Personal Hygiene and Dementia

Nia

New member
Nov 29, 2018
6
0
Hi
Could do with some advise, I care for my mother from a distance (another country). She has carers that come in twice a day to give medication and a private carer for a couple of hours a day 5 days a week. She has vascular Dementia for the past 4 years. She doesn't leave the house and spend every day in her dressing gown. She believes she gets washed and dressed every day. But we know otherwise as there is nothing in the washing basket.
She also believes that she does the washing but the cleaner does that this is why i know she has none.
We ask her every day if she is getting washed and dressed and she says yes, i am at a loss of how to approach this. She still believes she is totally independent and does not accept that there is a problem.
We have tried with the carer putting cloths out on the bed for her this worked once.
I keep loosing my patience and i know this isn't the right thing to do.
Any advise please
Thanks
 

Duggies-girl

Registered User
Sep 6, 2017
3,620
0
Hi
Could do with some advise, I care for my mother from a distance (another country). She has carers that come in twice a day to give medication and a private carer for a couple of hours a day 5 days a week. She has vascular Dementia for the past 4 years. She doesn't leave the house and spend every day in her dressing gown. She believes she gets washed and dressed every day. But we know otherwise as there is nothing in the washing basket.
She also believes that she does the washing but the cleaner does that this is why i know she has none.
We ask her every day if she is getting washed and dressed and she says yes, i am at a loss of how to approach this. She still believes she is totally independent and does not accept that there is a problem.
We have tried with the carer putting cloths out on the bed for her this worked once.
I keep loosing my patience and i know this isn't the right thing to do.
Any advise please
Thanks

Hi @Nia This could be my dad. He has had alzheimers for seven or more years and he too believes that he showers and has clean clothes everyday. He doesn't. He still lives alone with twice daily visits from me.

He still has a wash, I believe that he may have forgotten how to use the shower or maybe he really does think he still uses it. I know he does not because it is bone dry in there and has not been used for months. The only bonus is that I no longer have to worry about him slipping up in there. He will wear the same shirt until I do his washing and then I just say 'I will have that shirt as well dad' and he will give it to me. I haven't seen pants or socks for months. He always used to wash his socks in the shower (an old naval habit apparently)

I think it is just another step down in his dementia. I have read all of the stages of alzheimers and dad seems to be a classic case. The next step I can look forward to apparently is dad forgetting how to dress properly followed by incontinence (if it comes)

I don't know how vascular dementia progresses and it may be different but my dad also believes that he does his own shopping and goes for a walk every day (he doesn't)

I can't help you in how to approach this. I am just going with the flow at the moment as he still washes and does not smell or appear dirty at the moment. I have suggested a few times that he changes his shirt because it has food stains but when I point to them, he doesn't see them which is strange because his eyesight is fine.

I will have to face up to it if he starts to smell and I am not sure how to handle that at the moment. I have to add that dad would be mortified if he realised as he was always such a well presented man.
 

canary

Registered User
Feb 25, 2014
25,018
0
South coast
Hello Nia and welcome to Talking Point.

This is a really common problem with dementia and is very difficult to solve. Im probably not the best person to advise you as I never did solve this problem. Mum was living at home in the early stages and was convinced that she was washing, changing her clothes, doing her own laundry, shopping, cooking, doing housework. One look at her and her house told you otherwise :( Im afraid that this problem was only solved when mum moved into her care home where the carers were experts at persuading mum to get clean
 

Bunpoots

Volunteer Host
Apr 1, 2016
7,342
0
Nottinghamshire
For a while I managed the problem of dad not washing by getting there early, before he dressed, switching the shower on and behaving as if it was his idea to have a shower. Could the carer try this?

I used to aim for a shower once a week.

Eventually dad had carers going in every morning to help dad with washing and dressing. We still aimed for once a week for a shower. The rest of the time it was bits, pits and teeth - not always successfully - but dad smelled better once he had regular morning carers.
 

witts1973

Registered User
Jun 20, 2018
731
0
Leamington Spa
It's tricky a lot of people with dementia are scared of water,it's not so bad for my mum as she is bed bound so it doesn't seem to bad for her as she is washed with flannels from a basin,she hates it when I have to wash her hair,all though I use a non rinse shampoo so she doesn't get too wet
 

