I wonder if anyone could give me some advice please?

NatB123

Registered User
Aug 2, 2016
57
0
Nottingham
Hi Everyone!

Just a few issues that I was looking for some advice on if anyone has any experience for me please.

Firstly, the great shower saga....It is now nearly 3 months since any sort of water touched my Grandmas body or hair. We have brought a foot spa and managed the whole of about 1 minute in that before she started screaming and will not entertain the idea again! The last time we got her to wash her hair was by getting a hairdresser to come and cut it for her and before they cut it they washed it over the sink which she was more than happy with, although the next time we went to do this she would not have any of it. We have carers in and they have asked her a few times to have a bath, shower or even just a wash but cannot get her to do it as she just says she's had one.

I have read on this forum how people with Dementia can be scared of having the water on their heads or deep baths so last night I went round and tried to make it a nice experience for her, I turned the heating up so it was lovely and warm...I then wrote a note when she wasn't looking pretending it was from the carer saying she hadn't had a bath that day and they would like me to run her one (She really likes one of the carers in particular and will do anything she asks, apart from any form of washing it would seem!) I went up and ran her a shallow bath and involved her in which shower gel she would like to use and she seemed to be more than happy to do as the 'carer' had asked, taking her jewellery off and going upstairs, she even started to get undressed.

But as soon as she realised she was going to have to get in the bath she got angry...I understand she is scared so sat next to her on her bed and asked what she was scared of, was it the water etc. (I don't know why I thought she'd be able to tell me but I was trying to put across to her that I understood it was something that she wasn't comfortable with doing and that maybe she could just have a strip wash and that I wouldn't look if she didn't want me to but if she did want me there then I would be...) anyway, to cut a long story short she couldn't tell me why just that she wasn't going in but the discussion ended with me now sporting some lovely bruised handprints across my right shoulder where she hit me repeatedly whilst shouting that she wouldn't!

My problem is this.....do I just resign myself to the fact that she probably wont shower again? She seems oblivious to the fact that she smells, her hair is greasy and her clothes are dirty so its not as if it is upsetting her in anyway. But obviously not washing will lead to UTIs or other illnesses. Or do I do something about it, if so what??


My second issue is with the carers, they clearly aren't trained in dementia. The notes often say I asked if she would like anything, she said no, all ok so left....she is paying for 30 minute visits twice a day and the longest they have stopped for so far is 15-20 minutes each time but they still charge for the full 30 minutes. I was there the other day and witnessed the carer listing off a number of different things for my Grandma to 'chose' her dinner from, she obviously just looked at her blankly and said 'yes' rather than picking a meal and then the carer sounded annoyed that she hadn't answered the question. They also gave her an out of date sausage roll the other day (out of date by 4 days!)

I've picked up my concerns with the care company and they have asked me to write up a meal plan for the week, every week and put it into their folder so that they can follow it. They also want me to write a plan for what they should do each day, such as give her, her tablets, cook her meals, try to give her a wash etc.

If this is what I have to do then I will do it, but the reason we were getting carers in is because I work full time and was having to go straight from work to do these things for her alongside looking after my own young family.
Is this normal to have to tell the carers what to give the person to eat and what they need to do with them? I've never been in this position before to require carers so I don't know the procedure... it just seems strange that I have to tell them how to do their job?
I don't mind what she eats as long as its something and isn't out of date and I don't mind what they do when they are there as long as she is getting the full half an hour that she is paying for! So what do I do, is what they are asking me to do something that every care company would ask for (we already had the meeting at the beginning to say what she needed help with and agreed on food, tablets and washing and choosing clean clothes) or is it time for me to look for another company who will stay the correct amount of time and maybe have a better understand of Dementia meaning that she would get a better standard of care? The carers are so lovely and my Grandma has taken a shine to a couple in particular which I never thought would happen, I'm just not sure if I'm 100% happy with the help that she is receiving at present.

Sorry for the long post, once I'd started I couldn't stop!! I just really do not know what to do.

