she refuses to shower or wash her hair and she doesn't have clean clothing she puts on soiled and wrinkled clothing. she lives with her handicapped son and refused to do anything to help herself or let anyone help her.
dear cricket33....WELL SAID! yes, it's heartbreaking to care for our loved ones with dementia....but the truth is....there is nothing to treat this! my mother is in her dying stages...in bed all the time...can't talk, can't move...it's the worst!!! i've gone thru all the changes with her at home...and i'm amazed i didn't lose my mind!!!! now, i just keep her comfortable, clean, and fed when she can eat!! i will be grieving this journey way after my beautiful mother dies...it's a horrible journey for all involved!!!
The medical community is sadly very ignorant about dementia. It is a physical disease as well as a mental / cognitive impairmenent. Anyone with moderate to severe neurological or circulatory problems has a mysterious aversion to water. The moment i saw "vascular dementia" - circulation and brain activity/cognitive impairment are having a battle. You might encourage sponge baths - warm soapy water [there are no-rinse soaps such as cetaphil et al] , and offer to give her an over-the-sink hair washing. Mom loves having her hair brushed but barely tolerates even the spritz of herbal essence dry shampoo. The foaming no-rinse shampoos were less tolerated. herbal essence was quick and did the job though - and took away excess oils and left a lovely mild fragrance. The stimulus of "needles of water" stabbing at the bare skin [showering] can be too much stimulus - actually painful. Mom really fought me when trying to assist her with a shower once a week. i just did not understand, and in my ignorance, thought she was being combative. Sure she was - but she didn't have the ability to explain [nor understand herself] the reason WHY! i was too sensitive and caught up with proper care and hygeine to think outside the box - and thought she was mad at me. What a whirlwind of confusion and misgivings. Such a beautiful wonderful spirit - stolen and lost in a maze of dementia. And no doctor could or would offer any prognosis. i was actually told by a Rehab/NH to "google it" when i'd have questions. i brought mom home to care for her myself. i am so very tired and frustrated at the seeming nonchalance of the majority of doctors we trust with our health. Dementia, alzheimers, and all of the tentacle versions of cognitive impairment just get shuffled off as "old age" -- or something that the person CHOSE. So very far from the truth. The change shows up on the MRIs and other equip. Caregivers are sadly left on their own, in a rather grass roots movement, to understand - day to day.
Just please, appreciate and treasure those moments of lucid conversation and tender exchanges with your loved ones and family and friends.
Behavioral changes are often caused by fear that they cannot express -- like waking up in a different foreign land each day - some things are familiar, others are not. i hope the "friend" is blessed with a lucid moment to talk with her friend who is afflicted with dementia, and have a heart to heart exchange. The dementia victim may be caught in a whirlwind of confusion and fear - that they cannot possibly rationalize their way out of. As a friend, i'd rather take that route before going behind their back and reporting her to the authorities. They would be most likely to separate the family and be of the opinion that the state of affairs in the home are by choice -- not even having the compassion to realize the extent of fear and the lack of direction/information that victims of the disease, and the caregivers, are subjected to on a daily basis. May God Bless.
How old is the son and is his handicapped to a point that he can't help his mother or is he still able to move around, walk, etc? Maybe he can help talk some sense into his mother about her cleanliness and maybe even help her with some things.
I have this problem with my mother who lives with me. I continually tell her that my job is to make sure she is healthy, and just like when she took care of me as a child, that sometimes means she has to do things she doesn't like. Being dirty is unhealthy and if she doesn't cooperate, I'll have to hire Nurse Ratchet type who will make her bathe. I try to say this in a funny way that can make her laugh and she usually goes along. Creative lying also helps. When the eldercare office sent someone over to do an assessment at my request, Itold her it was required by the health insurance. I try to make it seem like I'm conspiring WITH her and not against her to keep her home and keep unnecessary intruders out. Sometimes it works.
