Difficulty showering dad

Pheath

Registered User
Dec 31, 2009
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UK
Our carer battles every morning showering dad, he screams and shouts and threatens to hit her as he can't stand having the water on him. As soon as the shower is over he calms down. Just wondered has anyone else got similar problems and any techniques for getting round it. Thanks, Pam
 

2jays

Registered User
Jun 4, 2010
11,598
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West Midlands
I dont know with personal experience, but I have been reading a book about alzheimers and it says that if a person is at a certain stage, and if they didnt have showers when younger, they may get frightened of what a shower actually is, that the sensation may feel like bugs crawling over them and also the noise can be frightening.

It suggests keeping the person warm with a towel round them, (could make a poncho out of a towel by cutting a head hole in the middle of the towel) shower through the towel - the force of the shower will be gentler, wash the important bits under the towel with a flannel, rinsing off with water in a jug, not the shower unless the person has "got used" to the shower. they will be able to "see" the water and may get an understanding that the shower will not hurt them. it can also help with a privacy issue - perhaps they are shy with this percieved stranger washing them

just thoughts, no idea if this works, but it may be worth trying
 

Nebiroth

Registered User
Aug 20, 2006
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Personally I'd stop trying to force the issue - it's obviously causing massive amounts of distress. There are other ways of dealing with personal hygiene without resorting to showers.

Lots of people with dementia become terrified of water for some reason. There are so many things about it that could be upsetting your dad, he can't articulate them but can only express his distress. It could be the water, the noise, a privacy issue, etc.

Alternatives might be a good wash with a flannel, or disposable wipes.

At the end of the day, hygiene is of course desirable, doing without might be unpleasant but it's unlikely to be life threatening.
 

CraigC

Registered User
Mar 21, 2003
6,633
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London
Hi Pam,

Dad always had showers but when he needed help showering it was just impractical.

We went for shallow baths and hand help shower in bath making sure he could do as much for himself as possible. When we eventually needed to get careers into help there were quite a few difficulties. The main issue was time, they just rushed dad and did not talk him through the process - dad needed respect along with gentle guidance, this takes time.

We also found that we needed better lighting in the bathroom as dad was uncomfortable with another career in a badly lit room. It a very personal thing and needs a gentle approach.

There is a very helpful factsheet on washing and bathing which covers these issues and a whole lot more.

http://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=155

Kind Regards
Craig
 

littlegem

Registered User
Nov 11, 2010
837
0
north Wales
Personally I'd stop trying to force the issue - it's obviously causing massive amounts of distress. There are other ways of dealing with personal hygiene without resorting to showers.

Lots of people with dementia become terrified of water for some reason. There are so many things about it that could be upsetting your dad, he can't articulate them but can only express his distress. It could be the water, the noise, a privacy issue, etc.

Alternatives might be a good wash with a flannel, or disposable wipes.

At the end of the day, hygiene is of course desirable, doing without might be unpleasant but it's unlikely to be life threatening.
I'm with Nebiroth on this one. I wash hubby down with a flannel, one good scrub a week- he doesn't like it but puts up with it. Seems unecessary to frighten someone who doesn't understand what is going on. He's got carers in at the moment as I've had an op and they are taking it very very slowly, just a suggestion at the moment of washing and letting that sink in. He's not dirty just a bit stale and it's not going to hurt him
 

piedwarbler

Registered User
Aug 3, 2010
7,189
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South Ribble
My mum has been so anxious at the thought of a bath or shower that she has vomited. She also suffers vertigo from her MS and the dementia just makes it all worse. I don't have any easy answers at all. I like the idea of the poncho though, I might suggest that one to the care home.

When your loved one is incontinent I worry that they need a proper soak down below to be really clean and not set up sore skin that then breaks. I don't know if this is just a worry in my head or if it is more likely to happen if you don't manage to get them to have a proper wash?
 

