Someone recently suggested having an 'accidental' spill over father's pyjama trousers so that he definitely needs to take them off. A nurse also suggested doing as much as possible of the changing while he is lying down in bed, so that things just get pulled up etc when he finally stands. Perhaps you do a 'bed bath' type wipe around the bottom end at the same time, and forget about the shower. That method needs less co-operation from him and less risk of injury to you. Good luck - it seems a very common problem.
I'd consider that he may not be able to participate and do what you are asking. I think that sometimes the person may appear to be able to physically move their hand, arm, leg, etc., but, they are not able to use it in a functional way, which is due to their brain damage. So, it could be ability or it could be resistance to care, which is also quite common.
Have you looked at the videos on You tube, by Teepa Snow on dementia behavior and care? She has some helpful suggestions.
I might also look to see if changing how you are doing it would make a difference. Try different techniques. If you are doing it in the bathroom that is cold, try heating it. If you are doing it on the bed, can he be made to feel more secure on the bed? He may fear falling. Are other people present? Maybe, he needs privacy. Are you using wipes that may be cold? He may find it unpleasant. Could you make sure that he's calm first? Perhaps, play soothing music? And, if you ask him to do something, like move your leg and he doesn't, don't keep repeating it and get frustrated. Just do it for him and continue, so he doesn't feel defeated. Using positive and comforting words may make him feel less agitated.
I hope you get more suggestions. I only helped changing my LO's clothes.
I'm not sure if you mean that he is uncooperative with beginning the task (as in you indicate it's time to change and he refuses) or if you are having trouble with him completing the steps associated with the task because he can't remember in what order to do things.
If cooperation is the problem, try offering a small reward for compliance with the request. ("Hey let's go use the bathroom, and then we'll look through your magazine or get some ice cream")
If an inability to complete the steps required for the task, then you must provide very simple instructions for each step. (1. Let's go in the bathroom. 2. Unzip your pants. 3. Pull your pants down. 4. Pull your underwear down. 5. Sit down. etc. etc. etc.)
My mom didn't have Alzheimer's, but she did have a terminal brain disease that caused rapid dementia. At times she would be very uncooperative as she forgot she was incontinent and she would insist she was "a big girl" and didn't appreciate being told what to do. She also lost the ability to do all the steps. (Can't tell you how many times she tried to sit on the toilet with Depends still in place.) Couple this with the inability to control movement and some joint rigidity and she would appear to be physically resisting the efforts of those assisting her. Eventually, she became wheelchair dependent, then too big of a transfer fall risk and became bedridden, so the toileting issue was moot. Caregivers just changed her incontinence garment (diaper-style once she was bedridden) on a schedule.
I'm not sure how far along your dad is in his Alzheimer's journey, but you need to be able to gauge what he is ABLE to do (which of course is a moving target with a progressive disease) and adjust your expectations to his abilities. You may find that toileting will always be somewhat of a struggle that changes as his disease progresses.
Have you looked at the videos on You tube, by Teepa Snow on dementia behavior and care? She has some helpful suggestions.
I might also look to see if changing how you are doing it would make a difference. Try different techniques. If you are doing it in the bathroom that is cold, try heating it. If you are doing it on the bed, can he be made to feel more secure on the bed? He may fear falling. Are other people present? Maybe, he needs privacy. Are you using wipes that may be cold? He may find it unpleasant. Could you make sure that he's calm first? Perhaps, play soothing music? And, if you ask him to do something, like move your leg and he doesn't, don't keep repeating it and get frustrated. Just do it for him and continue, so he doesn't feel defeated. Using positive and comforting words may make him feel less agitated.
I hope you get more suggestions. I only helped changing my LO's clothes.
If cooperation is the problem, try offering a small reward for compliance with the request. ("Hey let's go use the bathroom, and then we'll look through your magazine or get some ice cream")
If an inability to complete the steps required for the task, then you must provide very simple instructions for each step. (1. Let's go in the bathroom. 2. Unzip your pants. 3. Pull your pants down. 4. Pull your underwear down. 5. Sit down. etc. etc. etc.)
My mom didn't have Alzheimer's, but she did have a terminal brain disease that caused rapid dementia. At times she would be very uncooperative as she forgot she was incontinent and she would insist she was "a big girl" and didn't appreciate being told what to do. She also lost the ability to do all the steps. (Can't tell you how many times she tried to sit on the toilet with Depends still in place.) Couple this with the inability to control movement and some joint rigidity and she would appear to be physically resisting the efforts of those assisting her. Eventually, she became wheelchair dependent, then too big of a transfer fall risk and became bedridden, so the toileting issue was moot. Caregivers just changed her incontinence garment (diaper-style once she was bedridden) on a schedule.
I'm not sure how far along your dad is in his Alzheimer's journey, but you need to be able to gauge what he is ABLE to do (which of course is a moving target with a progressive disease) and adjust your expectations to his abilities. You may find that toileting will always be somewhat of a struggle that changes as his disease progresses.