And thank you in advance for any advice that you can give. :)
 

marionq

Registered User
Apr 24, 2013
6,449
0
Scotland
Routine is probably out the window. I would possibly write a variety of things on a white board that they could choose from depending on her mood eg. Put washing in machine, wash kitchen floor, give Mum tea and a sandwich/scrambled egg/soup etc. Throw rubbish in bin, wash up dishes and so on.

Somewhere in there you could say offer Mum a shower or to wash and blow dry her hair.

I would get them to note in the daily diary what they did from the selection.
 

Toddleo

Registered User
Oct 7, 2015
411
0
What a conundrum Nat, and a sadly not unfamiliar tale. i am sure there are loads of people waiting to dive in with their own experiences, as most of us have "been there and done that!"

Mum did not wash body or hair for two years and slept in the same clothes that she wore all day long, yes 2 YEARS, I stressed about it so much! she even got scabies, but the doctor reassured me that, there was little that we could do about it, so we applied the ointment for the scabies, and left the clothes as they were Lol. It was not till further along in her alz journey and the introduction of anti psychotic meds that we became able to wash her properly, the meds worked like magic with regards to her compliance.

Carer wise, it's tricky, personally I used to leave a note each day pointing the carer towards the ready meal to cook for that particular day, it worked OK ish, but mum was never brilliant with food. Certainly the care agencies differ greatly, and some are better with Alz that others for sure. Does your gran go to any clubs or day centres? it sounds to me like maybe the carers need a bit more direction?
 
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LadyA

Registered User
Oct 19, 2009
13,730
0
Ireland
Sometimes, there's absolutely nothing you can do about the washing. Have you tried Bath in Bed wipes - would they work? They are like flannel sized, slightly thicker wet wipes. I used those with my husband when he refused showers for a while. You can warm them in the microwave. I also, because my husband hated being undressed, made a sort of towelling "tent" like those used for changing into swimsuits long ago - basically a towel joined up at the side, and with elastic around the top for the neck (put it just under the arms, as it's safer to have the hands free) - and he kept that on in the shower. Yes, it was awkward, and I had to wash him through it as best I could, but it meant he got washed now and then! When finished, I put a bathrobe on before taking off the "tent" underneath. He was much more comfortable that way.
 

Slugsta

Registered User
Aug 25, 2015
2,758
0
South coast of England
I don't know when Mum last showered but I do know it is not for some months. She thinks she has done it and tells the carers this when they ask. The only time she has allowed anyone to help with a strip wash (still not a shower) is when she has been incontinent of faeces - fortunately not often!

I find that some of the carers are better than others, it is not uncommon to find that things written in their book as done were not. I also discovered that some of them write the care notes before they have even started :(

Some are better than others, of course. Some are glad to do the minimum and leave (they are not allowed adequate travelling time between visits), others will push a bit if Mum says 'no' to something or find something else to do.

It was agreed with the agency from the start what they would do, I phone them if I want to change anything and it is written into the care plan. Mind you, this is still no guarantee that something will be done!

On the whole I am thankful that someone is going in and seeing Mum, giving her meds (this was the main reason for getting carers in) and offering food. In addition, Mum is happy with these people, I try to focus on that and not worry too much about the details.
 

Angie1996

Registered User
May 15, 2016
515
0
Somerset
My dad was 18 months before he had a bath, only then because he was sectioned and put on antipsychotics, which made him more compliant, oh boy he smelt soooo bad!!! I gave up trying in the end.

I bought not water shampoo to wash his hair, that worked well... you can also get no water body wipes.... they are really good...... it's like a body wash and hair wash without using any water.....

But I only got him to let me use the shampoo.... never convinced him with washing his body....

You can also get shower caps which has the shampoo solution built in, to wash hair, again no water required


Sent from my iPhone using Talking Point
 

oilovlam

Registered User
Aug 2, 2015
386
0
South East
I hate care agencies.....they charge an arm & a leg but deliver very little. Sometimes it is the staff who are in the wrong job or not trained. Often it is the agency management who over promise and under deliver. Why should you pay for 30 minutes and get 15. A disgrace. I cannot always blame the staff, they are under pressure with zero travelling time & too busy a schedule. But the management still want their pieces of silver. For the CQC such things aren't even on the agenda...who cares what the customer experience is like.