Doe

Registered User
Mar 26, 2007
55
0
London
My husband also gets extremely distressed by the shower so I am with Nebiroth on this one. Showering every day is too much. I limit ours to once a week maximum and a good wash down each day. My husband is incontinent but I just make sure I wash these areas thoroughly wearing a washing glove and then dry him carefully and make sure I put on plenty of zinc and castor oil cream as protection. Also during the day I use baby wipes on him on the assumption if babies come to no harm then neither will he. I also use body lotion on him to stop his skin drying out and he really enjoys having it gently rubbed onto his skin. He certainly never smells. He is 88 years old and as a child he was lucky to have a bath once a week and survived :).
 

Nebiroth

Registered User
Aug 20, 2006
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My mum has been so anxious at the thought of a bath or shower that she has vomited. She also suffers vertigo from her MS and the dementia just makes it all worse. I don't have any easy answers at all. I like the idea of the poncho though, I might suggest that one to the care home.

When your loved one is incontinent I worry that they need a proper soak down below to be really clean and not set up sore skin that then breaks. I don't know if this is just a worry in my head or if it is more likely to happen if you don't manage to get them to have a proper wash?

It depends on which sort of incontinence. If it's urinary then you could get soreness but only if you let someone sit in the wet items next to the skin for any length of time. Urine is normally sterile.

Faecal incontinence is a bigger problem, as it sticks to the skin and needs to be got off, it's also rich in bacteria which are harmless if they stay where they are supposed to but can cause infections if they get to other places. But a good soak probably isn;t necessary, so long as you use wipes thoroughly. Baby wipes are ideal, after all, you don't have to give babies a bath every time they soil themselves but they can be small. If you Google you can find places (usually incontinence product specialists) that sell adult sized wipes. They are antiseptic and usually moisturising, eg aloe vera. If soreness appears, you can use a barrier cream - in effect this is nappy rash (same cause), so a barrier like zinc oxide will work

Using soap can actually make it worse, as it dries the skin and removes the natural oil barriers
 

piedwarbler

Registered User
Aug 3, 2010
7,189
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South Ribble
Thanks Nebiroth for that thorough explanation. I am less worried now I suppose but as Mum is in pads then I guess the issue is just like with babies, changing as soon as there is a motion passed.
 
I think that everyone should have a bath or shower every year, whether they need it or not. :)

But in between? As and when needed. If you work down the pit like my grandad did, then do as my grandad did and get the tin bath down every day. If you live a more leisurely life, sitting in an armchair and maybe pottering down the garden, then baths aren't so urgent.

I've worked in places where it wasn't easy to get access to a bath or shower and not easy to strip off and wash. You can last a long time with keeping your face, underarms, feet and private parts clean.

Obviously, keeping the skin clean becomes more important where someone is stationary for long periods and may develop bed sores, when the points of contact need to be kept clean.
 

Pheath

Registered User
Dec 31, 2009
1,094
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UK
Thanks everybody so much for your help with this one. I'd just kind of assumed dad needed a shower everyday (like most people do) and will definitely look at some of the other options you suggest. He is urinary incontinent so a good wash daily down below and legs is essential but agree upper body not crucial especially if it causes him so much distress. Because I haven't personally had to deal with this aspect of his care (do everything else) I hadn't realised what an issue it was until he had a particularly big flare up yesterday. By the way if you are washing just down below in the shower what kind of products do you all use? Nebiroth mentions soap isn't a good idea. Pam
 
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Why not try out and see what he likes? If you're just washing urine off and he has no urine infection, water is enough. Otherwise, if you want to get him washed quickly and have problems with other things, consider low-foaming products like camping shampoo. In fact, talking of shampoo, I like to use supermarket cheap shampoo, and it produces very little foam so is quick and easy to wash off, and that would do just as well for washing a body.
 

