Personal Hygiene

mimi427October 20, 2005

Once again, I am looking to you wonderful people to share your experiences with me. As most of you know, my mom has moved to my sister's home. I realize that mom is probably still adjusting, it's been less than two weeks. It seems that mom has gone back in her mind to when she moved in with me and is resisting assistance from her aide, the same woman that was here with mom. The problem we are concerned about is her personal hygiene. She showers only once a week, which is what she's been doing for quite some time now, but she always washed up in the sink every morning. Now, the aide tells my sister that she runs the water in the sink, but doesn't wash up and refuses any help from the aide. My feelings on this is you need to pick your battles and this is one battle that needs to be fought; that the aide has to insist on helping her to wash up. My sister is at work when mom wakes up (between 11a - noon), so she can't help out. Mom will NOT wash up at night. She's even fighting to not change her underwear in the morning (Depends - if she hasn't messed them, she won't take them off) do you handle this? Do you take a tough approach and just tell her you must let the aide help wash?

Mom's doctor did tell me that a trauma, such as hospitalization or a move could cause a sudden decline and I believe that is what we are seeing now. I call her every night and all she says is "I'm so confused, I don't know where I am, where I am going, what to do", and all I keep calmly saying is "it's ok mom, it will get better"...please help!!

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Mimi, I agree this is a battle worth fighting. With this recent decline for my Mom, she went from showering 3 times a week with her aid, to refusing for 11 days to shower at all. She was "too tired" or "too cold" every time. I finally told her I was going to help her shower and wouldn't take no for an answer. I prewarmed the room, the water, the towels, got her disrobed and in the shower over her continued (weak)refusals. Once in the shower, she relaxed and smiled,and "helped"wash her hair and the rest of her, and enjoyed herself. We lotioned and powdered and got her dressed in warm clothes before leaving the bathroom. I was soaking wet, the bathroom looked like a rainforest, but she looked,felt and "smelled" so much better. Now she is back on the 3 day a week schedule with the aid, but she makes sure she gets the "pre-warmed" everything every time!

    Bookmark   October 20, 2005 at 10:31AM
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Oh Mimi. Such heartbreak. The thing is, hygiene is especially critical for incontinent patients because if that area is not kept clean, they run the risk of the skin breaking down.

Could your sister take one morning off and just be there when your mother wakes up, so she can help the aide? You do need to fight this battle, you're absolutely right. However, the aide is a detached professional who might have other patients to tend to. She may not be able or willing to fight this battle.

Can you talk to someone from the Alzheimer's Association, to get some ideas on how best to handle this?

    Bookmark   October 20, 2005 at 10:37AM
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She may be back to the Shower avoidance thing. Suggest that the aid fix a nice warm bubble bath the first thing in the morning. Have her take her right from the bed into the bath. It might work. This might just be another phase that she must go through. Only time will tell whether or not she gets easier to handle.

    Bookmark   October 20, 2005 at 12:36PM
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Agree with lasershow that aide may be unable or unwilling. I would add that IMHO its unreasonable to expect an aide to "fight" with her charge -- too much to expect from hired help. That part of it is a personal issue that you and/or your sister must rightfully address.

Also agree that this is a "battle" that must be fought.

These are difficult times. Sorry for your trouble. I know how discouraging these things can be.

    Bookmark   October 20, 2005 at 12:40PM
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How about a bed bath. With my mil I got to the point, when she was getting up I would take a small pan of warm water, with the No Rinse soap and also my famous sguirt bottle with warm water. I would hand her the wash cloth and let her do what she could, I would place a thick towel under her and she would rinse her private parts. I would give her a back rub with some smelly lotion (she loved the attention). As time went on I did more and more of it, but it was a routine that we had going by that time. I think often times they are afraid they will fall in the shower but afraid to say so.
Good Luck

Here is a link that might be useful: no rinse soap

    Bookmark   October 20, 2005 at 12:41PM
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This can be a big problem with dementia folks. ??Some unrealistic fear vs effort for independence??? Who knows?
Elders do not need as much bathing as they did in earlier is drier and sweat glands less active. IF she has not been incontinent during the night, she probably does not really need to wash up. Save it till she has been incontinent.; Except for hands, face and, perineum, once every week or 2 is enough...and actually better for older skin. A big change, I know, but true. Derry

    Bookmark   October 20, 2005 at 5:58PM
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Mimi....I totally agree that this is a battle that you must win. I loved the description that LSCSue, I've been there, too.

