SusanHeart Asked April 2022
Shower or lack there of...How to resolve this situation?
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My dad is in AL MC he has his own apartment. In his care plan we have assistance with shower 2X week
my dad refuses assistance, refuses to take a shower, going on 3 weeks now. The CNAs offer to help, his PT and I try to convince him to take a shower no go.
have any of you encountered such situation? Were you able to resolve? If yes how?
he needs a walker, we bought him 2 shower chairs one for the shower the other for him to seat to get dressed. He complains it takes him 2 hrs to take a shower and he is too busy.
help!!!!!!
thank you in advance
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I suggest you read this 33 page booklet (which is a free download) which has THE best information ever about managing dementia and what to expect with an elder who's been diagnosed with it.
Understanding the Dementia Experience, by Jennifer Ghent-Fuller
https://www.smashwords.com/books/view/210580
Here is a list of useful tips from her e-book I found to be excellent:
The “Dont's”
· Do not reason and argue
· Do not demand that they reason or problem-solve
· Do not demand that they remember
· Do not demand that they get their facts straight
· Do not correct their ideas or scold them
· Do not reorient them
· Do not think that they are being uncooperative on purpose
· Do not think that they really do remember, but are pretending not to
· Do not use a “bossy” dictatorial attitude in care
· Do not act with impatience
The Do's
· Enter into their frame of reality, or their 'world'
· Be aware of their mood or state of mind
· Use few words and simple phrases
· OR use no words, just friendly gestures and simple motions
· Do everything slowly
· Approach from the front
· Wait for a slow response
· Constantly reassure them that everything is 'OK'
· Keep people with dementia comfortable 'in the moment' - every moment
· Maximize use of remaining abilities
· Limit TV or radio programs which they may feel are frighteningly real
· Maintain privacy
· Provide a safe physical environment
Language Needs
· Use short words
· Use clear and simple sentences
· Speak slowly and calmly
· Questions should ask for a “yes” or “no” answer
· Talk about one thing at a time
· Talk about concrete things; not abstract ideas
· Use common phrases
· Always say what you are doing
· If they repeat their question, repeat your answer as you did the first time · Give them a longer time to process information
· Wait patiently for a response
· Be accepting of inappropriate answers and nonsense words
· Speak softly, soothingly and gently
Care Needs
· Recognize that receiving personal care feels intrusive
· Reassure with your tone and manner
· Do one thing at a time
· Talk through the care “play-by- play”
· Be aware of your body language and use it to communicate relaxation and reassurance
· Be sincere
· Use a soft, soothing touch
· Be aware of the individual’s unique triggers
· Be aware that a person with dementia may not accurately judge whether a situation is threatening to them
· They may respond to fear, pain or anxiety by defending themselves with what we call “aggression”
· If they become distressed, stop immediately and allow them time to calm down – don’t try to restart the activity right away
You need to change your behaviour to adapt to the dementia because the person with the disease cannot.
Teepa Snow also has good videos on YouTube about bathing an elder with dementia.
Good luck!
I used the no rinse products when I had an appendectomy; I actually felt just as fresh, if not more so, than when I take a shower.
I can get the products in the massive pharmacy/beauty section of the local chain shopping stores, or at drugs stores (where they tend to be more expensive).
Examples:
http://cleanlifeproducts.com/
https://www.walgreens.com/store/c/productlist/no-rinse-cerave/N=303414-308402
https://www.walgreens.com/store/c/no-rinse-shampoo/ID=prod3946587-product
How about reducing to 1x a week at a consistent time of his choice?
I suggest you read this 33 page booklet (which is a free download) which has THE best information ever about managing dementia and what to expect with an elder who's been diagnosed with it.
Understanding the Dementia Experience, by Jennifer Ghent-Fuller
https://www.smashwords.com/books/view/210580
The 36 Hour Day is another excellent reference book on the subject.
