How do you handle a person with dementia who won't let you wash their hands when they have fecal matter on them?


I'm my mom's caregiver 24/7 and as the Dementia increases she becomes more combatant. I don't have a problem until she becomes irate and fights me when I change or bathe her. What I don't understand is how her memory is still good, but when she gets into her moods swings, I have to wait until she realizes I'm there to help her. This is not my first time as a caregiver and I took of my lover who died from Aids in 1993, but this is totally different.

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I also use hand sanitizer with my mother after toileting. I squirt some on her hand and then mine. I model rubbing my hands together and she copies the motion - sometimes getting carried away and rubbing it all the way up her arms. But basically it works because getting her hands under running water has become impossible. Wet wipes are my go-to for fecal matter followed by hand sanitizer.
I’ve given up trying to figure out why running water creates such fear in her mind - hand washing, showering, tooth brushing - and just try to work around it.
Thanks for all the great tips in this thread!
Helpful Answer (1)
Reply to madzeena

Caregiverology, ahh great advice about the alcohol based hand sanitizer deterring LO from putting hand in mouth!
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Reply to Pepsee

Alzheimer's patients don't like their heads washed or touched much just saying
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Reply to maggiemay1014

caring for an aids patient is such a blessing thank you!! dementia is different in that they don't know you or wonder why your doing it, comical but serious ,alzheimers are happy or angry has no bearing on you they don't know its you, just be patient and tidy up when they are calm or distracted
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Reply to maggiemay1014

My mom was the same way, ej. When I helped her to the toilet and she was finished, I got her back in the wheelchair and parked her in front of the sink and proceeded to run the water and I myself put liquid antibacterial soap in her palm and stood there and asked her to finish the deed. Did she balk? Most of the time,not really, with the soap in her palm it sort of clicked in her mind that she needed to get rid of that “stuff” in her palms. 
For the times this didn’t work, hand wipes. Eyerishlash’s approach is a wonderful idea.
My mom’s cleanliness post toileting was a pet peeve of mine and I tried to get her in that habit. I would say I was successful 75% of the time, however.
The orange stick is a great tool as well!
Hygiene was always a battle with my mother in her last years whether it was hand washing or bathing.
Helpful Answer (3)
Reply to Shane1124

Ejwebb93, I suspect that Aids and Dementia don't have much in common. Your previous caregiving experience is no doubt valuable but probably not directly applicable.

Does your mom have a preferred way of washing her hands? My mother liked to partially fill the sink and swish her hands in the water with some soap. Since I never put the plug in the sink and I wash under running water that wouldn't have occurred to me. And my mom liked bar soap instead of liquid. Would your mom like some special washcloths that only she uses? If she had things exactly the way she liked them, would that help at all? (Probably not, but it is worth a shot!)

I like the "manicure" idea, too!

My husband did wash his hands after using the bathroom -- that was a habit too ingrained to drop -- but I was concerned that it wasn't as thorough as it should be. I put a basket of washcloths near the sink, and a hamper for them in the bathroom. They became single-use hand towels. My husband was always fastidious about drying his hands and then using lotion. (Another long-standing habit.) I hoped that between the casual washing and the thorough drying his hands got clean.

The bonus to this is that folding the washcloths gave him a chore that he could do well. I used all kinds of patterns and colors and textures, to make the folding a little more interesting.

I continue to use these single-use "towels" for my hands. I feel they are more sanitary than reusing larger towels.

Of course if your mom isn't willing to even wash her hands at all, then drying them thoroughly probably isn't adequate!

My mother lived with my sister for over a year, and she fought taking a shower every time. When she spent weekends with me we all thought she'd love my walk-in tub. Nope. That was a fight, too. When her care became too much for home-care, we placed her in a nursing home. One sister and I happened to be visiting when an aide came in and told Mom it was her turn for a shower. Mom went off with her without any protest. We were told she never fought her shower. We wondered who this impostor was and what they had done with our mother! Hiring a bath aide to come in once or twice a week MIGHT reduce the fighting. Ask her doctor to order that.

Reasoning with dementia is seldom successful. Explaining the benefits and risks probably doesn't work. So you may have to be a bit sneaky about how you get her to do what is best for her!

And if you find things that work, come back and tell us. This is a very common problem, and we learn from each other.
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Reply to jeannegibbs

Excellent idea Eyerishlass!
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Reply to Pepsee

After she's done in the bathroom and is situated in a chair bring over a pan of warm, sudsy, fresh-smelling water and encourage her to soak her hands for a manicure. Approach it as a pampering thing and not a cleaning-up thing. After she's soaked for a while take a soft wooden orangewood stick (in the nails section of your pharmacy) and gently remove the stool from beneath her fingernails. You won't need to dig, the water will have softened it up. After you're done gently massage her hands with lotion for a few minutes. Her hands will feel great and her nails will be clean.
Helpful Answer (5)
Reply to Eyerishlass

I work as a nurse in a hospital and have encountered similar situations. Luckily, we have help. Regardless of how much the patient hates it, we clean them up together. Having fecal matter on skin for long periods of time can cause some serious skin issues. Not to mention if she ingested it, which is certainly possible. I like the wipes suggestion. Even quickly squirting hand sanitizer on her hands would be better than nothing. The taste of the alcohol would at least keep her hands out of her mouth.
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Reply to Caregiverology

Yes, you're right, AIDS is a totally different type of caregiving than dementia. As you are learning, you can't reason with someone who has dementia.
I'd be right there with Wet Ones disinfectant wipes before she leaves the bathroom. Grab her hands and remove as much as possible. Have a few ready and hopefully she'll cooperate. Maybe she doesn't like the feeling of running water or that it's too cold.

Maybe it may be time to apply for Medicaid and look for Memory Care placement.
Helpful Answer (6)
Reply to SueC1957