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The starting point of her anger is her own hygiene! She refuses to change her dirty clothes and if the helper succeed in changing her ( mom is in a care home in an appartment) she changes back in her dirty clothes. Now she refuses to be washed once a week, because she thinks it is every day. Last week she hit the helper and almost hit me.The comforting answers I used to give her and the reasonable ones ( last resort) doesn't work anymore. Everything anger her: the food ( delicious but she loose taste), people, the care. She wants to leave and I' m the big bad daughter. She's 86 and was diagnosed at 84 with moderate to advanced dementia. Her health is mostly good.What is the best move the best words to help her? I' m at lost!

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Thank you all of you. The off the showertime worked well as the staff didn't come back each day till she said yes. They asked once and accept her refusal. The next week, she was ok with the shower.

Now, they will check if she has uti ( the doctor come once a month). He's pretty sure she hasn't.
Mom used to wash herself by hand and put the same clothes again for the weekmwhen she was younger and more sane so she tried to keepmher old ways but with the memory problems weeks turn to months.. with the respite, she is now more open to talk about her clothes and accept suggestions. Phew! What a relief... for the time being.
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Your mother's agitation might be progress of her dementia. It might be from pain. I'd focus on pain management now. What are they giving her for lichens scléreux? Is there anything else they can try? She deserves to be as pain-free as possible, even if that doesn't solve the aggression.

I'd go with the social worker's advice and let them back off on the full bath/shower routine for a while. Obviously if the aggression lasts months this could be a problem. But skipping a week or two isn't going to give the dear lady leprosy! Maybe a little gentle help with her sponge bath would be useful. (The hygiene for the lichens scléreux must continue however. Perhaps if Mom sees this as a medical procedure to help with pain she would be more accepting of it.)

As you sadly know, there is no cure for dementia. But many of the symptoms and behaviors can be treated and if not stopped at least lessened. Certainly you don't what your mother to turn into a zombie, but calming medicines can be used without causing that. It may take some experimenting to get the best medicine and dosage, but be assured it can be done.

There are a couple of videos on youtube that you might find useful. My husband loved bathing so I didn't need help with him, but I wish I had seen these videos before I tried to help my mother bathe!

One is by Teepa Snow (she is great!) called Bathing a patient with dementia/Alzheimer's. The entire video is not available on youtube, but even the first part is educational.

UCLA has a video called Caregiver Training Part III: Refusal to Bathe

The VA has a nice training video for caregivers in their facilities, but I can't find it again. :-(
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I'm not sure what your fear of calming meds is based on. Dementia is a progressive, degenerative neurological disease. In essence, your mom's brain is broken.

Our first clue with our mom was that she was way more anxious than she'd ever been in the past (and she was plenty anxious before) and that everything agitated her and was an emergency. Mom had to leave her home and go to an Independent Living facility due to her anxiety and agitation (which was mostly due to her cognitive decline, although we didn't know about that until later).

So, anxiety and agitation are the symptoms, the enemy, the thing to treat.

Talk to a geriatric psychiatrist about what your mom's medication needs are right now.
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I'd address the issue of whether she has pain that she cannot verbalize.

Also, staff who are trained to work with dementia patients deal with those who don't like baths all the time and they do a great job. Those who are not equipped seem to have the most difficulty.

I'm not sure that a Social worker saying that they just won't bathe her would cut it with me. So, is mom really capable of attending to her own hygiene needs? This is for a woman who refuses to change into clean underwear? I don't follow.

I'd explore her agitation and see if medication is needed. There are stages of dementia, but, there is no guarantee that her agitation will pass. I'd just do more research on dementia. Unless this social worker is specifically qualified to provide this opinion, I'd do my own independent research.

