The lady I care for is in the later stages of Alzheimers. Numerous mornings she wakes with soiled diapers and refuses to get in shower. She will punch, hit, pinch, and try to bite. It is so stressful for us both. How do I deal with this? I am the only person who baths her.

I understand the fear of water and everything that goes with her not wanting to shower. Her violent behavior occurs randomly throughout our 9 1/2 hour day. She will throw drinks at me etc. It is getting worse. This behavior also occurs towards her husband. For an elderly lady, she is strong and my fear is that she'll hurt someone or her self.

We go on walks and for car rides to get out of the house. She sleeps very little and won't sit down when awake. It seems that medication would help her anxiety and agitation but her family doesn't think it's necessary. Her level of care has greatly increased and has become more difficult after 3 years. Any advice on what to do?

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I would tell the family that you have done all you can do and that her care is getting to be more than you can handle.
State that due to the risk of getting seriously injured you are tending notice unless the following things change.
1. She sees a Doctor to get medication for anxiety and agitation. This does not mean she will be drugged up and in a stupor as many people think will happen. It does mean the person will be more relaxed and able to cope with day to day life.
2. For Bathing request another person to help you. Dealing with a person that is not a willing participant in a bath can be dangerous. While dry it is dangerous, once the person is wet an outburst can become deadly. (a slip and fall for either of you could be very serious)

Just a thought is this a shower or bath you are giving? A shower might be easier and in particular if you have a shower chair so the person you are bathing is seated, comfortable, stability is better, and with a shower chair you can turn the person so the water is not directly in the face and on the torso, both vulnerable areas that can cause agitation.
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NeedHelpWithMom Apr 3, 2019
Good advice, grandma. I would still do as Barb says, look for another job! Shower, bath, either one as you say, slip and fall. Very bad! Violence and water, very unsafe combo!
Get Out before you get seriously hurt. You can look at it this way, if you were to get hurt, family may say sorry, then get someone else.
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First off. let me say I understand completely. I had a good friend that I helped for many years. Her son had severe autism. She was a single mom and had no one helping her other than her mom who lived about an hour away.

Her son was fine when younger and everything was under control. As he grew into a teenager he became very aggressive. He took Ativan and other meds but it didn’t help much.

He started physicaly attacking me. He was over 6’ and over 200 lbs and I had bruises all over me, hair pulled out, bent my fingers back and almost broke them, head butting, etc. You name it, he did it! I am only 5’ 1”.

She had a ‘safe closet’ that we ran into to hide. I finally told my family what had been happening. I had worn long sleeves to cover bruises, but the absolute worst thing he did one day terrified me, it’s embarrassing to even say this, he grabbed my breast and twisted incredibly hard and I couldn’t escape his attack. I screamed. I was black and blue. He grabbed light bulbs from ceiling fans and threw at me with glass shattering everywhere. I don’t know how he didn’t electrocute himself. He trashed her apartment.

And forget driving with him. He tried to jump out of my car. I always had to have child locks on. He hit me in the head. He grabbed my arm while on the steering wheel.

I ended up in therapy over it. The therapist said, “This is abuse. Do not help her anymore.” I responded by saying he had autism and couldn’t help it. He repeated that it was abuse and the head butting alone could leave me brain damaged or dead.

I told my friend I could never sit with him again. Did she understand? No! She blamed me for not getting to the ‘safe closet’ fast enough.

Her only concern was her autistic son. He attacked her mom, woman in her 70’s. He attacked his sister. The sister ended up leaving and lived with her dad. Attacked his mom constantly. Was a nightmare! She said she would never institutionalize him for fear of him being abused. She only apologized to me once, after the first time he did it. I guess you will all think I am dumb for trying to help her but she kept telling me that his psychiatrist hadn’t found the right meds for him and I was trying to be loving and patient with him. I had known him since an infant and her several years before he was born.

Sadly, our friendship ended because I couldn’t take anymore.

Sometimes it seems there is no hope. Cases become so severe and she was so afraid of authorities taking her son away if they learned of his abuse to others.

The dad wanted to put him in a group home or institution but she wouldn’t hear of it. He tried telling her that they wouldn’t be around for him forever but she said no, he would stay home with her.

So my advice, GET OUT! Do not take the abuse if it is severe. Please do not make the mistake I made trying to help someone that would never care about the big picture.
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shad250 Apr 3, 2019
Mom was right to be concerned about her son being in institution . He could be physically or sexually abused, hence why she looked to you for help
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I would stop forcing her to shower if she's becoming violent.  It's not good for her or you.  How about some nice cleansing cloths?  Yes, they're not as good as a shower but they will clean her and its something she can do while you supervise or you can do it if she'll let you. they can be used while she's sitting on the toilet or before she gets dressed for the day.  Just a thought.
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I would line up another job and give your notice. Families in denial rarely snap out of it.