They don't like getting in a shower or bathtub. We had paid caregivers come in and they weren't supposed to do bathing, etc. but one became an excellent friend to us all and would wash mom's hair in the kitchen sink once a week and then put it up in rollers. It gave them both something to do. I had a home health aide come in once a week to give mom a bath, and SHE became a good friend. We sat and talked for quite a while, then we stood up and asked mom to show our new friend around the house. Walked down the house to the bathroom where clean clothes and diapers, etc. were set out, and still talking, the home health aide was able to sit mom down and give her a sponge bath, part by part. It worked out well if we didn't make a big thing and sort of coaxed mom along. (the funny part was, nobody-nobody!- was allowed to clip her awful thick smelly toenails. I did what I could. Otherwise there was a travelling podiatrist who would come over to clip them, though it never came to that.) Oh, and LW should see about rescuing the disabled son. Otherwise LW could be charged with abandonment, or abuse, or something and get her name and the whole story in the paper. I've seen THAT happen in my long life. "oh, we just didn't know what to DO". So they did nothing, with awful results.)
I care for my mom she's at the stage of LBD were she doesn't realize if I don't remind her she will wear the same set of clothes every day. Once she's in her sleep clothes I remove the clothes she wore from her room. I keep her clothing in my room and I give her a new set each morning. Bathing is easy as long as I prepare the tub for her and she sits and washes herself. I wash her hair once a week because she won't let me wash it more often but if you try these things with the sister they may work. This issue is serious because not bathing and washing hair can cause a breakdown of her skin which will in turn lead to open sores. Contact the local area office on aging or even her doctor can make sure social services is aware of these issues and they will send someone to visit her and see what type of services she needs.
If there is a change in the persons normal behavior, caring for themselves it is a warning that something is wrong and they need help. Saw this with my sister in law and my husband has FTD and he had problems with his checking account being balanced, he was unable to do his job, turned the shower on and forgot to shower, etc. They need help. Sister in-law would not her children in the house. Finally her daughter had to go in........was quite a shocker. You have to be observant. Easy to look back and see the warning signs then.
oh rainmom....GOD BLESS YOU AND YOUR SON!! i was so moved by your post! and i sure hope you have a loving family member that will help you when you need it.
I work for our local senior center, and have a mom the nursing home. The most important thing to remember is that they are still a human being with feelings. They think differently than us, but they are still in there. Be respectful:your loved one is still an adult, don't talk or act that they are not there; be creative and flexible: a particular technique that worked before may not work any longer; touch is still a strong human need. Their understanding of the world is now different from ours. Don't accuse them of lying or other things, instead use distraction. Temporary change of subject. Kindness, calmness, and quiet can be quite effective. Find some books or articles on how to work with your loved one and how to act and not react to their actions. It is not easy and it changes every day, but remember it is the disease and not the person.
My mom TRULY believed she was taking a shower and caring for herself or the house. The house was awful and when my dad would take her to eat, he would keep her out a litle longer so the cleaning girls could do what they could in what little time they had (she didn't want ANYone in the house). Her hair never got washed except when I would tell her she had made a hair appt. (which I had but she didn't remember. She only went because I told her she had and we didn't want to stand the hairdresser up). She never took a shower but told us she did. She would wear same 3 outfits or layer. When she first went to facility it would take 3 people to get her in the shower she would fight so hard. By the way, with dementia patients this is quite common. They are afraid of a small place (shower) and they also don't like mirrors because they remember themselves as young and don't like those "others" that are looking back at them. I'm afraid it will take care of itself when she gets bad enough. She will either have to go somewhere or have someone come in to take care of both her and her son. It sounds like the son might be in some sort of danger if she can't remember to give him medication, drs. appt., etc. I hope she doesn't forget and leaves something on the stove or in the oven. I would call Adult Protective Services or Social Worker. They deal with this everyday and it might help her hearing it from someone else other than you (the one that she thinks nags all the time). Good Luck and God Bless you on your Journey.
She has dementia and fear if bathing is a symptom. Actually, terror is more like it, that's why she refuses so strongly. If your fruend is not already the poa and hcp, she should get that paperwork done while her sister us still legally able to consent. Next, she shoukd talk to her sister's neurologist about a non-drowsy, anti-anxiety drug called Buspar. Has a good reputation and did wonders for my mom. If she has dementia now, I worry about her ability to care for her disabled son. You should start now, planning for what will happen to him when she can no longer care for him. Explore your options and get a good plan in place. There are many services for the handicapped.
