My wife has a form of dementia resulting from radiation and perhaps chemo she had several years ago to address a frontal lobe glioblastoma. Her dementia has become progressively worse. I am her caregiver and we live at home.For the last several months she refuses to bathe or shower. I have tried to persuade her but she simply will not agree. I tried to bring in a trained helper but she didn’t cooperate and was very resistant. I know I could physically force her to shower, but that seems to cross a line which I am very reluctant to do. I do not want to put her into a care facility and feel she is better off at home.Can anyone recommend strategies of best practices for addressing this kind of situation.
If, after you try all these excellent suggestions, you still cannot keep your wife clean, you may realize that she is NOT better off at home. Skin sores can be fatal. Being unable to inspect her for problems such as lice or scabies is detrimental to her health.
We don’t like to think about such things, but you’ll have to because you’ve decided you want to keep her at home. I wish you luck in keeping her as clean as she needs to be.
It might be good to keep alternate plans in mind. Professional caregivers are trained to do what you may not be able to do.
You have to wear them down and speak the plain truth. How to do this, is no one gets anything to eat, drink, no entertainments (tv, computer, games, puzzles, etc...), or even a conversation on any topic other than getting the washing up done.
All of this and then you throw in the honesty. Tell her she smells bad and that no one wants to be around a person who refuses to be clean or wear clean clothes. If you have adult children, tell her they don't want to come around because she stinks. Let your kids know ahead of time that you're not throwing them under the bus trying to hurt her feelings. You're desperately trying to get her to take a shower or wash up. Use the old reliable tactic I used for years which is, 'Your doctor said that you must shower (X times) a week otherwise you will have to go into a nursing home. He will be sending a nurse to check up on you'. Then make a showering schedule/calendar and tell her it's from the doctor's office and you have to fill it in and hand it in every month.
I find threats of a nursing home or going against what the 'doctor' said is usually enough to get a hygiene-resistant senior to be compliant.
If all of these fail, you can force her into the shower. Tell her it's for her own good. Or fill a basin with warm water and make her take a sponge bath.
Those with Dementia are like children and children usually do not like showers. Don't ask her if she wants to take a shower, just take her. Make sure the room is warm. Have a shower chair away from the spray. I had a handheld shower head. I would rinse Mom down, then suds her up and rinse again. (She would allow me to wash her hair) You do this as quick as possible. I had a towel on the toilet seat where I put her. Then dried her off quickly. Dressed her in the bathroom because it was warm.
Gradually I've become her father.
Changing diapers several times a day, or even wash her waist-down, are not big deal, but showers... That's another story.
Yesterday, though, I put some music in the bathroom, just to cheer me up (it is hard to shower a person who hates water). First time I do something like that. I sought in my smartphone and chose "I Want to Break Free". My mother, a 88-year-old Spanish lady, didn't know Queen. But, man, she loved Freddie Mercury's voice so much I could shower her without any problem. It was like a miracle.
Why don't you give it a try?
Sending you strength from Barcelona.
“I love you and you have a choice here, you can cooperate with me now or you can check into a care facility.”
Since his appetite has been waning steadily, I keep a store of things he likes that can be made easily in the air fryer or microwave. His control over what and when to eat has been very helpful.
It is how I handled my wilful toddlers years ago and the same technique applies here. God bless and good luck.
Every time I feel like placing my loved one into a nursing home was wrong, I go visit him and see that he ok. I had lost the ability to help him at home. He still seems to be resistant with me when I take his arm to help balance him after he stands up. Your wife wants to be independent, so maybe say hey if you want to clean up, I'm
here for you. That's what I did. Then I would say ready, let's do it.
Maybe she wants to decide.
I think it depends on what is causing her reluctance. I would try asking her if she is able to communicate what it is that makes her uncomfortable. It may feel unsafe; you could adapt the shower with a seat and a hand held sprayer. She may not like the spray of the water; you can try pouring water over her gently. She may have developed an irrational fear of the water or dislike getting wet; You can try bed baths - that is, wiping her down with a warm, damp washcloth.
I think hiring a person who is trained to help with bathing was a good idea. They may just need to try a different strategy or method of helping her.
Since my husband doesn't feel comfortable with even getting close to him for washing, he would grab the cloth from my hand and throw it, hit the water basin, sending water flying everywhere, I would give him a soft dry hand towel, to give him a participatory role and some control, instructing him to use it to dry as we go. That was somewhat successful - at least for a few times. Then, he got wise to it and would simply throw his towel to the floor and continue to fight me.
It's a challenge. Hopefully you an get your wife to communicate what she dislikes so you can address her concerns. If she has (or ever had) a stubborn streak, I would avoid verbally trying to "persuade" her, or turning it into an argument. Sometimes with dementia, you can not ask ( the answer will always be NO, and then they will dig their heels in). Instead, you must tell them, "Okay, it's time for your bath now." And just start doing, taking charge whether getting her in to the shower and helping, or doing a sponge bath while she is sitting up in a chair or on the bed.
You mention not wanting to cross a line by physically forcing her. But, at some point, she can no longer be in control of her personal cares and you, or someone you hire, must take charge, gently and with patience and respect, helping her to feel more comfortable with the task. Sometimes offering a reward after an unpleasant task will be effective.
For those who STILL sit on toilets or... if not the toilet, you can still do this while sitting on side of bed, bedside commode, while standing up at recliner?
If they still using the bathroom... they sit on the toilet and while they are sitting on the toilet you may not be able to get EVERYTHING done but they normally sit on the toilet several times per day so, do "a little at a time"... start with the , private areas first.
Have EVERYTHING READY: towel, wash cloths, cleaning cloths... whatever you use to clean them. Have their Depends ready to put on, clothes, etc. You can get a ton done in 5 minutes if the water is already to go, in the sink, tub, whatever.
I also do this... while they are sitting on the toilet, I have warm water in plastic drinking glasses, cups... containers, maybe even plastic drink bottles... pour water from them down their privates in the front.. water goes into toilet. But... even if you spill some, easy to clean up? Have them either stand up while you clean the buttocks or.... while seated on toilet, have them scoot forward on toilet seat, pour water down backside.
In 10 minutes you can get everything done. Hard to do legs? Too much bending? Do while they are laying in bed anytime!
And... yes.. as someone said. DO NOT ASK THEM IF THEY WANT ANYTHING THAT IS NECESSARY! They are going to say "NO". Just do it. You might even say to them.... things like.. I bet you can't wash your face? And people do not like to be told they cannot do anything. Or say something like, How do you wash your face? And then just give them the wash cloth. No ifs, ands, or buts. Treat them like you EXPECT THEM TO DO IT.
You can wash them while they are in bed.... they grab ahold of the handrails and turn themselves if they can do this. If not, you turn them, undo the tabs on the Depends, lay it down on bed and us that Depends to catch the drips from the washcloth you are using to wash them. Please use the Depends with tabs for those people who are bedbound. Easier to change/wash them.
Also, here is another trick---- use a women's pad they use for when they have their periods... put inside the Depends... easier to change... can check them often, too. Also, can use these on men--- wrap around their penis...and much better, easier and cheaper to use than the pullups. I hate pullups.
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