Seriously, this must be addressed, and you just have to know that she doesn't understand the reprocussions of not bathing. To her it may just be a nuisance. We had a shower chair, with a back, for Mom and when she got in and was handed the long hose, she just relished holding it and showering over herself. Her care-worker did most of the washing...she was such a gentle soul...that Mom just felt spoiled in that shower. Then she got poofed, powdered and put into fresh clothes or gown and robe and had a nice cup of tea and cookies. LOL!! Just like a little child! But..that's what they are: children...who also don't understand it's important to bathe.

Perservere, Mimi....and yes, if your sister or you could assist the first few times, I'm sure that would help. your Mom alone the rest of the day??!! I'm not sure I realized that.

Good luck!

    Bookmark   October 21, 2005 at 11:24AM
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No, no, my mom is not alone Linda...she hasn't been left alone since November of 2004. Urszula, her aide, was with mom when mom lived with me - she was here from 7a - 4p, since I work full time (most of it from my home office, but I am inundated with calls and scheduling so I needed someone here to be with mom, and now, she is with mom at my sister's home, from 8a - 5p, since my sister owns a retail store, so she's gone most of those hours. Urszula is a warm, sweet, gentle soul who has told me many times she loves mom like her own and they got along great for most of the year she was here...just had trouble at the beginning, getting mom to accept her help, and then later on, when mom decided every now and then she didn't need anyone's help. It just seems that now, since the move, she's regressed back to where she was when she first moved in with me...I realize the move is traumatic for AD patients and has really caused her major confusion. Now, once again, she's refusing all help from Urszula, and telling my sister and Urszula she is washing up (by the sink with a washcloth, since she refuses a shower more than once a week), but Urszula peeks in and has told my sister she is not washing, just running the water. This too, will pass, I suppose. I did talk to Urszula yesterday and she told me yes, mom is being difficult, even telling Urszula to get out of the family room, which Urszula does, but not more than 3 minutes later, she's calling her and asking her where she is and why she's not in the room with her. So, as I said, she really sounds very confused. Hopefully, she will settle in soon. She is sleeping very well at night and I'm thankful for day at a time....

    Bookmark   October 21, 2005 at 11:41AM
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Oh, good, Mimi! I was just having a "twilight zone" moment, then! ;-D

Wish I could be there and help you thru this....I finally learned to relax through all those changes. They're frightening, at the beginning, and yes, they do regress and pop back into reality. It's a roller-coaster, that's for sure. Even now, when I visit my Mom I feel she's in the "now" sometimes, and at other times she seems to be living in the a time when our kids were small.

Your Mom will get into a routine and do well...just don't worry so much...try to relax...each day brings new surprises, and just when you thing you can 'coast' a little...WHAM! Something else pops up that puts your knickers into a twist again. Just roll with the punches...that's the best way to cope with this insidious disease. When my Mom complains about something that I know to be a figment of her imagination, or a passing fancy, I just smile, hug and nod my understanding. Then she's off on another tangent! If I get upset at each thing she says, I'd be in the next room to her! haha!!

Your Mother certainly is fortunate to have you, your sister, and Urszula caring for her. I'm sure she knows that and appreciates all you do for her.

Continued good luck...and take care of YOU, too! ;-D

    Bookmark   October 21, 2005 at 10:40PM
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Check out the no rinse shamphoo's
You can order them, but you can also get them at most medical supply places.
I use them for the last year of my mil life, and she had hair long enough she could sit on it.

Here is a link that might be useful: no rinse shamphoo

    Bookmark   October 28, 2005 at 6:14PM
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