So basically find the good carers (they do exist) and try to keep them, although despite the promises of continuity it won't happen. But as long as you get the 'good uns' for the majority of the time. And complain when you feel it is warranted. Personally I'm very bad at that...I sort of make an informal complaint that never gets recorded (which means that nothing gets done). I did once say that I wouldn't pay for a visit & the proverbial hit the fan....I think they only care about the money.

I have only really had one shocking carer...a few dubious. The shocker said that if my mother started to fall she would have to step out of the way (whilst climbing the stairs). Also said that it was 'illegal' to give my mum a drink if she said no (which is complete b0ll0cks btw). I informed the agency that if she ever turned up at the door I wouldn't let her in. The 'crazy' carer continues to work for them apparently despite other 'complaints' (so I have heard).

So find a good agency...none of them are perfect. Get rid of the odd 'crazy' carers. And complain...as much for other people as for yourself. I would say that there is no excuse for a carer to leave after 15 minutes into a 30 minutes booking. They can chat, give them a drink, do a bit of dusting. Good luck anyway.
 

oilovlam

Registered User
Aug 2, 2015
386
0
South East
Slugsta is 100% correct. Concentrate on the benefits that carers can do. Set yourself a minimum target that you expect on every visit.

I was a bit dubious about the agency asking you to fill out the care plan. Firstly that's something they should do in consultation with you. Secondly the carers hardly ever read it (they don't have the time & they are never checked on whether the read it).

I'm sort of lucky because I'm always here to vet carers (they do mum's personal care). If I was a 'distant' carer then I would be almost paranoid...hence the use of surveillance cameras by some concerned relatives. Although you should still complain that you are only getting 15 minute visits when you are paying for 30. Try suggesting that you only pay 50% of the fee when that happens....and watch them jump!!
 

Skyrim

Registered User
Jun 19, 2015
37
0
Oh dear, this echoes this morning's conversation with my partner about his mum's lack of washing and what to do next. She has not had a bath in years but has always had "a good strip wash" and, until August, would let me assist her. Now the "wash" lasts about two minutes and she is insistent that she's done the biz but, as she's started wearing the same things day and night (and insists she hasn't), its blatantly a fib. She is not so confused that she can't time herr trips to the bathroom for times when she thinks I'm not around, like 4 a.m and then, when I appear, the shouting starts.

The embarassing thing is that I am an HCA and have tried every trick in my repertoire (and I have been very well trained) -she knows what she's about and I can't force her. That's technically a legal position -it would be assault, and its also a physical one....I too have had slaps and bruises. Its mortifying. Incidentally, when I have had a client who refused my assistance, its recorded and always reported to the line manager.

Having worked for a private care agencies and then in both Local Authority and private care homes, I can understand some comments about carers, but can also defend them in other ways. A good care home should have a "best interests' policy which determines a course of action to be taken, after consultation, when a person's behaviour could causee harm to themselves or others. So not accepting a wash at least on more than two occasions should flag a potential problem and we would start talking about other tactics. Same goes for not eating, eating only one type of food etc etc. Do not accept shoddy notes and PLEASE don't let them do just anything to get your thirty minutes worth -you have a contract and it must be adhered to.

Your agency is making money and should be advising you, not leaving you to worry like this. If they can't do this, or provide the level of service you request, find annother one that will. Or perrhaps consider hiring a personal assistant yourself.

For my part, I found a sneKy way to ensure at least one thorough washing in months....I got the District Nurses to come and do a check for skin degradation. They turned up, fully briefed by myself and the Older Poeple's mental health Team and it went perfectly well. But this is obviously simething I can't call on regularly. I leave wet wipes in the loo, bathroom, her bedroom and the kitchen, I use dry shampoo and the occasional trip to the hairdressers, when its fairly empty. But, overall, I feel a failure. I can't expect even two carers to come into my house and attempt this as I know from personal experience its misery for all. I wish I could be offering a solution to this problem but I really can't and there is no "one size fits all"...just flag up your concerns and try every tip that comes your way...I hope the right one turns up for you.
 