Martarita

Registered User
May 11, 2018
112
0
Hi there Nia ,I think I've brought this subject up before I'm my Husbands carer I had problems with him showering or getting into the bath .he too use to say he'd been in the shower or he'd had a good wash ,I knew he hadn't he would go for weeks with out bathing it wasn't like him at all he was obsessed with being clean ,it really bothered me when he wouldn't
shower , one Sunday morning I filled up the bath and made it all nice and bubbley ask him if he'd like to get in the bath and I would wash his back and his hair for him ,and too my surprise he got in ,told him to have a good wash while I put clean bedding on the bed . I thought WOW I've cracked it and every Sunday morning we made it bath morning and then , HO NO then this morning I filled the bath up ,put clean undies on radiator to warm for him ,he said no I'm not getting in I'm not dirty I've been washed ,after a time of no I'm not and Ho yes you are he finally did get in with a lot of persuading ,only hope we're not gone back to that again ,but some how I really think we will , i hope not I don't know what advice I could give I don't know what too do myself if we go backwards,good luck with this one ,and welcome to Talking Point ,everyone is so welcoming I've only been posting for a few week and it does really help to talk everyone at TalkingPoint knows what your going through . Take are .x
 

Rosettastone57

Registered User
Oct 27, 2016
1,839
0
Hi
Could do with some advise, I care for my mother from a distance (another country). She has carers that come in twice a day to give medication and a private carer for a couple of hours a day 5 days a week. She has vascular Dementia for the past 4 years. She doesn't leave the house and spend every day in her dressing gown. She believes she gets washed and dressed every day. But we know otherwise as there is nothing in the washing basket.
She also believes that she does the washing but the cleaner does that this is why i know she has none.
We ask her every day if she is getting washed and dressed and she says yes, i am at a loss of how to approach this. She still believes she is totally independent and does not accept that there is a problem.
We have tried with the carer putting cloths out on the bed for her this worked once.
I keep loosing my patience and i know this isn't the right thing to do.
Any advise please
Thanks
As other posters have already said this is an extremely common problem. I don't have any magic wand I'm afraid but to put it in perspective my mother-in-law who had carers three times a day never washed her hair for 5 years whilst they were coming to her home. As she never smelt I didn't really fret about it once she went into a care home they had her bathed and hair washed within 48 hours
 

Rosie56

Registered User
Oct 5, 2013
75
0
Hi Nia, you have my sympathies! I am also a distance carer though not from quite such a long distance as you. Mum has advanced dementia. She thinks she is shopping, cooking etc whereas in reality I and the carers run her life for her. She is doubly incontinent and unless pressured she will not wash, change her clothes, brush her teeth or change her pads. She has been known to pull the pads out of her knickers and stuff the knickers with toilet paper, so that she has no real protection. She hides dirty knickers around the house. Her carers come in several times a day and though some of them have managed a limited amount of personal care, she absolutely won't let anyone bathe her - she fights and screams, and is worse with me than she is with them. She smells awful and I worry constantly about skin conditions and infections. I have only had two successes: I once got her to bathe by filling a bath and making the bathroom very hot, then asking her 'not to waste the heat' (she is very frugal). And recently I got her to change her dirty clothes in order to attend a party at the day care centre by telling her that I was dressing up and so must she - we couldn't go scruffy, because 'a party is like The War - everyone must do their bit!' To my amazement, after this appeal to patriotism Mum meekly changed her clothing. Most of the time, though, it's total failure and hopelessness on the hygiene front. I completely understand your frustration.
 

Nia

New member
Nov 29, 2018
6
0
Thank you everyone for your words it is comforting that i am not alone. But i do question at what stage do i need to bring in social workers and question going into care, the last time i got them involved was because i believed she was not coping she went for a visit and told them everything was fine and she copes well on her own. They offered her a carer twice a day but for us this is a waste of time. She reacts well to the carer we employee privately who cooks and cares for her. If i brought up the idea of a care home she would kill me, i keep saying to myself if she is not in danger and eating then this should be ok.
 

Rosettastone57

Registered User
Oct 27, 2016
1,839
0
Thank you everyone for your words it is comforting that i am not alone. But i do question at what stage do i need to bring in social workers and question going into care, the last time i got them involved was because i believed she was not coping she went for a visit and told them everything was fine and she copes well on her own. They offered her a carer twice a day but for us this is a waste of time. She reacts well to the carer we employee privately who cooks and cares for her. If i brought up the idea of a care home she would kill me, i keep saying to myself if she is not in danger and eating then this should be ok.
Perhaps you need to ask yourself whether she is safe in her own home when the carer is not there. With my mother-in-law the time had come for 24/7 care when she could no longer find or remember the toilet in her own home . She was fine when the carers were there but of course they are time constrained when the carers weren't there then she was unsafe. By that time she could do virtually nothing for herself so there was no option but to find a care home
 

Ruth1974

Registered User
Dec 26, 2018
128
0
This is an ongoing problem for us and when i used to try to push the situation he got quite angry / upset.

What i do now is, he has a diary and i write bath/change clothes in it every other day. Then when i remind him to get a bath and he says had one yesterday i can just ask him to check his diary....

