Mom refuses to shower when I suggest it. She thinks washing up is good enough when it's not. She is prone to UTIs and we have spoke with all of her doctors about it. They said showering every 3 days is sufficient. I can't get her in the shower twice a week but maybe once a week. Today she refused to shower. We were planning on visiting my husbands family and she agreed to go with us. I refuse to take her unless she showers. She continue to get dressed and put jewelry on, ignoring me. She says that washing up is good enough. I told her she might as well not even put any jewelry on or get dressed because I'm not taking her. And she said I'll get a cab there. She doesn't even know where she lives and she could not even make it out to the curb to get in a cab. She's on oxygen 100% of the time. She has advanced COPD, heart issues and a mass in her lung that is suspicious for malignancy (she doesn't know this). Unfortunately she is high risk and cannot endure any invasive testing and surgeries. We have already spoken to a palliative care doctor regarding her situation. She can just about walk and when she does can only go four to five feet at anyone before having to sit and rest. We cannot see my in-laws because she is being stubborn. I am at my wits end end. She doesn't even care about how much my husband and I do to help care for her to enable her to stay in her own home. I am living with her and have for the past four years. My husband lives four blocks away and comes four days out of the week to sit with her while I work. We have one lady who comes in on Mondays and my sister comes another day. I just cannot believe how hurtful she is by actually telling me she isn't showering to spite me. She got me so upset crying that I actually told her I hated her. I really don't hate her I love her very much but she is a selfish person. She has been selfish all her life and I have overlooked it. So now my husband and I both cannot go and I think it's so unfair. I work full time and have no social life. If I want to go out, I have to find a sitter. That is hard because I have only two people and they are here taking care of her during the week. I just do not know what to do anymore. I am getting burned out.
There is equally this: "She doesn't even care about how much my husband and I do to help care for her to enable her to stay in her own home."
So, first of all, I am so so sorry for how exhausted and heartbroken you must feel. Getting burned out? Goodness, you must be a cinder. I have tears of sympathy starting, too, at your brilliantly honest - and thank you, because it needs saying and you're brave to do it - description of how your feelings boiled over until you told her you hated her. Of course you don't, but it's so much to deal with. Truly, I not only understand how you feel: I lost count of the number of times I shook with frustration over my mother's refusal to be even minimally co-operative about her own safety and lectured her endlessly about it. Completely pointless. I wish I hadn't. Too late.
What I'd say is, avoid the regrets I now have about the time and tears I wasted on arguments. Longer term, you could offer your mother assistance with 'washing up', or perhaps aim at getting in an extra caregiver visit specifically for help with a shower; but just taking as an example the thwarted visit to your in-laws - what would have happened if you'd all gone, shower or no shower?
It isn't that your position is in any way unreasonable. You're going on a visit, it's normal to do your hosts the courtesy of being clean and tidy. True, correct. But your mother hasn't the energy for normal. There *could* be other reasons for the reluctance to shower, and it's worth checking that there isn't a problem she hasn't thought to mention; but with her health history I'd guess that she is too tired to bother. Literally, she just doesn't care about it - she can't be doing with it. It's the sheer effort, and she probably doesn't even want to discuss it any further, I expect? - that's why she came up with that snapping retort about doing it to spite you (what nonsense, of course she isn't).
Have you had a respite break recently? (Probably a stupid question, I guess). Something to consider, because if you can possibly find somewhere that will care for her well for a full week it will do you a power of good.
But back to now. It's a battle-picking question. Choose them very carefully, and stingily. And don't, please don't, waste breath on arguments. The second your mother starts to dig her heels in about something, drop it - change the subject, leave the room, give her a quick hug and say "ok, we'll come back to that one." There really aren't many things that deserve a place on your priorities list at this point. Preventing uti's seems important, is important, but her shower count isn't going to solve that issue on its own - which means it's not worth the battle. And supposing you'd gone on that visit, after all? Your in-laws might have raised an eyebrow (or God forbid reached for some clothes pegs); but then again I expect they're open-minded people, aren't they? Perfectly able to understand that your mother is in very poor health, and that personal hygiene isn't so easy to manage.