smartieplum

Registered User
Jul 29, 2014
259
0
Could be worse. She could be trying to wash her face with Lucozade, like my mum. Or putting cat food in the washing machine, or peeing on the kitchen floor. Oh, and found a baking tray in the washing machine yesterday. And trying to feed the cats listerine. Oh, the joys. :rolleyes:
 

Princess t

Registered User
Mar 15, 2016
184
0
My mom is on her third care agency in ten months. They are not dementia trained, can't get any that are. They should be with her four times a day half hr slots, they should help her wash change clothes feed her, do light housework change bed but what do they do? Ask her what she would like she has no clue. So they leave. They were asked at beginning what to do it was all agreed and put in writing in folder. All three agencies the same and the second agency sent men/boys to look after her....yes she's really going to let a man shower her and put new knickers on!!!! So far none have got her to shower or wash or change clothes because she says she's ok so that's OK by them. My mom goes long periods without washing and changing clothes, it's six weeks since she brushed or washed her hair and had a shower, she just doesn't see what we do. But if she knows the docs visiting on goes the lipstick and perfume!!! I try and make light of the hygiene side if it. But done times it's not nice kissing some one who stinks!!!!
 

NatB123

Registered User
Aug 2, 2016
57
0
Nottingham
Hi everyone!

Thank you for all of your replies. Sorry its took a while to get back to you. I threw myself into sorting the carers out....I took your advice marionq...I wrote up a list of things that they could do for her (changing her bed being right at the top, but also ensuring change of clothes, help with bathing or even just a short wash, hoover, put her washing in etc.) I then did the meal plan as they requested, went through her freezer, wrote down which meals I wanted her to have on which days and even which drawer they would find them in, in the freezer. I made sure anything out of date or even nearly out of date was thrown away (2 bin liners full!) and even made sure I wrote at the bottom of the board how much I appreciated everything so that they didn't think I was being funny with them.

I ended up ill over the weekend so didn't go to see my Grandma as thought that was the last thing we needed, her catching a sickness bug! But in a way was happy that it would give the carers time to start using the meal plan and carrying out the other tasks.

Fast forward to 4.45 last night...I'm back at work and get a phone call from the care company 'We're just ringing to let you know that Grandma isn't in, the carer is there now and I know you said you wanted us to let you know if ever she wasn't in the house when we went' I asked if they had checked all over the house and she assured me they had and she was 100% not in the house.
Panic set in...its cold, pitch black, where on earth was she?

I rushed out of work and rang her boyfriend who luckily only lives a 30 second drive away from her. He got to her house exactly 2 minutes and 45 seconds after they rang, went round the house....she was in bed. Fast asleep.
When I got up there she was sat downstairs in her nightie. The same nightie that, according to their notes, they had put her in the day before that was absolutely FILTHY. I nipped upstairs to check everything was ok and noticed the bed had blood on it, but most certainly not new stains and absolutely stunk. So much for them changing the bed.

So yet another phone call to them this morning, the manager asked the carer who attended whilst I was on the phone if she had definitely checked every room in the house and she said she had....really :rolleyes: the old lady who cannot walk faster than a shuffle managed to get back in the house from wherever she had supposedly gone, remembered to lock the door behind her, up the stairs, into her nightie and into bed and be fast asleep in less than 3 minutes? Clearly what she means is she couldn't be bothered to check upstairs.
What would have happened if she had fallen over or worse?? As compensation they are not charging her for any visits yesterday and have promised from now on that if they do persuade her to change her clothes they will make sure that they are clean and have also said that they will change her bed as requested.

I suppose at least for now they're actually managing to cook meals for her :rolleyes: but I will definitely be taking some of your advice and looking for a new care company and before signing anything will be putting down EXACTLY what I expect from them. Like you say though Princess T, where do you go for the carers to be properly Dementia trained??

Skyrim - your reply has really helped me, I know they haven't flagged up any of those issues and like you say they are the ones earning money so should be the ones advising me, after all, they are the professionals.

Thank You again everyone, and yet again sorry about the long moany post - it just seems to be one thing after another at the minute!!