wasn't going home. She was grasping at us, crying, slamming her fists, etc., in frustration. My sister and I got out as fast as we could, leaving the poor CNA on staff to deal with her anger. But we were totally spent.
Part of this is venting...part is asking for your secrets to get someone to WASH?? I'm very concerned she's going to get a UTI (if she doesn't already have one) because it's very clear that's the center of the problem. She says she's very careful about that, but no, she isn't.
More info: she HATES pills and doctors. Doesn't listen or want their advice. She's racist and most of the house staff is non-Caucasian. I would just be grateful if she didn't stink so much. Dusting powder only covers so much. What can we do??
[Can I have a prize for most helpful response? 😬]
The thing is. It is perfectly true that a person ought not to be forced to do something. However. Coaxing, cajoling, persuading - NOTHING is going to make your mother agree to be showered or bathed.
And although it's fine for these things to be less frequent than her habit used to be, it is not fine for her hygiene to be neglected altogether.
It is even less fine for this to be pursued to the point where she sustains injury, even if the injury is accidental/self-inflicted.
What is running through my memory at the moment is the process employed on the first stroke ward my mother stayed in (briefly, thank God). And the point about this process is that consent was never an issue, because there was never a point at which she was consulted or could have objected.
It takes a team of three nursing assistants, they get in there, they are so fast and efficient, and they wield so much muscle power among them, that it's over in minutes before the person knows what is happening, pretty much. It isn't pretty, but it's efficient and you end up with a clean mother.
I have to tell you that I was whimpering and bleating in a corner while all this was going on until the lead aide turned round and said "do you want your mother washed or not?" So that was me told.
Anyway - the point is that this is about attitude, experience and sheer heft. The people in the nice family atmosphere place are not prepared to seize hold of your mother and get the job done, because they are following different ethics. I wonder if, ironically, and seeing that your mother's miserable whatever you do, she might in fact be more efficiently cared for in a more institutional setting.
Other options;
#1 humour (depends on your mother). One posfer here told her mother she smelt like the elephant house at the zoo! Her mother laughed & concented to a wash. Lol.
#2 pamper. Read this online. More for at home than in care settings. Don't use words like bath, shower, wash. "Mother It's time for your spa treatment". Out comes the super soft towels, scented candles & smelly soaps.
(I sure don't have time for that & my Mum was never a spa type...)
#3 don't ask, just do. Like the 3x carers but much more low key. Don't talk about it. Just move into the bathroom chatting about other stuff. Just start the process & see if you get away with it. May work some of the time.
#4 basin of water & wash cloths. A body part or two every day. Good for the shy/private types.
#5 study the situation. What's behind the refusal - fear, embarresment, pain? Especially after hip surgery: is the shower commode uncomfortable? Is the room cold? The water too cool? (My Mum hates being cold). Is the bathroom white & sterile looking? Add some colour! At respite they added a bright tissue box & coloured towels - more home like, less scary.
#6 control. Ask mother what Day she WILL wash. As you wish: Mondays & Fridays. That is actually working for my Mum at home after constant refusal at rehab. Trouble is she will probably argue it's not Monday... sigh.
Sorry for long post. I do sympathise.
Attended my family Easter & we all had to sit next to an open door, waaaay away from Mum.
What's going to be better about a NH setting is that there will be Behavioral staff (psychiatrist, behavioral team, what have you) who will be able to advise on the appropriate medication for your mother's agitation and possible depression. While meds are not going to turn your feisty and uncooperative mother into a pussy cat, they might make everyone's life a little easier when it comes to hygiene, visits, daily life.
One rule that I learned early on in my mom's dementia? Bring the party to her. Don't take a person with dementia out of their facility, especially not in a private vehicle. My mother grabbed the steering wheel from my husband while we were on a highway. We were lucky that he was driving; had it been me, we'd all be dead.
This is why, if it were me, I would find a way to slip some meds into this poor woman's food if that is the only way to get her to take medicine. If it calms her down and reduces her anger and anxiety, and makes it so people can help her (get her clean), then I don't see the harm in it.
I'm looking forward to the doped-up stupor personally. For me, not her! ;o)
1. Staff will remove the soiled clothing from her room every night once she is sleeping. Every visit, my husband and I gather up any clothing in her room we think might be dirty. We take it home, wash it and return it the next visit.
2. We make an appointment for her every week to have her hair washed and styled. (Salon is at the facility)She has only refused a few times.
3. Staff will keep trying to get my MIL to shower. When able, my husband and I will encourage her to shower while we are there. The staff will try to be as flexible as possible with this.
A few select aides have had better success than others cajoling her to shower. Unfortunately, the two good ones are no longer employed there.
She has worn a wig (that looks like a dead possum if you ask me) since I was a little girl. That thing should be burned somewhere as toxic waste. She never did like salons and since this is a home, there's not one onsite anyway.
