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I have tried to be a good forum user by looking for answers from past posts and I'm sure there is one that would be super helpful for me but I'm brain-tired now. I have my own caregiver issues... but my husband is in a delicate time with his mom who is dying from cancer and is in home hospice. My husband and his brother are switching off weekly as the live-in caregiver. Professional caregivers come in twice a day for four hours and a hospice nurse stops by three times a week. Here's the problem. What to do when his mom refuses to let the caregivers change her diaper or help her put on a clean gown? I assured my husband that the caregivers are trained to deal with angry, mean, miserable people who are sick and dying and they know not to take anything personally. But the issue is, my MIL fights them off physically and seems to prefer to stay in a soiled diaper. My poor husband does his best to try and convince her to allow them to clean her but it does no good. He's got his own health issues; bad arthritis in every joint and when she fell after sneaking out of bed, he injured himself and had to go to the ER due to trying to carry her back to the bed. It was a disaster... He's now on muscle relaxers and painkillers and just isn't up to physically or emotionally wrestling with her about her hygiene. Can anything be done about this situation?

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If this is a sudden change in mental status then yes, testing for a UTI is certainly the first thing to do. But someone also needs to alert the hospice Medical Team about this. If they refuse to test for anUTI, your husband needs to push back hard.

Hospice is about comfort care for the patient and for the family. It doesn't sound like anyone is comfortable right now.
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Have you or your husband asked her directly why she is behaving this way?

If she is off dialysis, I believe that toxins start building up fairly quickly, which might affect her thinking.

As I said before, I think you need to address this with the hospice folks, i.e., the SW and RN assigned.
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Rollergirl228 Nov 13, 2020
I haven't been there since she started acting aggressively. I'm not sure if my husband asked but I will definitely check. The comment about dialysis makes a lot of sense. My father's home health nurse said to also check if she has a UTI.
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Thank you for your answers. I know she's not been diagnosed with dementia. I can vouch for that since I talk with her regularly. She often says she feels no pain, but my husband did say he gave her some morphine yesterday. It was the first time that she needed it. When I visited her three days ago, she said the caregivers were bugging her. She said they're always disturbing her and she even resents when they bring her a meal. She acts as if it's an insult. My husband says she's refusing to take her meds which include anti-anxiety pills. She was on dialysis until about two weeks ago when she said she didn't want to do it anymore. It's been several weeks since she's had a chemo treatment. They sent a male nurse the other day which really set her off but she hasn't been much better towards the females either. Could it be a pride thing? Might she be humiliated by strangers seeing her genitals and behind?
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I would address this immediately with the hospice RN and social worker. Most aides can be very persuasive about hygiene.

Agree with Geaton, can she tell you why she doesn't want changing?
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Rollergirl, what do you think is the source of the combativeness? Is it dementia, or pain or chemo-brain or...? I'm only asking because I think any further insight will help you get the best support. Blessings. Take care of yourself!
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