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Annabox Asked February 2023

My father freaks out when they try to bathe and dress him?

My dad is 82 and is currently living in a memory care facility. He moved into this facility about 6 months ago following a very abrupt departure from LTC. My father has dementia, but for the past four years had been pretty independent (transferring in and out of bed, toileting and eating independently). He did require some assistance with bathing and dressing, but that was it. SOMETHING BAD happened in his previous facility which resulted in an ER visit, hospital stay, and never going back to a place he called home. Upon his discharge from the hospital (and I to the new facility), a dosing error was made with the medication, DEPAKOTE. He was accidentally prescribed a dose that was three times the normal amount he was supposed to take. This mistake turned him into a lump of lifelessness. Dad could no longer transfer out of bed alone, stand, or eat alone, and definitely could not wash, dress, or toilet independently. While he remained a lump of lifelessness, nothing bothered him (he was barely existing) and no one at the new facility, thought anything of it (considering they did not know who he was 3 weeks prior). Since then, although it has been a long road, I have managed to prove to the new facility that the DEPAKOTE dosage was a mistake, and now he is off of it entirely. THE PROBLEM that has arisen as he has become more aware (and less lifeless) is that he completely panics during washing, changing and dressing. He Absolutely freaks out and has even gotten combative with the staff. But once the task is finished, he’s completely calm and content for the rest of the day. My father does not exhibit this behavior at all during the day, JUST during changing and dressing. The new facility, which I do love, has suggested we medicate dad with Ativan, Xanax, or some other medication that will allow them to do wash and dress without such a fight. The problem is, regardless of how comatose, my father may get from these meds (and he will become comatose because I have seen it ) he is quickly wakes up and throws himself into fight or flight mode during changing dressing or bathing. I have become very anti-medicine, considering I could’ve lost my father from a mistake that was made by a neurologist in a hospital. I don’t want him to be a zombie or at risk for an earlier death, but I also don’t want him to feel the stress every morning and night, like he has to defend himself - when he’s just getting washed or dressed. I have spent countless hours researching suggested techniques for the facility to try to keep him calm and reassured during this task, but they tell me it’s not working. How can I possibly be OK with chemically restraining my dad, when this behavior is so isolated, and I believe in my heart that he is suffering from some sort of PTSD from the other facility? I suggested that my father be visited by a therapist, in hopes that she may be able to uncover something that happened, or just be able to reassure him that he’s safe “now”. I don’t know what else to do? I feel like we’ve tried everything. Help Please!

Fawnby Feb 2023
Please don't be anti every medicine. There's a chance that he hasn't tried the right one in the right dosage yet. Keep trying. What your dad is going through is miserable for him as well as others, and if you could find a way to keep him peaceful and comfortable, everyone would be much happier.

NeedHelpWithMom Feb 2023
Anna,

Your story is truly heartbreaking. My mom was on Depakote for seizures. I would have been devastated had this happened to her. I’m so sorry that you and your father are experiencing such extreme anxiety.

I understand that you are hesitant to use medication but you aren’t helping yourself or your father by being paralyzed by your fear.

My mother was prescribed Ativan and it made a huge difference in her ability to remain calm. Think about trying Ativan since it was suggested by the staff and may help your dad be more comfortable.

Best wishes to you and your father.

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Daughter1932 Feb 2023
My Mom apparently is not cooperative when a male CNA goes to change, dress or bath her. She crosses her arms and her legs. Male CNAs are rare, but they do have one.

Maybe your dad feels the same about unknown females.

I suspect my Mom's behavior while dressing, etc. may be part of the reason, they want to move her to a NH.

lealonnie1 Feb 2023
My mother had great success with .25 Ativan which calmed her just enough to keep her functional without knocking her out. As your dad's agitation spirals, you'll have to do something which does not focus on a dosing error made in the past. He deserves relief here. Speak to his doctor right away about how to keep him calm during events he dislikes. A therapist is used for a cognizant person to talk things out.....not when dementia is involved. Its pretty impossible to make sense out of, or use logic, with dementia. As it worsens, your only goal is to keep dad in decent spirits.

Best of luck to you.

Catskie62 Feb 2023
It breaks my heart as well and I also understand what too much medication does to an elder. It happened to my mother and whenever people say "oh it's just the age, blah blah" nonsense I want to scream! I feel terrible about what happened to your dad
:(

funkygrandma59 Feb 2023
I'm not sure how much good a therapist would be with someone with dementia. Hopefully this is just a stage that he is going through and it too will pass.
I'm sure the facility doesn't bathe him every day, so can you just tell them that on the days that he's combative to just leave him in his pajamas to keep the peace. I mean why does one have to "get dressed" if it causes such stress?
And I know that you and he had a bad experience with the Depakote, but in all reality, having your father take some type of calming medication just on the days that he needs to get bathed doesn't sound all that bad to me, if it makes things easier for him and the staff.
Oh and one more thought....have you yourself been there to witness your father during these attempts to bathe and dress him? Perhaps having you there would be a calming presence for him. Now don't get me wrong, I don't mean that you have to be there every day, but perhaps twice a week while they're trying to get him in the shower. Just your presence could be calming for him. Just a thought.
I wish you and your father the very best.

cwillie Feb 2023
Consider that allowing him to experience the fear, anger and lashing out isn't doing him a kindness either, and it is definitely affecting the staff charged with caring for him.
Therapy is for people who can participate in the process, I have doubts that a person with dementia would benefit. In my experience the sedating effects of some medications lessen as the body becomes accustomed to them, allowing the benefits without the side effects, if they don't then a lower dose or a different medication could be an option. The care he received from a neurologist in an acute hospital setting is going to be focused in treating the immediate needs presented, perhaps working with a gerontologist or geriatric psychiatrist would be an appropriate step.

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