WendiG Asked May 25, 2024
Parent in memory care nursing home won't get up, refusing showers and physical therapy.
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The nurses have asked that when I come to visit I help them get her to the shower. They also tell me that she doesn’t get up and ask if I can help her get up when I come to visit. What can I do? I can’t be there all the time to make sure she gets up, takes a shower, just participates with life? The CNAs try to help, the nurses have told me that they can’t force her because they could get into trouble. She makes big scene when she doesn’t want to do something she is eating. They are bringing her meals to her room. She wants to sit at the table and eat with. anyone. Is this the end?
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The first order of business when she landed in an ALF was a shower. She HATED showers and thought they were low class. (IDK why!) She kicked up one heckuva fuss but the aides were adamant. And the kids didn't 'fight' for her right to not bathe.
She died 7 days later, and hadn't had another shower, but at least she was reeking of 'old body' odor. Her house smelled so atrocious--the first time I went in, after she died, I had to open all the windows. She had been such a clean person--immaculate in home and personally. To have her home smelling fiercely of 'old' person was very sad. My SIL couldn't smell it. I was gagging and had to open windows the few times I was there.
I know the 'kids' were used to the smell. I have a strong stomach--but for one person to make an entire house smell that bad--she had not been getting 'quality' personal care.
Gut wrenching but, some things just HAVE TO BE done and this was one of them. Her overall well-being was at stake and that trumps everything.
Sounds like your mom needs a higher level of care in a long-term facility.
Edited: Clients right to refusal. I've seen this in the extremes with clients refusing to get out of bed ending up with bedsores from lack of movement. One client died due to refusal of sitting up, getting out of bed and refusing physical therapist. The physical therapist who was coming to his home discharged him as a patient. Client continued in bed for another month later died from complications. It happens. This client did not have dementia. However he did have the right to refuse care.
I've never heard of a nurse who's given a patient a bath in the last 30 years. That's aide work.
If she won't take a shower they can wash her up with a bed bath or take her in the bathroom and help her wash up.
Sometimes you have to be a little bit intimidating with seniors who are resistant to hygiene care. As you know if you've already tried the coaxing, conjoling, and promises of treats to no avail, that's when you have to get demanding and the person gets washed up whether they want to or not.
I’ve noticed recently that you have escalated again with these type of comments .
My mom got pneumonia and then fell a couple weeks ago so she's had a rough time lately. She refused her first shower post fall and I didn't want her to get out of the next one so I did tell the aid I'd be there at shower time.
I didn't baby her nor was I forceful. I simply told her it was time for a shower and while she did that I'd go make a run for a green tea frappuccino (her favorite) and I'd give her a foot massage afterwards. Success! Yes, I bribed her but it worked.
Showers shouldn't be something that's presented as an option. The staff should know this and know how to persuade her. "Time for a shower. I have the room warm for you." Tell them to have a fresh set of clothes out and show them to her and ask if she would prefer to wear this or something else after her shower. Does she like sweets? Have them tell her they will get her something after her shower and is there something in particular she would like? Tell them to offer a reward at the end of it for her.
You shouldn't have to be there at all to get these things done.
If my mom ends up refusing again I'm going to get to the bottom of it and find out why. Does she feel she doesn't need one? I'll explain why she does. Is she embarrassed? Is it uncomfortable? Does the shower chair hurt? Does she get too cold? Is she afraid of falling? I'm going to ask and see what feedback she provides.
The other stuff...eating and PT...let it go. No big deal.
Grandma1954 is right. It's not up to you to get your mother up, showered, and fed. That's the care facility's job. They're getting probably between $10,000 and $15,000 a month (depending on your state) to get these tasks done for your mother. So you be insistent to them if you have to, but don't you do their jobs for them.
I think Alva who is a retired RN is right. Your mother is likely dying. She is all done with this life and wants to go. Let her go with some dignity. At this point no one should force her to get out of bed or eat in the dining room. What must be insisted on even if it's against her wishes is hygiene care. If she's not being kept clean she will get skin infections, skin breakdown, sores, and UTI's which will be a cause of pain and suffering to her.
Talk to her doctor about putting her on an anti-depressant or an anti-anxiety medication. This can help her feel better and make her care easier for the staff to get done.
My Aunt had advanced dementia for 12 years. She passed 1 month shy of 101, only after she got out of bed and fell, breaking her hip and then she didn't thrive in rehab, passed in her sleep, possibly from a clot (which is a common complication with large bone fractures). But nothing else was going to kill her "sooner" since she was absolutely healthy is all other ways (except her mind).
Unless your Mom currently has more serious health issues (or develops them eventually) like CHF, diabetes, COPD, cancer, etc, she could live for many more years.
How much longer would you expect her to want to go on with all of this?
Is it not a constant torment for all, and especially for her?
It is time now, imho for Hospice.
They will be a boon for the CNAs attempting to care for her.