Teepa Snow has wonderful videos on YouTube to help you learn how to handle your mother & her histrionics.
my husband can go three weeks without a shower sometimes. When I ask him to shower or tell him he should, (because he’s soiled his clothes) he says I’m not his boss and I’m nagging him,,,even if I only say it twice in a day… He’s in the SAME clothes and disposable underwear the whole time! I know he’s in pain all the time (from two back surgeries and a hip replacement) yes, he takes meds ,,,but he gets up to go outside and smoke and to get food for himself. He refuses to use a walker or cane to go for a walk or even to walk around the yard because “someone may see him using it”
He sleeps in his recliner and is in it all day watching TV or sleeping, he sleeps a lot. He has central sleep apnea and will not use C-Pap machine,,,he has tried three times and always thought he could fool them about using it….all said and done,,,,his neurologist will not say he has dementia or MCI,,,,,,he passes the verbal/written test each time,,,, I could go on and on about not having answers,,,
I have searched for help but I have none available, we live 76 miles from services. His PCP in town has no answer either..
it’s the only thing he can really control in his life, maybe that’s one reason…he lost his license three years ago also due to the apnea and alcohol abuse.
I feel for you as I am at a loss for an answer also..…….
Best wishes
But the "takes 2 hours and he is too busy" excuse is only what he's telling you when you ask him about it. What is he saying to them when they prompt him to shower?
Will not give reasons why (which could help improve the experience).
Always says "I just showered a few days ago".
Gets upset/defensive when it's discussed.
I live with this person, and short of calling APS on myself for elder neglect, I'm at a loss.
"Grooming and bathing are disrupted when the person forgets how and when to do things. They may forget what the steps of washing are. They may forget that they need to wash. They may be unable to remember how much time has elapsed since they last washed or changed their clothes. They may also believe that they are clean and take offence should anyone suggest otherwise. Dealing with such situations in a manner that is kind and jovial, rather than confrontational, is important. One fellow, who needed to help his wife bathe as she was no longer able to do so herself, was puzzled because she was calm and cooperative until he helped her step out of the bathtub, and then she became agitated and wanted to get covered up immediately. As it turned out, as soon as she saw her own reflection in the mirror, she thought there was another person in the bathroom, and she was embarrassed. As you can see, the cause of the distress for a person with dementia is not always readily apparent to the rest of us, who can take intact thought and reasoning for granted.
If a person with Alzheimer disease is looking at a solid black area, or a solid white area, such as a bathtub, they may perceive a yawning bottomless hole. Putting a coloured bath mat down may increase the likelihood that they would be willing to step into the tub. Putting blue food colouring into the water may allow them to see what they are stepping into as well. Generally, with altered depth perception, it becomes challenging to judge how high, deep, long, wide, near or far things are.
If you send clear signals through your tone of voice, facial expression and relaxed and confident attitude, that you mean them no harm, they may trust you to the point where you are able to help them with their personal care. People with Alzheimer disease become extremely sensitive to the body language of others, as they no longer possess the judgment and insight to understand the situation, so they evaluate the threat posed to themselves by the frown or aggressive stance of the other. It is important to exaggerate your body language communication to let the person with Alzheimer disease know that you intend them no harm. A smile on your face, a relaxed tone of voice and body stance, a sense of calmness and reassurance, perhaps a hug, all communicate that you mean to help, not harm. If you feel like you’re overdoing the positive body language, you are communicating your intent effectively for a person with Alzheimer disease.
Remember that their short-term memory may not permit them to remember what you are doing when the two of you are part way through a task, such as a bath. People have found it effective to keep chatting throughout the task, as the continued connection and reassurance of a soothing tone helps the person with Alzheimer disease stay calm in a situation they would otherwise find threatening."
I find that with almost 25 years of caregiving service, that asking an elder to shower or wash up is usually a futile effort. They have to be told. As in, 'Tuesdays at 1pm is shower time around here'. Then make them do it. If you or the staff has to nag and complain and harangue your father into showering that's what must be done.
I've had elderly clients over the years that I would have to wear down every time to get them in the shower. Nobody watches tv, or gets a snack, or gets taken out, or does anything unless the shower happens. No changing the subject or promises to do it later either. It's hard but works and it establishes a habit. Most elderly people like routine.