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I'm not sure if this has come up with anyone before but I'm sure it probably has. Hopefully you can all give me some pointers on this and how I could ad"dress" it. Mom has Alzheimer's but in the last 6 months of progression she's started "layering" clothes on. I've counted as many as 7 pairs of underwear, 3 pants, and 5 tops on at once. She adamantly refuses to let me touch her clothing, help her change, remove to wash or help her dress. I feel this is a hygiene issue. My father doesn't help since she get angry with him as well. She smells sometimes. She refused the HHC aide to even enter the house. I'm approved for an in home waiver, just waiting on the Medicaid.
Any ideas on how to minimize the layers? She absolutely won't even believe me when I tell her she has layers on? She wears them for days (or weeks) at a time. Last night she had 5 shirts on for bed, a bra, 2 pairs of jeans and who knows how much underwear. The room was 90 degrees it was unsafe but she wouldn't let me touch her....

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Wow! Does she say she’s cold? My mom keeps her heat on 78-80 year round and stays under an electric blanket ALL the time. If you lay out several things will she change & out them on or just add to her layers? Bathing is definitely an issue with my mom too. A helpful nurse told me that she’d most likely let the aide bathe her because it wasn’t me. They somehow hang on to that they’re still the boss of you. Mom hates others being in her house, it disrupts her rest but she actually let the aide bathe her last week, you could’ve knocked me over with a feather! Have you tried with an aide? I’m so sorry you’re having to deal with this. None of us here ever imagined what we’d be going through now.
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Imho, you need to address this with her physician. That is going to cause her to overheat, but is also quite common for someone with Alzheimer's.
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As a lot of people on the forum will suggest, you could try to limit her access to all her clothing. Try putting top, bottom, bra and panties on one hanger and then when/ if you can cajole her to take a bath/shower, it would all be together. This is certainly a tough phase to go through especially now that the summer is upon us. And definitely speak with her dr and hopefully he/she can prescribe something that will make her calm or less anxious so she wont fight you. Its so hard to help our elders when they cant realize or know they need help. Alz/dementia is such a cruel disease. Many blessings to you down this path. Liz. 💕
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I would talk to the doctor about giving her a sedative or tranquilizers for you can at least wash her in bed. I’m not trying to be gross but she probably has urine and feces stuck to her which can cause an infection. I agree with the others about putting all her clothes away except for one set a day and then don’t give her another until she bathes.
It sounds like she needs to be on tranquilizers daily. People will say you shouldn’t keep them sedated but at this time of her life, it doesn’t matter if they get addicted.
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Can you move her clothes to another room that she normally would not go. Maybe just leave 1 of everything in her regular go-to drawers or closets.

When she takes a bath, does she do that alone? Or has to have help? If you usually help her, just start talking early in the day about 'bath day' or warm baths feel good -- try to get bath into her head. If she absolutely refuses, some of the large adult wipes might be better than nothing.
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You are explaining repetitive behaviors in your mom. It is like a stuck record or a "do-loop" in a computer program where the same action is repeated over and over and over again. She can not control this repetition. So the best solution may be limiting the amount of clothes she has access to. As to hygiene, you may need to use the authority of "the doctor says..." to get her to take a bath or shower. I find that saying "time for your bath" as I draw the bath is better than asking "would you like a bath?". If she continues to be resistant to care from your or a HHC aide, she may need placement into long term care or receive medication to reduce anxiety.
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First of all, do all you can to push getting her into a facility. This behavior cannot be tolerated and I am not sure if you are the only caretaker that you can handle this. First of all, where is she getting all this clothes from? Put everything out of sight where she can't find it. Leave out ONE outfit that she can wear. Second of all, forcefully if need be, and your father must be made to help or you need to get someone with you to help, strip her of her clothes and wash her no matter how loud she screams and fights. Get medical intervention to calm her down and make her more passive. To smell and not get washed is not only sickening, it will lead to many more problems down the road. And get very tough with her and tell her in no uncertain terms if she does not cooperate, etc. this will happen. I am no expert but if kindness and reason do not work, and most likely won't, as long as you do not do physical harm, you must clean her and ignore her rantings. Also contact Adult Protective Services in the office on Aging and ask them for advice and help. You cannot allow this to continue.
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my2cents May 2020
Your comment, in my opinion, is a little strong. You mention behavior won't be 'tolerated' as though you are talking about a competent person making a choice to behave badly. This lady has dementia and, yes, her behaviors will be tolerated because this is her world now. You cannot punish or argue a broken brain to fix the behavior. And most disturbing to me is that you would suggest someone strip a person, forcefully if need be, of her clothes and give her a bath. Then you follow up with -- get tough with her and tell her the force will be used if she doesn't cooperate. Good Lord!
We had another person that used to post similar things on this site. Pretty harsh treatment in my opinion. It breaks my heart to think someone might be under the care of someone who would offer this kind of advice.
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I agree with limiting your Mom's clothes in her room. You mean, nothing can be removed, even though her underwear(??) and inner layers will get soiled with her waste?? Did you ask her doctor for advice?
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I went through this with my Mom. I found limiting the amount of clothes in her drawers and closet was a big help. Prior to that when it was hot out she put on more layers. The bra on the outside of her clothes was the real warning I had to do something. Bras were no longer needed.