I didn't mean to rabbit on at such length. The way you're feeling at the moment, it must be overwhelming. And there aren't *simple* answers - there's a great mass of philosophical and practical and emotional issues all tangled up together, and you're expected to deal with this at the very stage in life when you're overworked, under appreciated and plain battered. You're right, it's not fair.
But, battles. Cut them right back to basics, pare them to the bone. If it's not a matter of life or limb, and it's causing you or your mother or both of you grief, then let it go.
Once you start stopping your normal living outside the home, the more she will try other areas.., even to the point that you can't go to your room but be with her 24/7. I'd find a way to go and just leave her behind since she refuses to shower.
Taking a shower when you have all the things going on that she has with her health may feel impossible because it is so exhausting. She can probably hardly lift her arms over her head to take off her night gown. Does she actually smell? many people get by with a wash down for years when they have no running water. In my early years Friday night was bath night. We had a tub in the kitchen and Mum lit a fire under what we called the copper which was a metal tub that the clothes were boiled in and then transferred the water to the tub. If you are worried about UTIs make sure there are plenty of wet wipes in the bathroom so she can clean the genital area regularly.
Given all that do what you can with the wash up and take her anyway as long as she does not smell really foul. If there is any chance of incontinence take a Chux to cover the car seat and to put on the chair in your in laws home.
With advanced COPD and oxygen 24/7 I am surprised she is able to do any of her own personal care. Your mother has reached the stage where she will suddenly start to decline very rapidly to the point of being bedridden. Have you thought about how you are going to manage then or will a nursing home be the next step.
This is about far more than reluctance to take a shower.
Last week, for example, a young man was rapping to a girl on the bus. I was seated, and his behind was literally on my face. He looked at me, smiled, and farted. She complained about the foul odor, and he pointed at me. I lost it. "Pig a__, lying MF! ... I'm gonna knock your teeth out!" She immediately called him a nasty bastard, and got off the bus. The bus was so crowded I couldn't leave my seat, so he laughed and let another one rip before stepping off the bus. Once outside, he gave me the bird from outside the window. I shouted at the driver to let me off, but the bus began to pull off. The punk still had the finger up while grabbing his crotch. Suddenly the bus stopped and the door opened. I stepped out and asked him the reason why he was being so rude and nasty. He kept laughing and answered with a fist that barely missed forehead. I knocked him out dropping him on the curb. People on the bus clapped and laughed. I took a bow and went home.
What I'm trying to say is that sometimes a more direct approach is required regardless of the other person's condition. Don't suggest and sugarcoat. Just be assertive and say it straight out.
I do massage her body with cream every day and that, alongside the washing does mean she smells pretty sweet most of the time (not today today is a bad day but that's a whole different thread and not related to lack of hygiene)
Juju if she will sit in the shower area and you promise just to wash her down would that work. She may prefer a sponge down to a shower. You can use a cut out front shower chair so you can get at intimate areas and use a long handled bent sponge which will reach and wash those area with any lotion (i used a no rinse soapy wash diluted in water first and then just dipped the sponge in - saved me getting too intimate in the early days when I found this quite difficult to do - now I can do it easily but not at first. She may not mind the shower if you take the spray part off and just let the water run out rather than spray out - its not so harsh against their skin...all things to try.
You could also buy a shower attachment that will fit on your taps and allow you to spray under her while she is sat on the toilet but given elderly people's limited capacity for being safe while they move around at all let alone on a toilet seat I would not really advise this at all but if you decide to try it make sure you have a splashguard in place and a rail for them to hold on to. At least this way the water you sprayed would be warm rather than the traditional sprayer advertised above which would spray COLD water onto her butt - oh she would sure accept that....not. I would still try to assure her you want to wash her down but in the shower to avoid the drips on the floor which will either long term stain the carpet or be slippy if on a hard floor
bidetsprayerman posted on your message board 2/27/2016 at 1:04 pm
You are the expert, on everything.
I guess it is time to come clean. I am a published author on dementia for carers having written on safeguarding of vulnerable adults some years ago. I have visited over 200 care homes in the UK as part of my work and am well versed in good care average care and downright bloody awful care in a care home setting. it is all very different at home when the care givers are familial.
