It's no use arguing or pleading with someone who really believes that he did shower or that he doesn't need to. I know, because my mother was absolutely dead set against the idea that she needed to clean up. Mom never did go to assisted living or memory care. My brothers and I took turns caring for her in her own home and eventually in the home of one brother who lived in the same state. But something had to be done about the hygiene conundrum....
What finally worked was hiring a caregiver for a few hours each week. A nurse accompanied her for the first visit, and after the nurse did an exam, the caregiver took over and had my mother placidly allowing her to undress and bathe her. The nurse was amazed that my mother acquiesced so readily to a total stranger. Usually it takes a few visits before the caregiver becomes familiar enough. I told the nurse why I believed my mother was so compliant. The woman was a mixed blood native of the Caribbean like my mother. Even though she came from a different island, her accent was very close to my mother's. I believe Mom thought she was her mother. Near the end of her life she would ask if her mother was still asleep in the next room.
If your father has regressed far enough back in time, perhaps someone who he believes is his mother or father or other family member would be able to coax him to bathe.
GG -Are there possibly any other things that AL staff has mentioned that are of concern? Could be something mentioned in passing... like concern about his getting to meals on time, or on being able to do a fire drill. I ask cause I’m in the camp with Llama, Leah and Disgusted2 that his not bathing just could be a pretext for the AL to tell you in the near future that he needs a higher level of care in a different facility. Or that he needs to pay for additional services.
Most AL expect the residents to be pretty functional in thier ADLs (Activities of Daily Living) and be somewhat social and be timely in the routine of the place (they know 2 be correctly dressed & presentable & get to dining room btw 7:30-8:30 if they want breakfast). Like they are expected to be able to get their day started and pull together wardrobe but maybe need help with a zipper or in transitioning in & out of the shower. If they need help taking medications that tends to be a seperate fee for “medication management”. If he’s unable to bathe or do daily hygiene on his own, there might be a separate fee for a bathing team or he schedules regular on premises barber shop visits. But if this is more that he doesn’t understand why it’s needed, the AL will want him out if he won’t cooperate.
Assuming his AL allows visitors right now, the next time you visit make it a long day so you can see just what his capabilities are. Is he doing what the others are? Really stand back and evaluate if he’s keeping up with the other residents.
If his AL is still in lockdown, I’d suggest that you ask the SW or nursing staff to do a care assessment phone call with you. If he didn’t get a needs assessment done before he moved in, it might be a good idea to have one done. If this is about his needing a higher level of care it’s best your aware if this ASAP so you can start to find him a NH or MC and figure out if he has the funds for it or if he’ll need to file for LTC Medicaid. The ALs have been through this before, they will have suggestions as to where. If they have a sister facility that’s MC or NH, it might could be a simple move.
Please realize that AL can do a “30 Day Notice” that states they cannot provide level of care needed and it’s basically an eviction notice. As he’s just in AL, the AL does NOT need to find him another place to move to. He’s in AL and in theory he’s good on his ADLs with maybe just assistance in some things so he can be evicted. He’s not in skilled nursing care which is a Medicare covered benefit and requires secure lateral placement by Medicare. However, it’s bad optics for AL to do this so they tend to instead call EMS to take him to the ER as something seems amiss (the classic is it looks like a TIA / transient ischemic attack as they are pretty subjective) and then the AL refuse to take him back. It then falls on the discharge planner at the hospital to find him a place &/or very heavily press upon family to come and get him. If he doesn’t meet the criteria for needing NH or MC, he can be discharged to a shelter. Yeah horrors!
if your getting a vibe that this place doesn’t find him to be a suitable resident, please pls be proactive in dealing with this. It’s pretty stressful to deal with a 30 Day situation and now with Covid concerns even more so.
Tbh I think he has a right to decide for himself if and when to shower. My GPops showers once a week with extras if he’s had a mishap. Yes, on occasions he does get a bit ripe when it’s hot as he’s allergic to every deodorant I’ve tried him with so I just have to deal with it. It’s really not normal for us to shower daily and it’s not good for our skin and hair. Now I have that off my chest....!😉 my best advice is a gentle discussion with him to find out what’s happening and why he doesn’t want to shower. If the problems can be fixed you’re onto a winner. It might be that he doesn’t like being told what to do by the staff if he’s not actually causing a real problem. If that’s the case maybe it’s time for a different facility if the staff are being too stubborn with their rules?
My mom is in assisted living and was not bathing herself. I knew this because the soap and washcloths were going untouched week after week. I would say why don't I help you into the shower and she would respond with, no I just showered.
I ended up adding a "bath assist" to the services we buy. They are supposed to go in 3 times a week and say ok, its time for your shower, lets get all of your things together. Sometimes she refuses. When she does I tell her that they have to help all of the people that live there because the shower is a slipping hazard and the hand held nozzle is hard to operate. They would be sued if they didn't help. She seems to buy that story. Maybe you could spin a tale that would appeal to your dad...