When she is no longer willing to get to the shower she will get bedbaths, and they will attempt to turn her so as to prevent skin breakdown.
If she does not wish to eat of drink, then in my own opinion she should not be forced to.
Your mother is dying. Allow her to do so with dignity. She has already been through ALL OF THE LOSSES, including the loss of her mind. Please allow her now to seek the final peace which is where we ALL will go.
She is now in LTC in the same facility. The good news is she qualified for Medicaid. She has since forgotten that she chose to not get out of bed but now she's lost all her mobility. She will now go eat in the dining room and participate in activities but the staff has to Hoyer lift her out of bed for everything. She even has a special wheelchair because she can't sit up straight and has chronic back pain. This whole journey started in 2016. She'll be 89 years old in July.
All this to say it is true the staff can only do so much. Apply for Medicaid for her. If you're not her legal guardian then allow the social workers to start the process of getting her a court-assigned one. Then walk away and focus on your husband, who should have been your #1 priority all this time. I'm hoping you haven't been paying for her care. It's not over for your Mom but if she goes into LTC on Medicaid then she's as settled as she'll ever be and you can move on.
If they continue to ask you to do these things ask where you can punch in so you can get paid.
There is also a liability issue.
If mom gets hurt while you are getting her up who is responsible?
If you get hurt are they going to pay for your injuries? I doubt it.
If they are "asking" mom if she wants to shower, if they are "asking her to get up and go to the dining room or the activity room then they are not going to get very far.
They should be TELLING mom..."Mable" it is time to get up and go for lunch, let me help you" "Mable" it is spa time, lets go get ready" or "Mable" it is time for a shower, let me get your pretty pants and blouse that WendiG brought you"
They should know how to deal with a reluctant resident.
She never liked showers her whole life. Her whole life she took baths and washed her hair in the kitchen sink . At home when the bathtub got too difficult to get in and out she would take a shower now and then , but mostly was sponge bathing herself for years ( and washing hair in the sink ) until her brain was too broken to manage any hygiene at all . She would not allow me to help her at home with hygiene . She wouldn’t allow hired help “ strangers “ in her home .
While in the facility I bought her the big body wash wipes to use . It was easier for her to figure out than using the sink. Then she stopped using them , so I would help when she would let me to keep her from being kicked out of AL for unbearable odor .
Then her incontinence got worse and her room smelled so bad . The owner told me she had to shower by the end of the week or would be getting 30 days notice to leave . So the nurse and I told Mom that and she still refused . Later that week the nurse and an aide finally got her in to shower . BUT I had to tell them to clean her chair and the carpets in her room from urine when the facility complained that Mom’s odor was too much . Showering her wasn’t enough . She was forgetting to change her depends often enough and wouldn’t let them help her unless she was really soaking wet and she was having difficulty with her wet clothing sticking to her legs . I started lining up a move anyway because it was inevitable that she would have gotten 30 days notice . It was a shame because the memory care by me , the people don’t even talk . My Mom wasn’t that bad . She was going to be very upset leaving her AL. I kept thinking , if only Mom would let them help her .
She absolutely refused help from staff with bathing unless she had occasional diarrhea . She was very modest and embarrassed. She would allow her hair washed and dried at the hair salon at her facilty, weekly , and haircuts .
I agree with the advice of tell the facility to just give her a bed bath . And maybe see if Mom is willing to go to the salon for hair wash weekly . Or have them do a shampoo cap in her room .
My mother regressed to staying in her room except for meals as her dementia got worse . I suspect had she lived longer she would have eventually refused to come out at all . I wouldn’t force her out of her room , let her be .
So sorry , it is very hard to watch , I know . Let the facility take care of her , you should not be expected to do these things . My mother died , probably a heart attack , during her afternoon nap . They found her at dinner time in her chair in her room ( she hadn’t shown up for dinner in the dining room ). It was for the best , because we were facing a move to memory care or SNF over her uncontrolled incontinence. Mom was aware because the nurse from the new facility had visited Mom days before her death and Mom didn’t want move .
The folks at your moms memory care are the ones who are responsible for getting mom into the shower, and for getting her up out of bed, not you. That is what they're paid for.
If she continues to make a scene, you just tell them to give her a bed bath. And if she wants to stay in her room to eat. let her. These are her choices and with a broken brain there's not much you can do to help.
You now have to protect your mental health, and I know that being around the woman who gave you life and who you were estranged from for a very long time, has to be very difficult, so I would just limit my visits to perhaps just once a week and tell the facility NOT to call you unless it's an absolute emergency.
Either that or just let the state take over her care, so you can concentrate on your healing and your marriage as you say that this is now affecting that.
I am a FIRM believer that no child should EVER take on the care of a parent who abused them in any way. Period. End of sentence.
And to answer your last question, "Is this the end?" I can only hope and pray for your sake that it is.