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I am caring for a woman who has progressive Alzheimer’s as well as dementia. I have been here for about a month now & I know it’s important to try and keep them on a daily schedule but at this point I feel like it’s impossible. She has the ability to walk, and stand up but is very apprehensive about the getting up part..but that’s another issue. Right now my biggest issue is getting her showered. We try to do every other day (66yrs old) but yesterday as well as today she flat out refuses & she will fight you every step until (normally) she’s actually in the shower. She will Not wash herself AT ALL, I’ve tried multiple times & it just doesn’t register with her besides I’m sure she’s forgotten what that even means. So I wash her as best as I can. I feel like I can’t do my job like I should because I can’t force her to do anything but the constant pressure of her husband wanting her to stay on a schedule as much as possible (I’m aware that’s the best thing) but what do you do when they simply will not cooperate??? Since I’ve been working for this particular patient my anxiety & stress level are insane! I am literally emotionally/mentally exhausted every single day I leave work to the point that I’m so tired when I get home that I have to fight with everything in me to get anything done in my own home. Needless to say my home is a mess & I have read everything to try and understand what I can do but so far I haven’t been able to figure out how to get her showered or even coax her into using the bathroom @3 times a day bc she will not get up and go on her own. HELP!!!!

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Let me start off by saying, you are more important than your client or her care needs.
Your home and your life should not be suffering because of some client. You should not have such a level of stress and anxiety over her. She's a job and not worth it. Quit her.
If you insist on remaining with her and need to get her into the shower try this approach which has worked well for me for many clients with Alzheimer's/dementia.

When it's time for the shower both you and her husband have to approach her together. You do not ask her if she will go for a shower. You tell her it's time for your shower and you're going to do it now. When we're finished you can have (whatever her favorite treat or activity is). Try this approach. If it doesn't work then her husband should look into care facility placement for her.
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KCaresTN22 Oct 23, 2021
Thank you
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This list was given to me by a relative who is caregiving for my aunts:

Rules for engaging our loved ones with dementia:

1) Agree, do not argue

2) Divert, do not attempt to reason

3) Distract, do not shame

4) Reassure, do not lecture

5) Reminisce, do not ask “Do you remember…?”

6) Repeat, do not say “I told you”

7) Do what they can do, don’t say “you can’t”

8) Ask, do not demand

9) Encourage, do not condescend

10) Reinforce, never force


The overall goal should be to keep them as calm and peaceful as possible (because they are less and less able to bring themselves to this state on their own).

This list would be good to print out and post where the husband will be able to refer back to it daily. You also may want to sit with him to watch some Teepa Snow videos on YouTube so he can learn better ways to engage with her to make the daily care less contentious.

Dementia is a progressive disease and thus she is in the process of change/decline every day, so being a flexible problem solver is what a caregiver needs to be. Wishing you success in finding the right strategies to help the both of them!
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wearynow Oct 22, 2021
Excellent list - thank you
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My mother dislikes showers so I try and make it as positive as possible.

I start talking about it in advance, how we’ll make her hair nice etc and how she’s got clean, beautifully smelling pj’s to look forward to.

I heat the room up half hour in advance with a portable heater fan as well as heating lamps. For me it’s actually too hot, it’s more like a steam room lol. But for her it’s the desired temperature, besides I’m not in the water so hence the experience is most likely different.

BUT key factor!! I play her favourite songs!! I make the shower time a concert she can look forward to.
This way she goes in there dancing! She may still hesitate at the undressing part but I distract with words from the song to get her singing.

In saying that,.. it still is tiring putting so much effort in for a shower,.. by the time I’m finished,.. I’m ready for a shower myself and bed!!

we don’t always do a full shower,.. sometimes it’s only a bottom wash. I do this if I sense she’s in a more difficult mood. I let her keep her top on and I hold the shower head for her while she quickly washes her bottom parts. I’ve been able to reason with her for this as she has realised how much better it feels after and it only takes a few minutes. I usually announce it as we are changing her depends - “time to do a rinse”. This way she’s already undressed at bottom and less likely to be against it.

But overall the music has been a winner for now!!
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answry Oct 24, 2021
You are so correct. Regardless of all the heaters going from the ceiling and from the floor, it is hot enough to pass out but it's either just right or still not enough. I can't stay in the entire time, I have to step away and cool down.
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ALZ falls under the Dementia umbrella but it effects the brain differently than most Dementias. You can have ALZ and another form of Dementia that effects the brain in a different way. ALZ and Dementia were discribed to me this way.