As others have suggested, it may be time for a higher level of care!
My understanding of assisted living is that they expect the residents to be able to bathe and dress themselves. Every day tasks with the exception of remembering to take their meds. They should be able to follow basic instructions.
I'm surprised that the ALF has not reccomended memory care.
There may be some state guideline they are required to follow and want to have adherence to. I'd touch base with your long term care ombudsman's office. Although, this is AL and not a NH....they can and probably do document his refusal which he has a right to....but this will also prove their point and his aroma may offend others impacting the environment and their quality of life so is it possible by guidelines he may be kicked out? Or they will charge an additional fee for giving him assistance....Keep us posted....
What finally worked was hiring a caregiver for a few hours each week. A nurse accompanied her for the first visit, and after the nurse did an exam, the caregiver took over and had my mother placidly allowing her to undress and bathe her. The nurse was amazed that my mother acquiesced so readily to a total stranger. Usually it takes a few visits before the caregiver becomes familiar enough. I told the nurse why I believed my mother was so compliant. The woman was a mixed blood native of the Caribbean like my mother. Even though she came from a different island, her accent was very close to my mother's. I believe Mom thought she was her mother. Near the end of her life she would ask if her mother was still asleep in the next room.
If your father has regressed far enough back in time, perhaps someone who he believes is his mother or father or other family member would be able to coax him to bathe.
Most AL expect the residents to be pretty functional in thier ADLs (Activities of Daily Living) and be somewhat social and be timely in the routine of the place (they know 2 be correctly dressed & presentable & get to dining room btw 7:30-8:30 if they want breakfast). Like they are expected to be able to get their day started and pull together wardrobe but maybe need help with a zipper or in transitioning in & out of the shower. If they need help taking medications that tends to be a seperate fee for “medication management”. If he’s unable to bathe or do daily hygiene on his own, there might be a separate fee for a bathing team or he schedules regular on premises barber shop visits. But if this is more that he doesn’t understand why it’s needed, the AL will want him out if he won’t cooperate.
Assuming his AL allows visitors right now, the next time you visit make it a long day so you can see just what his capabilities are. Is he doing what the others are? Really stand back and evaluate if he’s keeping up with the other residents.
If his AL is still in lockdown, I’d suggest that you ask the SW or nursing staff to do a care assessment phone call with you. If he didn’t get a needs assessment done before he moved in, it might be a good idea to have one done. If this is about his needing a higher level of care it’s best your aware if this ASAP so you can start to find him a NH or MC and figure out if he has the funds for it or if he’ll need to file for LTC Medicaid. The ALs have been through this before, they will have suggestions as to where. If they have a sister facility that’s MC or NH, it might could be a simple move.
Please realize that AL can do a “30 Day Notice” that states they cannot provide level of care needed and it’s basically an eviction notice. As he’s just in AL, the AL does NOT need to find him another place to move to. He’s in AL and in theory he’s good on his ADLs with maybe just assistance in some things so he can be evicted. He’s not in skilled nursing care which is a Medicare covered benefit and requires secure lateral placement by Medicare. However, it’s bad optics for AL to do this so they tend to instead call EMS to take him to the ER as something seems amiss (the classic is it looks like a TIA / transient ischemic attack as they are pretty subjective) and then the AL refuse to take him back. It then falls on the discharge planner at the hospital to find him a place &/or very heavily press upon family to come and get him. If he doesn’t meet the criteria for needing NH or MC, he can be discharged to a shelter. Yeah horrors!
if your getting a vibe that this place doesn’t find him to be a suitable resident, please pls be proactive in dealing with this. It’s pretty stressful to deal with a 30 Day situation and now with Covid concerns even more so.
Now I have that off my chest....!😉 my best advice is a gentle discussion with him to find out what’s happening and why he doesn’t want to shower. If the problems can be fixed you’re onto a winner. It might be that he doesn’t like being told what to do by the staff if he’s not actually causing a real problem. If that’s the case maybe it’s time for a different facility if the staff are being too stubborn with their rules?
I ended up adding a "bath assist" to the services we buy. They are supposed to go in 3 times a week and say ok, its time for your shower, lets get all of your things together. Sometimes she refuses. When she does I tell her that they have to help all of the people that live there because the shower is a slipping hazard and the hand held nozzle is hard to operate. They would be sued if they didn't help. She seems to buy that story. Maybe you could spin a tale that would appeal to your dad...
As others have suggested, it may be time for a higher level of care!
My understanding of assisted living is that they expect the residents to be able to bathe and dress themselves. Every day tasks with the exception of remembering to take their meds. They should be able to follow basic instructions.
I'm surprised that the ALF has not reccomended memory care.
(((Hugs)))