Also, I have discovered that the Memory Care unit where my LO resides plays music when the residents are getting their baths.  It helps them relax.  
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My social worker gave this advice : don't insist on the hygiene as long as the agressivity period is there, since mom is able to wash herself more or less.According to the s.w., agressivity will pass. Mom today was very sweet and calm. Thank you again for your advices and hugs! God bless!
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And a very happy Valentine Day with all your loved ones.( here I sent e-cards to my friends and something special for my hubby. Mom will have hers tomorrow. It's her day, other time confused her). So be happy the best you can!
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yes big hugs. i am going through the same agitation with my mom. she is 78 years old. and got diagnosed with dementia. i don't know what to do. she is not eating and says weird things. But be strong Michou, bc you are not alone and sending you prayers to make you strong. you can be there for her and just say that this is all that you can do, just be there for her and take deep breaths. that's what i do.
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Thank you all of you. God bless you all. I'll give you an update tomorrow after my day ( 9 to 3 pm)with her.
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Hugs, Michou. This must be very distressing. By all means reassure your mother that you're doing your best to find the right place for her. Heaven knows it's true enough.

If your mother is still agitated and upset in spite of anything you can say, all you can do is be there for her. BUT take advice from the nursing staff; and if it turns out that she is calmer when you *aren't* there, consider whether it might be better to cut back on how often you visit, or to make your visits shorter, or perhaps to change the time and see if that makes any difference. You can always telephone for updates instead, so you won't be neglecting her. Look after yourself, too.
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Even when I' m there these last days mom is agitated.
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Thank you. I lie to give her peace if it is all right. Yes she has hemorroids plus lichens. I know she suffers and taht I can't really help her makes me very sad. I fight the best I can an immune desease ( Sjogrën and it attacks diverse organs and makes me exhausted most of the time. I was a caregiver for dad and her for years. I feel a bit spreaded thin these days). I'll ask the nurses if calming meds are possible but I fear mom losts more if under calming meds. She has already something for the night. I used to be so good to bring her what she needs, now I feel so useless!
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You can tell her the moon is made of blue cheese if it makes her happier in the moment, but her agitation when you are not there indicates that she is fearful and unhappy and probably in pain from her condition, something more needs to be done to help her be happy and comfortable.
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Lichen hurts very much especially when water or urine burns the open sores. and it being in that private area doesnt help :(
Mom fought me over her dirty underwear it was hard to sneak clean ones after i got her to take off the dirty ones- quick switch hiding them. But if you are only there once a week- Personally I would ask about anti-anxiety meds for her, a very small amount.
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Is she on meds for agitation? B
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Thank you every one. Don't worry for the personal: They are very patient with the residents and most are not easy. It is a good place. They have a special area where they said they put mom if the dementia is getting worse. For them, she is not there yet. I could ask for the nurses to check again for uti, but I think it would be difficult now that mom is in this agressive state of mind. I'm from Quebec. Here the facilities are not quite the same as yours in the USA. Anyway, I asked also my social worker for help.
I just wanted you helping me with what to say to mom. Is it all right to lie to her, to say that I will look for another place?
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I agree. And I would add that if she has suddenly become defensive about receiving personal care I'd be deeply suspicious that there is something she's anxious to hide. Would she let a doctor or a senior nurse examine her, to check? - and sneak in a quick urine test while they're about it, perhaps.
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It is possible to have lichens scléreux AND still get a UTI, has she been tested?
I would think that a home of the type she lives in would soon get fed up with an argumentative, smelly, violent resident, it's not as though there are dozens of aides to share the load. What advice are they giving you?
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Thank you for your answer. Mom is in a private home and once a week I pass a day with her. They don't like to put their residents too fast in the specialized area. Mom is more agressive only since last week and only when the personal hygien is the trigger. She used to be happy there but she had always resented to be taken in charge.
I' ll wait and see. One day at a time! She doesn't have a uti but another condition " lichens scléreux" for wich she refuses the nurses to take care pretenting she could do it herself. More or less true.
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Especially as hygiene has become the trigger issue, I would suspect a u.t.i. It's certainly worth checking, if only to rule it out.

What sort of care home is your mother's apartment in? If they claim to offer specialist dementia care, this is the time for them to step up and use that expertise - after all, that's what your mother is paying for. If not, and she's getting beyond them too, then it might be time to look for a more highly specialised memory care unit or facility for her.

I'm very sorry not to be able to suggest any magic formula you could use. Sadly, anger and disorientation could be part of the progression of her disease - nothing anyone can say will put things right in her brain. I'm so sorry for what you're both having to go through.
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