Dementia...you know its a stove just forget how to use it

ALZ...you forgot its a stove.
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My mom is stubborn about showers and refuses help. So the caregiver “fixes” her hair. In the process, mom gets a bath. It is usually a washcloth bath but it works. Turns out my mom gets cold easily and sees the shower as uncomfortable. She also doesn’t wash, she just is in the water stream. So the caregiver, warms the bathroom up to hot, gets mom in her warm robe to fix her hair. AND this only happens 1 time a week. Every day or every other day is unreasonable. When I worked in a NHome, we showed the residents 2 times a week mostly and some only 1 time a week because they were getting daily clean ups. Our caregiver ensures that mom’s skin is clean and because her skin is dry, lotion keeps the skin from itching. Mom has stucco keratosis and her skin is so dry. The derm doc told us to get the Eucerin (red top) lotion for dry skin and it has helped tremendously. It has 10 percent urea to soften the dry skin.I don’t know how to handle the husband but prayers for everything is what keeps me calm and I pray with mom when she and I are having a hard time. I just ask her if I can pray because I don’t want to upset her. Her dementia waxes and wanes, but her demeanor after I pray is wonderful even if it means I am calm .
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I would try to make this as spa-like as possible.

De clutter the bathroom so the room is as “low stress” as possible.

Try some gentle massage, use fragrant soaps (if she can tolerate the smell of them) and play relaxing music. Use lotion when she is done. (Try some different kinds of music to see if one type relaxes her more than another).

Talk to her as if she is normal (even though she might not respond accordingly).

I’m sure your client’s husband is stressed because he just wants his wife back. 66 is young for dementia and this must be very disappointing and scary for him. Listen to his demands patiently- he can’t help but feel frustrated.

Do your best to keep her on schedule. Surely, if you ever have a day off, he will realize your great contributions and will understand that staying on schedule is a goal that simply is not always attainable.
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First, you say, “her Alzheimer's as well as dementia”. You say you've been reading “everything”. I don't know what you're reading, but you don't understand that Alzheimer's IS dementia. They are not two different diseases, in fact, dementia is not even a disease. Dementia covers many different conditions and diseases, Alzheimer's is the most prevalent of the dementias.

“Since I’ve been working for this particular patient my anxiety & stress level are insane! I am literally emotionally/mentally exhausted every single day”. This is obviously not the job for you. Are you a paid caregiver or are you volunteering to do this? In either case, it appears you do not have the skills to continue with this particular patient, you are in over your head. I don't mean to embarrass you or make you feel your efforts are not praise worthy, they certainly are, but you don't need to do this. Showering is only one problem, there are many more to come.

If I were you I would excuse myself from this job after looking for an agency or individual who has experience in dementia care to replace you. I appreciate that you are a caring person, and I applaud you for wanting to serve others, but you cannot do this at the expense of your own health.
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MJ1929 Oct 21, 2021
You could have multiple types of dementia. There are more than 70 variations, and yes, Alzheimer's is one.
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You need to drop this client for many reasons. She needs placement. Trying to cope with this client only prolongs the decision at your expense. There are some families that you just can’t help.
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Reply to Chellyfla
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First of all no job is worth your health! Your skills are in demand and you can find another person to care for. If you decide to stay with this husband and wife than never ask her if she will take a shower. What I have found is asking usually will get a No answer. Tell her it is time for her shower! Point to your watch. ( pointing to my watch seems to really help Mom do things) When I do this she will ask is it time> I say yes YES right now it is time…And she will usually cooperate. If she refuses than tell her if she won’t shower for you, you will have to get the male orderly and he will pick her up and put her in the shower and you don’t want him to do that to her. So get in the shower NOW. I find firm tone of voice and command works better than coaxing. Than if you get her in the shower soap up a face cloth and tell her to wash her legs, her arms etc. I have found that handing individual face clothes for different body parts my Mom will follow what she is told. But never cooperate if she is asked. I think a lot of refusal has to do with confusion and fear. By giving directives she may feel safer and more willing to cooperate. Than I also keep saying good job, great job your doing great. And I also reinforce that taking a shower will make her feel better as she is washing. After a few times she now still gives me a hard time but will get in and when she is in the shower she now says showering makes her feel better. I hope this works for you.
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Reply to Charlie714
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Will your patient agree to sponge baths? A full shower is not necessary to stay clean. ....Warm water and towell to wipe down and then use products that will clean without rinsing. They have them at the hospital. I watched the nurse do it at the hospital....they use a small bucket with warm water and wash face, body, etc. For the smelly parts(bum and feet, etc), they use a foam product that you wipe on and does not require water rinse. I would not fight this patient if she does not wnt to step into shower. There are many ways to stay clean.
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