My sister and I have had little success in getting her to bathe. She insists she has. But as everyone says, you can't argue or try logic with Alz victims. We keep bringing it up - she has the same answers. Sometimes, when the aides have success with it, they are so excited that they'll call us. I hope for one of those calls soon.
Regarding the bathing, I agree that the approach from the staff is more than half the battle. My Mom is in total care now. But I recognize the same frustrations prior to her being incapacitated.
I used to give options to Mom, but options I Controlled that would result in the desirable outcome. For example "Mom, would you like a bath now or after your breakfast?" I let her make the choice of time, then proceed with the choice made. If she resisted, I gently reminded her "You chose ______, so that is what we are doing today". We had to eventually resort completely to bed baths. But the approach can, again, be half the battle. I found that giving Mom a warm wash cloth to wipe her face and hands herself kept her occupied while the caregivers worked on washing the "difficult spots"! They now use this tactic, providing a warm washcloth and towel for her to wipe her face and hands herself, and good smelling lotion for her to rub into her hands.
With regards to medications, Mom has trouble swallowing pills, too. But the nurses crush them, and offer them in applesauce or chocolate pudding. They always say "we have something that will help you" or "we have your medicine for you to take". When the spoon of applesauce appears, Mom forgets "medicine" and takes it. There is no deception.....and it accomplishes the goal of getting her to voluntarily swallow what you know will truly help her.
Lastly, as a family, we had to give up taking Mom out for events. It was too stressful, and the reintroduction to her Memory Care facility became too upsetting for her AND for us. Instead, we found quite corners in the facility to meet for a special dessert or visit. Sometimes we arrange for a few family members to be waiting in the courtyard when we go for a walk....it is always such an unexpected surprise...then we spend time outside together, take a few photos, then print them up to share as new family celebrations.
What I truly discovered was that going to all the trouble to take her out, encounter all the stress it put on her, etc....was self-inflicted on me and unfair to her. She simply enjoys quality time with Us....family and friends....and she also enjoys introducing or showing others in her facility "her family", "her daughter", etc.....kind of a "show and tell" for her to integrate into her new community.
As your Mom progresses with her disease, she will forget and the resistance she puts up to seemingly everything you are trying to do to care for her will lessen, and eventually go away. I have to believe that those suffering with the challenges of dementia taking control of their minds are fighting with all of their strength to retain some control over their life. They try to make some sense of the world they are loosing touch with and are inadvertently hurting the ones trying to help them them most.
I am caregiver to my almost 93yo Dad in his home, plus managing Mom in her Nursing home, a registered nurse (but can not work due to caregiving), a Mom, an only daughter (so no siblings to help me). Thank you for sharing your frustrations.....it is good to know we are not alone in this journey, and hopefully can support each other in some meaningful way!
Thanks for sharing your experience with us.
My daughter is a RN in a rehab/nursing facility. I had complained that medical staff tend to ask "would you like to take a shower?" Of course a person suffering from Dementia says "No". My daughter said that you have to make them feel they made the decision. Like "Mrs E, wouldn't you feel better being clean and sweet smelling. A shower would make you feel so much better" more likely to do it.
Its also been mentioned on the site that showers tend to scare them. My Mom had a shower chair in her shower and a hand held shower head. I would rinse, soap up and then rinse her off. She was never under the shower constantly. Her bathroom was warmed up. It was done as quick as possible.
She stopped bathing at home, too. We got her giant "baby wipes" that we discovered while she was in the hospital and she used them for a while. Not a solution, but they helped. Now she won't even use those. She refuses shower chairs, stools, and other aides - those are for "old people." She used to love baths. Now she says she's taking them but there's no proof - not in used laundry and certainly not about her person. My gut tells me she'll get another UTI and land herself in the hospital.
you should also talk to the management of the home and find out why they are failing at bathing her. They should have “trained staff” that know all the tricks to get this done.
If they are truly MC specialized unit staff and cannot get her bathed, I'd explore medication with her doctor to help with her agitation. I would imagine being that agitated would be mentally painful.
As to medications, she is refusing to take the 2 she is on about half the time. In our state, they cannot force her to take them; she must consent (completely asinine law for the mentally impaired). I'm sure she's in a great deal of mental pain. We arranged to have her speak with a neuropsychologist but she clammed up and wouldn't say a thing. She doesn't believe in Western medicine and can't swallow pills anyway. Some can be in liquid form but again, they cannot force her to take meds without consent. Just an ugly situation from all angles.
It isn't forcing, it's more... just not asking. Here we all are, here's the bath ready, in you get, rub-a-dub-dub, out you get, Bob's your uncle. The aides can take it in their stride, taking her consent for granted. I suppose, what it comes down to is that every time you pause to ask her permission, you're prompting her to hate it and refuse. Don't pause, and although she can still refuse and must still be listened to, it's harder for her to stop a process that is already well under way.
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