With my husband refusing to take a shower, thinking he had just had one, I tell him this is the day I put clean sheets on the bed and no one gets in bed without a shower on clean sheets. Another thing I have done is, I don't say anything in advance, just start the shower water and tell him "The Doctor Said" this is the day for shower. As I have big band music from the 40s playing on our Alexa. To promise a reward for after the shower might work, like ice cream is worth a try.
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My mother with dementia also did that, and I have heard of others who did it, but not as many layers as your mother - she's setting a record, I think. I've even heard of a mom who put her bra on over her other clothes and was ready to leave the house like that. Just remember that her brain is getting unwired with dementia/alzheimer's. She doesn't make logical decisions or have good judgement at this point, and can't help herself. She may not be aware of her impairment. In time, this odd behavior will probably pass, and something else odd may take its place. But getting layers of clothing off of your mother will be a challenge. Can you slip her clothes off of her while she's sleeping, without waking her up? Also, when you buy new clothes, make them easy to get on and off. I found that elastic waist knit pants and stretchy knit tops are easiest. We got rid of the bras and use camisoles. I found with my mother, the best way is to distract her when she becomes unreasonable.
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Have you seen any of Teepa Snow's dementia advice? This sounds like what she calls 'Amber stage'.

I don't work for her or anything! I just found her info helped me to understand & the YouTube's gave me ideas to try.

The bits that jumped out were *repetitive behaviours* & *care is refused*. Does this sound like your Mom?

From Teepa's website:
Amber ~ Caught in a Moment of Time ~ Caution Required.
Focused on sensation: seeks to satisfy desires and tries to avoid what is disliked
Environment can drive actions and reactions without awareness of safety
Visual abilities are limited: focus is on pieces or parts, not the whole picture
What happens to or around an Amber, may cause strong and surprising reactions
Enters others’ space and crosses boundaries attempting to meet own needs.
Has periods of intense activity: may be very curious or repetitive with objects or actions.
Care is refused or seen as threatening, due to differences in perspective and ability.
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My MIL's problem was wearing dirty clothes several days in a row, and putting them back on after a bi-weekly bath (by a technician). Limiting availability was the answer, as others have suggested. We supplied only one complete set of clothing at a time. Perhaps you can lock up or hide the extras. If she is cold she would probably welcome a tee or thermal underwear.
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Does she think that putting on new clean clothes means that she is now clean? Can you think about why she might not like to take off the dirty things?

I like the idea of limiting the options. Is she capable of taking things OFF? If so, could you let her do it in private, and say that you will put the clean ones in through the door after she pushes the dirty ones out? Or perhaps puts them in a basket (you could even pull it out the door with a string, then push it back in)?

A friend of mine had a grandmother who had to have her body shaved AFTER she was anesthetised for an operation 'down there', because she was so stressed about anyone seeing her naked. It might explain things a bit.
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Mom can no longer access the logic needed for the getting dressed sequence.

She will either need supervision for dressing, or as others have said, have only one set of clothes out ready (the rest all hidden). That way she can still dress independantly.
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I guess the only way is as stated above - only leave her what is appropriate for her to wear at a time.
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One thought on this, I had a similar problem with my Husband.
Is she cold? My Husband in the sweltering summer would wear a leather coat on top of a flannel shirt, on top of a t-shirt. And leather gloves.
When I would try to get him to remove a layer he said he was cold. The reason he was cold was he was sweating and the normal air felt cool on him. I just put away all the "extra clothes" so he had limited clothing to select from. And the coat and gloves got put away as well.
Remove all but 1 or 2 days of clothing from the closet..."they are in the wash".. so she can not layer.
As far as the HHA ..ease into it. Have her come in for you not mom...as mom gets used to her she may accept help a little easier. A GOOD HHA can work magic getting someone to comply.
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