My mother has begun to have screaming tantrums when it is time to have her diaper changed. Any suggestions?
My mother has always had a difficult personality, and as time goes on, her personality has become even more difficult. We have been through many aides, but I now have a team in place that she can tolerate and that can tolerate her.
Recently, she has begun to have screaming tantrums when she needs to have her diaper changed. One aide handles the situation like a pro: She advises my mother it is time to change her diaper and proceeds to change the diaper -- even if my mother is screaming at her. My other aides are frightened of my mother's tantrums and have left her sitting in the dirty diaper until my mother is receptive to being changed (and this can be hours later).
My mother has suffered multiple UTI's which can be caused by a dirty diaper, so this situation is of great concern. Has anyone had any experience with this issue? I would hate to have to let some of the more emotionally fragile aides go because they have been with us a long time and my mother is comfortable with them. On the other hand, I feel I cannot allow this situation to continue. I have tried to reason with my mother to allow her diaper to be changed when needed, to no avail: "I'll change it when I'm good and ready!" I've explained the UTI danger, to no avail: "I don't care!"
Any suggestions or advice would be very much appreciated!
Oh, and save your energy on explaining UTI to her. You're wasting your breath. My Alz. mother sometimes refuses to do things, and I tell her when she's done changing into a new clean diaper, or taking a shower, I'll take her out to go shopping. That usually gets her to cooperate.
What does you mother like? What incentive will work with her?
Any chance you can "foster" a cat or two, for a little while? If not, then so long as no pets in the house, they sell rodent traps with tasty poison... I can't use them, as I don't want the cats to eat a poisoned mouse! Hard to leave traps around too, as the cats could get a nasty nip! Often they do have cats who won't ever be "pets", but if kept in basement with litter, water and food, they might "manage" the rodent problem, then you can send them back. Basements are usually good for cats finding the mice...
Unfortunately she needs to be changed when soiled and her care providers need to change her in a timely manner.
I cannot imagine how hard this is for everyone involved.
If it is anxiety again medication might help.
OR
this is just her having a tantrum like you say. If this is the case then the caregivers that back off need to be TOLD, INSTRUCTED that they are to carry on with the change no matter the screaming that is done.
If they are from an agency you could request other caregivers that will do what needs to be done.
BUT if you mom is doing more than screaming, if she is hitting, biting, scratching then she needs to be either medicated or since this is in your home you can put mitts on her to somewhat restrain her hands. Sometimes giving someone a towel or a soft toy will keep the hands occupied.
I probably would not give her anything to eat during one of these tantrums as she could easily aspirate whatever is in her mouth. But a child's teething toy might work.
You need to hire people who can do just that: push past your mother's tantrums and change her soiled briefs. Otherwise, you're going to have a lot bigger problems to deal with than screaming fits!
Good luck!
While it may be "okay" to struggle through it, screaming and all, it would be better if there was a way to calm her down. I don't know how staff handles this issue, as clearly sitting in soiled briefs isn't good - generally, so they tell me, they can't force someone to do what they refuse to do. They usually have to coax them, promise something good, get them to think it's their idea, etc. Hospice nurse said mom seems to be "shy" now about being changed. It may be that her dementia has progressed further, esp with the stroke. But, much as I dislike medications, I would try that before trying to change a whirling dervish! The nice thing about the one she took, worked first time, every time, usually in about 15 m or so, and no need to wean her off of it if it doesn't work out. If you can find one that she can take a little before the usual changing time and it goes smoothly, go for it!
Otherwise, they'll just have to suck it up and continue bulling through the process. If those aides can't do it, find others. You can't reason with dementia, so trying to explain why the change is needed really won't help.
Can someone distract her with an object, shiny toy, doll. stuffed bear, an object, something? Or even talk to her about something? I think an interesting object might be better help and a positive focus Even a child's toy that rattles, or moves might help. Only a couple bucks. They do that for children to distract them so they dont kick out, fidget etc when changing diapers. They get annoyed as well. Altho with adults its called briefs for dignity reasons. They know enuff when someone says time to change diapers. That could make them mad. Just a thought.
Do people make a production about changing her? Like saying ok Christine (i picked a random name) its time to change you, as they gather supplies and get ready. That might be enuff to set her off. Because it was announced, and then it takes a min or 2 to gather supplies, and she has time to think about it and react. Maybe gather supplies first or have them near her, not saying anything. Then quietly do it? It might help, it might make things worse. You'll have to try diff methods to see what works. Maybe say - after your clean, we shall have lunch, snack time? Discuss the yummy food she will have. Maybe she will focus on that. Might help, might do nothing.
Id also call doc. She might need anxiety med. Now its not to drug her, its to help her with her anxiety. We want the senior to be calm and happy. They shouldn't be distressed and upset and miserable. Not multiple times a day. Remember their brain is not functioning properly. So what would be an annoyance could now provoked great anxiety.
Id also see if she is doing it with 1 person but not another, just in case. 1 person might be rougher with her to get it over with. It could be something/nothing. She might not like the way it is done with that person. Or their underlying annoyance with having to do it while she is getting anxious.. She could pick up on that.
My dad had problems with 1 cna he detested.. That was so unlike him. big warning sign. Turned out it was something to be very concerned with. She was fired. She treated elderly like an object to be manhandled. An annoyance to be dealt with. Just something to consider. I never thought about that until I saw his reactions when she was near. Im glad I watched closely.
She could also understand that her privates are out and she wants modesty. Doesnt know how to voice that any more. Especially bc its a carer. A stranger.. You have to be a sleuth. It could be something, it could be nothing.
There was a lady at the nursing home that would easily get anxious and sound off for a long time.. very distressing to her & staff. Her family gave her a doll and a teddy bear, (switched out at different times so it seemed new) and she was very happy hugging it. Never heard a peep out of her, and people stopped to chat about her doll. She loved that and just beamed ear to ear. With guys it might be something with trains. That was huge when they were young.
It could also be that they are in pain when rolled onto their hip. The hip might have arthritis, bone spur etc. That might cause anxiety.. or just being rolled on their side might be scary. The anxiety med might help. Talk to doc. Good luck let us know what works.
Also different styles of coverings are important, for example use scissors to cut the sides so you can bring the old one off cleanly and quickly, and don't use the panty style that she has to step into. as they feel very wobbly and vulnerable trying to step one foot into pants. have a heating pad nearby, so the washcloths or disposable wipes are warm and enjoyable, not cold and shocking, and that the air in the room is warm enough or have a nice little space heater blowing on her. Use music, for mood and distraction. . And establish a pattern with it, for example "every time I turn this music box on, we are going to freshen you up, just the way they do the Queen of England!" Consistency is helpful, and reduces opposition. Also a reward directly after... Like "after you are freshened up that's when you get a spritz of your favorite perfume," or "a cookie" or... A small peice of her favorite old time candy. I found creme stick candy in a candy store of a local historical farm, and wow it took mom back to happy childhood memories... I hope some of these are helpful.