As the mother of a severly disabled adult son AND the DPOA and daughter of an 89 year old mother - a mother who has dementia and lives in a NH, this is a subject that I spend some time thinking about. I could go on forever about my hopes and fears, about my "plans" - which I've learned take with a grain of salt - John Lennon sings "life is what happens when you're busy making other plans". But most of all I hope that if my plans don't work out or I loose my ability to think rationally before implementing them - I hope someone will care enough about me and my son to remove him from my home if I become unable to care for him.
SO SAD!!! FILTHY AND LIVING IN SQUALOR IS NOT THE SAME AS DIRTY! THIS IS EVEN WORSE BECAUSE HER HANDICAPPED SON LIVES THERE! I'VE SEEN SENIORS HOMES THAT CAN NO LONGER CARE FOR THEMSELVES AND IT'S SO HORRIBLE!! PLEASE KEEP US POSTED ON THIS SITUATION...MIGHT HELP SOMEONE ELSE!!
Many persons with dementia fear water. Sometimes there is a reason and sometimes not. The affected person may have developed a fear of water in their childhood, such a drowning, unexpected fall into a pool or larger body of water, a fall of a dock, etc. I tend to think of these behaviors as a progression of her disease. They annoy caregivers far more than the person with the behaviors. A couple hints. -Replace dirty clothing with clean when the person is sleeping. -Buy several of the same clothing item; then they will not notice the change in closing as dramatically. -Reduce the number of clothing items they have. Store away excess items or give them away. -Take responsibility for the son's welfare. Find a way to intervene. -Febreze, oder remover/air freshener, hides a hots of smells. -Use microfiber clothes for clean-up instead of paper towels. Ask your friend how much longer she can cope with these conditions. See what she says. Dirt/filth is an unfortunate symptom of memory loss. Good luck-your friend is going to need it.
If you contact APS be prepared because once the courts get involved they will step in and lock them both up in a facility where they will spend the rest of there days and if care for them they will destroy you in the process I do know this and it will not be much of a change they will no longer have any assets or control over their finances because someone else will and it will not be any family if they can help it. it will not change in a facility either only the clothes might get washed but they can not force a patient or resident to bathe. so you may want to continue trying by compromise. as our family members age sometimes they are afraid to get in the shower or bathe they gain a fear of falling when trying to get in or out of the shower. there are ways to fix this but it takes money and time. the more relaxed you can get them the better it is and the more you show they still have independence over decisions that is sometimes the easiest way. if you want to find out any more on this or have more questions just email me
Just a thought but has anyone asked her why? People with dementia can lose their sense of smell and her sight may also be failing - does she actually know I mean really KNOW that she is dirty
The problem with total lack of hygiene especially in the toiletting sense is that it can lead to UTIs and at this point someone will step in and do something. I know the care homes do their level best to keep residents clean and dressed in clean clothes but even they with ALL their training sometimes have to limit what they do and indeed are limited by law too
If it was up to my father (vascular dementia), he would never change his clothes or take a shower. It's a combination of not caring and, of course, forgetting. He's very proud, and gets angry if someone challenges him. On the other hand, he is a very affectionate person and loves hugging. I use this as a reason for him to maintain his cleanliness, and when I talk to him in a gentle, humorous tone of voice, it allows him to put his pride aside and do as I suggest. I have to be a bit persistent once he agrees, and that can be challenging - walking with him to his room, pulling out clean clothes and standing outside his closed door, continuously talking to him through the door as he changes and reinforcing that he's doing a wonderful thing - but it's worth it in the end. I offer a lot of positive reinforcement once he's clean and smells great, and then he gets a big hug. Over time, this has become easier. Often, the caregiver needs to put his or her own pride aside, and even if it feels as if you're pleading with someone, at least it allows them to keep their dignity and not feel overwhelmed. Of course, this won't work with everyone! And as noted in the other comments, being dirty is not the worst thing in the world. My favourite part of being a caregiver is the incredible opportunity to learn how to "let go."
