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!

Does you mom like hard candies or chewing gum? If so, try giving her one, so her mouth and mind are occupied with the treat, and maybe she won't think to scream.

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?
Helpful Answer (5)
Reply to polarbear

Turn her on her side quickly after opening diaper tabs, clean her while on her side... & hold her arm or put her hand to hold onto bar can also play music while changing diaper...dim lights ...stick to routine of changing her same time...maybe a script for calming meds...HUGS 🤗
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Reply to CaregiverL
Jasmina Dec 5, 2020
Thats a good idea. Maybe sing so the sr focuses on that instead of the changing. Great idea!
Thank you, thank you, thank you, all of you kind people for responding to my problem! I'm dealing with a sudden influx of mice in her home at the moment, and that's why I haven't responded sooner... I will write more when I have this situation under control! Very, very best wishes to you all, xoxox
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Reply to momissues
disgustedtoo Dec 6, 2020
We're further north than you, but this year the mouse issue has escalated! When I first bought this place, it was clear it was overrun with mice (slobs rented the place.) Every few days one of my cats would bring a mouse or two upstairs and then let it loose so they could "play" with it! I've been able to save and relocate some, others either were already dead or mortally wounded before I got to them. Some didn't make the transition period (large plastic coffee container with tissues and toasted oats - gives them some time as the shock can kill them.) Last year was fairly quiet, but egads, this year? I had to upgrade the "condo" to a "townhouse", aka old kitty litter bucket! Most were still too small to put out and then it got cold and snowed, so they are biding time in the bucket!

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...
First off is there any possibility that someone abused her and that’s why she is started having the screaming tantrums. On to the changing, do they maintain her dignity in the process, putting a cover over her private area while in process of removing diaper (like you would for a baby boy). My grandma was embarrassed when hers was changed and we were in the room. She could be associating pain (uti) with diaper change and be fighting that. Lastly is there any part of the process that she could participate in that might make her feel somewhat in control of the process
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Reply to Sfhoopes
Tothill Dec 5, 2020
I was thinking the same thing, if Mum faced sexual abuse as a child or young woman, she may be reliving the feelings of being violated.

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.
Went through the same thing. We stopped calling it a diaper (it was demoralizing for my mom, made her feel like an infant). We now call them briefs and undergarments and no problems!
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Reply to WendyM

Is the change causing your mom pain? If so if she can be medicated prior that might help.
If it is anxiety again medication might help.
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.
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Reply to Grandma1954

When I worked in a Memory Care Assisted Living facility, I'd often hear the Alzheimer's and dementia folks screaming bloody murder when it was time for their adult brief to be changed. The care giver would just push THRU the tantrum, change the brief, and move on.

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!
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Reply to lealonnie1

Surprisingly my mother wasn't too much of a problem with changing briefs (she was still able to let them know often when she had to go, so the briefs were more 'just in case'.) In the last year she's been in a wheelchair, refusing to stand/walk, but would work with the aides for changing or showering, etc (she's in MC.) More recently she's been having issues with having them changed and because she had a stroke early October, she requires 2 people to assist and now a Hoyer lift. She gets uptight, so they've decided to go with anti-anxiety meds. She's had them before, and the smallest dose was enough to calm her, but with stroke and weight loss, they're going with 1/2 of that (cutting it, full dose made her too sleepy.)

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.
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Reply to disgustedtoo

Im sorry that is happening to her and to you. That must be extremely distressing. Is she able to stand or is lying in bed?
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.
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Reply to Jasmina

My advice is to try to draw her out, to listen to what feelings she has, related to the necessity of wearing "depends" and having them changed. Could be shame mortification, anger, for my mother it was a profound feeling of embarrassment as she was a very private person, and did not want all those strangers seeing her bottom. Paying more attention to privacy helped. also I noticed the really good aides never called them "diapers" they always called them depends no matter what brand they were. You might call them "protection" or "time to change your protective panties!" If your mother is experiencing dementia then other techniques might work, like for instance standing her up at her walker, and saying "now you just watch your favorite show, while I get you all clean and fresh as a daisy" and reassuring encouragement like " this is only going to take another minute!". some people experience being laid down on their back as a violation or reminds them of sexual imposition past trauma.
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.
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Reply to Singingway
agingcareuser Dec 5, 2020
You’re a beautiful person. Thank you for sharing your ideas.
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