No-one in their right mind would introduce a cold spray onto an elderly persons genital area unless they could get them to understand why they were doing it. The person would be frightened may try to jump up and fall and for a million other reasons I just cannot see the usefulness of them in care for geriatric people with dementia. Im not opposed to bidets or shower sprays at all ...for me...but I have grown up in a different generation and am familiar with them, most people have not....Hell my mum had to walk down the garden to her toilet when she first married they didn't have one in the house, nor did they have a bath in the house except join Friday night when they brought one in and everyone bathed in the same water one after the other.
Times have changed and you have to understand that people with dementia do not grasp and certainly don't keep a grasp of new things let alone someone that intimate.
So thank you for calling me an expert.....Im not....I am just experienced in what good care skills rather than scare kills
People declare themselves to be experts in many fields with far less experience in their field than you have in yours.
I'd love to have a bidet but not one with only cold water.
The only true bidet I've ever seen was in my Auntie and Uncles house in Wales. It looked interesting enough, and had warm water I'm told, but I didn't try it.
When I started back in the day there WAS no training for people who worked with dementia....nothing.
Carers who didn't care about people's dignity, had no respect for their privacy, and witnessed some results of some very nasty abuse. Whenever I saw bad practice I reported to the managers for them to handle. On the very odd occasion when my report was ignored I just went to the authorities. You have to stamp out poor practice. I was using the self centred approach - I want them to be fantastic places just in time for me to need them!!!!!
Some care homes challenged people when they said weird things, some didn't, some told residents off when they couldn't find the toilet for the hundredth time and some just put a picture of a very old fashioned toilet on the door. Some overmedicated to keep the person 'quiet' some had exercise and music and 'light rooms' to stimulate them along with art, dancing (not always but mostly watching).
What angers me is that while these people had the skills to HANDLE people with dementia they had no understanding OF dementia and now although I HAVE the knowledge can I get training in the hands on stuff? Can I heck as like and that is where it all falls down. Knowing what to do and actually doing the hands on stuff is very different especially when you bolt on the swathes of emotion that come with familial caring. When I massage Mums body I have no problem (as long as I use gloves) I don't of course use gloves so even touching her I find not quite right especially buttocks breasts and upper inner thighs. It's too personal FOR ME. Yep I hear you ...get over it ...but I still find it hard and when it gets more personal than that I really struggle still 5 years down the line
Pick a time in the day when they are feeling a little more malleable as it were. Try using soothing music to soften their emotions - the last thing you want is a battle before you even get to the bathroom. Make sure all the towels are warm and ready to use. Anything cold on their skin is really unpleasant for them - older people are so much more sensitive to the cold.
If she absolutely point blank refuses the shower then using a no---nonsense approach tell her she can wash up but in the shower - its too dangerous now for her to do it over the sink - the doctor said so (great source of support even if they didn't say it)
Let her wash the way she always does then say right Mum I need to make sure your undercarriage is clean now (or whatever words THEY use for that part of their body) I am going to use a sponge and warm water to wash you ok? right and keep talking to her the whole time not about the washing but about the weather the dog the cat the music anything to take her mind off what you're doing. If she's incontinent once you have dried her then apply a barrier cream and explain that you are applying the cream that the doctor prescribed to keep her from getting sore.
Just remember to wipe from from to back and to wash from from to back and surprise surprise dry from front to back. Let her rest after you have showered or sponged her down dried and dressed her - it is exhausting for some people. Talk to her or find a photo album to look through once you have her dressed. Then continue - hopefully over time she will come to enjoy that
In the late fifties when I trained in the UK student nurses received absolutely no training about dementia and how to care for these patients. Patients who became "difficult" were sedated whether they liked it or not and had a very sad end. Uncooperative elders were made to be co-operative with physical force.
Student nurses were 18 year olds straight out of high school with no life experience. In the better London Hospitals they were also nice middle class girls.
You had to reach a certain level of education to be accepted.
Aides were a thing of the future, those duties were performed by student nurses but we were taught to protect the patient's dignity and and the right way to bathe.
Another area lacking in nurse education at that time way psychology which also applied to the medical students.
We also learned that she would not get into the bathtub for fear of falling so we did a tub cut to the bathtub, bought a shower chair and put handles around the bathroom making it safe for her to be in the bathtub. It works. It might help you too. Perhaps she is afraid of water or falling in the shower or feels uncomfortable in there.