Actually while she MAY (and I don't think this is necessarily the case) not have any influence over the sister she probably DOES have influence over the son's welfare and well being. If he is handicapped he is classed as vulnerable automatically as is the sister in actual fact therefore the courts would probably act to serve as guardians (or whatever the term is in the states) and act to protect and safeguard them both. It isn't a crime but it IS a safeguarding issue particularly as if she has dementia then she is clearly losing capacity.
You do say that your friend in caring for her - in what way? As a carer especially if she is getting remuneration there will be obligations that go along with the duty of care I would have thought but the USA people will know more than I on this one. In the UK there is a duty placed on a crew to act in the best interests of their clients and to address concerns over health (hygiene would be included in that sphere)
Agree with Ferris1. Adult Protective Services is usually most effective when someone is a danger to themselves or others. If the son is unwilling or unable, maybe guardianship is an option to help get the sister into a place that can support her.
I experience this first hand with my MIL and we all live together. She rarely showers or changes clothes, refuses to wear Depends and says she does not need them but poops and pees herself and her bed. She eats food and leaves it every where. She won't flush toilets when she uses them. She refuses/does not want help from anyone, to shower, to change, to really do anything that pertains directly to her. Tells us that we don't take care of her, she takes care of herself, which is laughable. She'd be in a home if we didn't all live together. We cook, we clean and maintain everything, she does contribute 1/3 of mortgage. She can be ok sometimes but she is usually combative too if you ask or tell her to do anything. That's on top of her constant paranoia and delusions.
I agree that asking adult protective services to conduct a welfare check is about all that you can do.
As ferris said, being dirty isn't a crime. If the condition is so bad that it affects the disabled son, then they will likely take actions for his sake. If they feel that the sister is in danger, they make take action to protect her but that could mean going to court, which isn't likely.
Unless "your friend" has MPOA/POA over her mother, there is not much she can do. Being dirty is not a crime, and unless she is deemed incompetent by a doctor or courts, she has a right to do as she pleases. Yes, you can make a call to Adult Protective Services which never discloses who called for a "welfare check" and let them visit with her.
Just please, appreciate and treasure those moments of lucid conversation and tender exchanges with your loved ones and family and friends.
Behavioral changes are often caused by fear that they cannot express -- like waking up in a different foreign land each day - some things are familiar, others are not. i hope the "friend" is blessed with a lucid moment to talk with her friend who is afflicted with dementia, and have a heart to heart exchange. The dementia victim may be caught in a whirlwind of confusion and fear - that they cannot possibly rationalize their way out of. As a friend, i'd rather take that route before going behind their back and reporting her to the authorities. They would be most likely to separate the family and be of the opinion that the state of affairs in the home are by choice -- not even having the compassion to realize the extent of fear and the lack of direction/information that victims of the disease, and the caregivers, are subjected to on a daily basis. May God Bless.
I tend to think of these behaviors as a progression of her disease. They annoy caregivers far more than the person with the behaviors.
A couple hints.
-Replace dirty clothing with clean when the person is sleeping.
-Buy several of the same clothing item; then they will not notice the change in closing as dramatically.
-Reduce the number of clothing items they have. Store away excess items or give them away.
-Take responsibility for the son's welfare. Find a way to intervene.
-Febreze, oder remover/air freshener, hides a hots of smells.
-Use microfiber clothes for clean-up instead of paper towels.
Ask your friend how much longer she can cope with these conditions. See what she says.
Dirt/filth is an unfortunate symptom of memory loss.
Good luck-your friend is going to need it.
You do say that your friend in caring for her - in what way? As a carer especially if she is getting remuneration there will be obligations that go along with the duty of care I would have thought but the USA people will know more than I on this one. In the UK there is a duty placed on a crew to act in the best interests of their clients and to address concerns over health (hygiene would be included in that sphere)
As ferris said, being dirty isn't a crime. If the condition is so bad that it affects the disabled son, then they will likely take actions for his sake. If they feel that the sister is in danger, they make take action to protect her but that could mean going to court, which isn't likely.
We'd love an update if you see any changes.
Carol
Baby wipes were helpful. Easier to use. Ones without alcohol.