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Hi! My 96-year-old gramma was recently diagnosed with moderate to severe dementia. My 76-year-old mom has been providing some care for her when my uncle (who lives with Gramma) is at work. But the arrangement is proving to be too much for my mom and basically ineffective in terms of providing a good environment for her. Recently, after Gramma took a nasty fall, I had gone to the house to get some fresh clothing and once there discovered that it was absolutely filthy. We solved the problem by bringing in a cleaning team who I worked with for a full 9-hours to bring the house into order and clear away the grime. But my mom and uncle are both too wishy-washy to ensure Gramma bathes, and neither has the patience to deal with her complaints or uncooperative behavior. We decided to look for in-home support for at least 3 half-days per week. Interviewing caregivers tomorrow. So my first question is related to the fact that I don't think my mom or uncle has tried to discuss her condition with her. I don't know that she'd be able to fully comprehend the diagnosis, nor would she likely agree with it, but how can you explain to someone that his or her mind isn't working as well as it used to? Secondly, the caregiver is really non-negotiable, but how can we make it palatable for her? Particularly worried because part of that person's responsibility will be to ensure she bathes, which might be quite a battle.

Thanks for the support and ideas! We have hired an agency and had our first meeting with a caregiver, which went fairly well. We've been focusing the conversation on the help that the person will provide for Gramma - things that she has been frustrated that she can't do right now like peeling potatoes, and lifting objects that are too heavy for her - and that seems to be more effective. She swings back and forth between being angry/resentful and sort of excited to have someone new to tell her stories to. I decided not to talk about the dementia with her until she starts to show concern that she can't remember things, etc. She keeps saying that we all think she's crazy, so bringing up dementia seems like it would take things in a bad direction. I just keep telling her that she's 96 years old, and it makes sense that she would need a little more help now - and that it makes me feel good to know someone is there to help her since we can't always be available.

I do have a very serious problem that I need to get some feedback on. Will post about it, and I invite you to share the benefit of your wisdom. Regarding elder abuse.
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Reply to gmadorisylove
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There is no point of discussing gma's diagnosis with her. You CANNOT explain to dementia, she is not able to process that information.

Caregiver? Don't tell her that person is there to care for her. Instead tell her this person is there to help you.
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Reply to gladimhere
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When you hire a caregiver don't direct her to bathe your grandma right away. Your grandmother needs to get familiar with the aide first. In order to build up rapport and trust the aide could start off making your grandma breakfast (or lunch or dinner, depending on what time the aide will be coming). Encourage the aide to sit and talk with your grandma, letting grandma get comfortable with the aide. Maybe the aide can look through photo albums with your grandma, encourage your grandma to talk about her family, etc. After the aide has been with your grandma a few times she could suggest a "bird bath". A little clean-up that's better than nothing but will spruce up your grandma a bit. The aide could help your grandma wash her face and arms, under the arms, legs and feet.

After the bird bath, at some point, the aide can suggest a shower. The aide should be reassuring and positive and tempt your grandma by telling her how good a nice, hot, sudsy shower is going to feel. The shower shouldn't be an "event", just a basic hygiene practice that we all do. The aide should assemble everything she's going to need ahead of time: 2 towels (1 for covering your grandma and 1 for drying), soap, lotion (always a nice touch after a shower), comb, toothbrush...anything the aide might need so she doesn't have to leave your grandma alone. Is there a shower chair in the tub? Safety rails? These are important.

After all of this if your grandma still refuses a shower don't force her. Your grandma has her relationships with her family but the aide should be an advocate for your grandma and not hop on the bandwagon with the rest of the family. But the topic of a shower should still be discussed regularly. I'm sure the aide has had other clients who refuse showers.

Regarding telling your grandma she has dementia, it depends. Does your grandma wonder why she can't remember anything? Does she anguish as a result? If her memory is a big problem for her I would suggest telling her she has dementia. She deserves the respect and dignity that being a part of her own care can give her. However, if telling her will send her into a tailspin then put it off or just don't tell her. But I think people deserve to know about their own health.
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Reply to Eyerishlass
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How did Gramma react to your house cleaning? If she liked having a clean house then I suggest starting by saying you have noticed that Gramma is slowing down and not maintaining her home or her person to the standard you have always associated with her. You want Gramma to be as clean and comfortable as she has always been and you can't come by to clean as often as you would like, so you have arranged to have someone come by and help her. Focus on how much it would help you for Gramma to accept this help and not so much on how much Gramma needs help.
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Reply to TNtechie
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