I agree with you completely that video taping her violent behavior would put you in a bad position. Who knows what that family would do to you if you sent such a video for them to watch. It's not your job to play detective or get her medically evaluated; it's the family's job.
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UTI's can go full blown in a matter of a few days or so, and it will effect her behavior. Get that issue ruled out. Tell family she needs to see a doctor, her behavior is really strange now. This will open up the doors for other questions and issues.
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I would suggest that family take her to the doctor, and have her evaluated again, and suggest that the palliative care in order, so a nurse practitioner can come out and take blood pressure, etc, and have them check for precursors for bed sores, pressure sores, so you are protected. Or, even hospice care, so they can have someone come in and give her sponge baths etc. 3 years... people age differently, and even check for UTIs. If she isn't allowing you to bathe her correctly, she may be getting UTIs, and you do not want anyone putting the blame on you. UTIs can make some people's personality change, like getting angry, etc. Have her checked out.
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Have them bath her a few times.

Having a bad day doesn't mean you kick, bite, pinch or throw things. What would this knot head say if you threw a cuppa at his head and then said, I am having a bad day, then walk by and pinch him. I bet it would not be dismissed.

Have they increased your wages to coincide with the increase in care required? Do they carry worker's compensation insurance for you in case she injures you? Are you being paid a regular paycheck with them matching your social security and Medicare tax? Are they withholding taxes and paying them to the appropriate agencies? Do they carry unemployment insurance for you?

If you answered no to the above, you are being exploited and should find a new job that ensures you are protected by the employer providing the above.

If you do videotape the struggle, DO NOT send it in any way shape or form. You will get in serious trouble. I don't care what any of them say, don't send it. Show them from your phone and then promptly delete. I would try to record audio first, do that every day and hopefully that will be enough.

This is a very sad situation and I don't know how it could end well for anyone. They are pretty ignorant of the blessing you have been. 3 years on the job has saved them untold headaches, so many people go through caregivers weekly because they can't find one that works. Your current employer may find out how valuable you are.

You will not have a difficult time finding a new position, people are begging for good caregivers.

Be calm and talk to your employer with the recorded evidence of this behavior, I would also do videos of the agitation that she lives with, they aren't even making sense to let her quality of life be so poor over a pill. Can you send a letter to her doctor and request that you remain anonymous? This poor woman needs someone in a position of authority to help her.

Come back and let us know how it works out for you.

Hugs and thank you for caring enough to reach out for help. This family is blessed to have you.
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Gr8fuel Apr 3, 2019
Thank you for taking the time to respond.
Teepa Snow is wonderful and I actually learned some great tips that really made sense from her.
Thank you.
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Yes, Teepa Snow's videos are great! Something has to be done.
Thank you for your response.
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I completely agree with the other answers. If the family don't see evidence of the problem, the current situation is easiest for them. You have to have evidence or be ready to quit before they will change their ideas, and quite probably it will lead to you quitting or getting the sack. Tell them that you care about her and will be happy to return if her behaviour is modified - although they probably won't ask you back because it would be an embarrassment for them. Also tell them that you will start legal proceedings for compensation if you are injured. Keep a record of what you have told them - they might even say it's your fault if she injures herself or someone else, particularly if that is the reason why you quit.
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You say the lady behaves violently towards her husband, too, besides you. Why does her husband not do anything about it? When you say the lady's family, are you referring to her adult children? It seems like it.

Do the family members (besides the husband) of the lady see how violent the lady behaves? If they don't see it, they won't understand. So, you should try to record it on your phone somehow and show it to her family.

If they know and see how violent the lady behaves towards you and still ignore your pleading, then you should not risk your safety for her or her family. You should look for another job.
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Gr8fuel Mar 31, 2019
Thanks for the suggestions. True, I can tell them that she was "combative" but the daughter has no idea. Her husband has experienced her behavior but chalks it up as a "bad day". All family (adult children) members are gone the entire day so really do not know.
I can get through to the daughter if I video. It seems unethical to film due to the worst behavior occurs in the shower.
Thank you for responding.
I think I would force the issue by saying to the family " I can no longer do this job if you won't have Mrs. L evaluated for medication for her agitation and dangerous behaviors."

Have you watched Teepa Snow videos on handling resistant dementia patients?

Have a new job lined up.
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