Its still hit and miss, and as soon as he gets in i have to remove all his clothes and put them in the washing machine or he just wants them back. I think his snell reassures him maybe?

Hes only in the bath for a few minutes. Going to bite the bullet and start washing him.
 

Ruth1974

Registered User
Dec 26, 2018
128
0
Thank you everyone for your words it is comforting that i am not alone. But i do question at what stage do i need to bring in social workers and question going into care, the last time i got them involved was because i believed she was not coping she went for a visit and told them everything was fine and she copes well on her own. They offered her a carer twice a day but for us this is a waste of time. She reacts well to the carer we employee privately who cooks and cares for her. If i brought up the idea of a care home she would kill me, i keep saying to myself if she is not in danger and eating then this should be ok.
If she wants to be at home and is safe at home, then she is probably better at home. I know it feels like she would be safer in a home but social services won't be in a rush to intervene unless she is at risk, and probably at more risk than we would find acceptable.

If she really needs to be assessed put your concerns in writing, give them a copy and keep a copy. They have to involve her in assessments which can be frustrating when her perception is different from yours and you dont want to upset her by talking about difficulties she isnt aware of.

If you are in the UK look at options for SDS, it could be that the care package they are offering could be used to pay the carers you already have.
 

Sirena

Registered User
Feb 27, 2018
2,324
0
Nia, as Canary says it is likely that carers in a care home would be able to get your mother to wash. They are not only expert at it, they also have the time to persevere and to get to know what works best for her. If you want her current carers to wash her, they will have to do it in a straightforward 'time for your bath' way - if they just ask her if she'd like to, she will say no.

Is your mother is self-funding? If so, it will be easier to move her should the time arrive for a care home. My mother had care at home for 18 months (4-6 hours a day, self funded) which worked fine for 18 months, but there came a point when she was no longer safe on her own for the other 18 hours. When she needed a care home I arranged the move without involving social workers. As Ruth says, if she is local authority funded SS will ask if she would like to move to a care home, and if she says no, she will stay at home until there is a clear crisis such as an injury or illness which leads to a hospital admission.

It may seem preferable that she stays at home because 'that is what she wants' but there comes a point when she is no longer able to make a coherent decision. My mother would never have volunteered for a care home, but she loves it there, as well as being safer.
 

Nia

New member
Nov 29, 2018
6
0
If she wants to be at home and is safe at home, then she is probably better at home. I know it feels like she would be safer in a home but social services won't be in a rush to intervene unless she is at risk, and probably at more risk than we would find acceptable.

If she really needs to be assessed put your concerns in writing, give them a copy and keep a copy. They have to involve her in assessments which can be frustrating when her perception is different from yours and you dont want to upset her by talking about difficulties she isnt aware of.

If you are in the UK look at options for SDS, it could be that the care package they are offering could be used to pay the carers you already have.
Thank you just to ask what is SDS?
 

Nia

New member
Nov 29, 2018
6
0
Nia, as Canary says it is likely that carers in a care home would be able to get your mother to wash. They are not only expert at it, they also have the time to persevere and to get to know what works best for her. If you want her current carers to wash her, they will have to do it in a straightforward 'time for your bath' way - if they just ask her if she'd like to, she will say no.

Is your mother is self-funding? If so, it will be easier to move her should the time arrive for a care home. My mother had care at home for 18 months (4-6 hours a day, self funded) which worked fine for 18 months, but there came a point when she was no longer safe on her own for the other 18 hours. When she needed a care home I arranged the move without involving social workers. As Ruth says, if she is local authority funded SS will ask if she would like to move to a care home, and if she says no, she will stay at home until there is a clear crisis such as an injury or illness which leads to a hospital admission.

It may seem preferable that she stays at home because 'that is what she wants' but there comes a point when she is no longer able to make a coherent decision. My mother would never have volunteered for a care home, but she loves it there, as well as being safer.
Hi Sirena,
No my mother is not self funded, i have had assessments in the past but they have just said if she says NO she doesn't want help then they cannot do anything. So i understand what you say about a clear crisis or hospital administration. We don't believe she is able to make a coherent decision for her self do we have a case with SS then or is it only if she is in danger? We do have lasting power of attorney for her on health and finance so maybe this will help our case. Happy to hear your thoughts.
Thanks
 

canary

Registered User
Feb 25, 2014
25,018
0
South coast
Unfortunately, if you are not self-funding then you have to persuade SS that it is necessary and that usually involves some sort of crisis because you have to show that they are a danger to themselves or others.

In the meantime you could go and look at care homes and find out which ones will accept Local Authority funding, so that when the crisis happens you know where you would like her to go.