Jo1958

Registered User
Mar 31, 2010
3,724
0
Yorkshire
Hi, we use baby wash, no more tears sort of thing with one bottle for body and hair and no confusion, it's very gentle and doesn't dry the skin out as much so less need to moisturise afterwards, although it can be good to give a gentle masssage to relax after the 'business' side of washing is done. I wash hubby down as and when and try to make it as fun as possible, especially drying as it's so important to be dry when you get cold so easily.

A warm flannel works well most of the time though, especially in the middle of the night after any accidents, I don't know about you but anything else at 2am is a bit much for me especially when it's likely to happen again at 3.30am.

A good rub down with an oily rag is how we work!
With not especially hygenic but clean best wishes from Jo
 

chrisR

Registered User
Nov 11, 2006
3
0
Merseyside
On suggestion i have & used to work was to put lavender oil in a washing up bowl, put his feet in it & wait. The aroma calmed him down & he then conformed & allowed the carer to give him a shower 2 x a week.
 

Splat88

Registered User
Jul 13, 2005
176
0
Essex
Is hygiene a myth?

I just don't understand the whole hygiene thing, as MIL just will not allow anyone to interfere with any sort of personal care, either me, a carer or even the nurses when she was in hospital briefly.
She often develops infections in her belly button and under her breasts,I usually only find out about when I eventually manage to get her to change her underwear. There have even been occasions where this has got so bad it bleeds, but she insists that she doesn't feel it and I'm fussing over nothing.
I have seen the state of her fingernails where she obviously doesn't remember to wash her hands after passing a motion, and any suggestion by me is met with the utmost resistance, she's an adult not a child she doesn't need to be helped. I know this is a common problem with her as I have to clean up the toilet and the floor and the toilet roll etc etc several times a day. But oh no, she's not incontinent because she'd know if she was!!!!:eek: I can't even get her to change her knickers regularly, and they are so hard to get clean when I eventually persuade her. The BO I can cope with, but several days of stained knickers are harder to escape the smell of!
My point is, to all intents and purposes she should have bubonic plague by now with her hygiene, but I think our elders are made of sterner stuff ( she's 90 this year)
 

karenlsinging

Registered User
Jul 10, 2007
25
0
Edinburgh
Dementia nurse at care home mum spent the last few months of her life in told us that it is often easier to start showering from the feet upwards. You can get a shower stool from Argos which has a horseshoe shaped seat and leaves a gap for the necessary access and then using the shower just spray the feet and ankles to get the patient used to the water before continuing up a bit at a time. If they struggle, showering is not that important!! My mum cried every time dad gave her a shower, even sitting on the seat, but in her first few days at the care home the nurse told me mum had had a bath and was a delight to bathe!!!

She occasionally climbed into the bath in the dark, fully clothed, and dad would find her there not knowing why she was there but he didn't try to get her into the bath at other times as he thought it would be too difficult to get her in and out.
 

Nebiroth

Registered User
Aug 20, 2006
3,510
0
Regular bathing is, by and large, a modern phenomenon. For most of human history people didn't bathe regularly, and often not at all. Keep in mind that most animals do not "bathe", at least, not for the purpose of getting clean.

Evolution equipped us to manage very well without bathing - the skin is a formiddable barrier to any infection.

Also, a great deal of "hygiene" problems come from the wearing of clothes, which trap heat and moisture and allows odour causing bacteria to flourish. Contrary to popular belief, sweat is sterile and mostly odourless, it is bacteria that break down dead skin and oil that cause the smell; moisture encourages this, so it is areas that trap moisture that tend to become smelly.

But it is true that areas that naturally trap moisture can become liable to soreness and possibly fungal infections. Generously built women are susceptible to this under the breats and it is certainly a problem in the obese who can devlop nasty problems in skin folds.
 

jools090867

Registered User
Jan 29, 2009
35
0
We have a huge problem getting my father to wash, brush his teeth and change his clothes. If we try to get him to do any of the above he shouts, screams and gets extremely nasty. He insists he has "only just washed" or that his clothes were "clean on yesterday" - even tho WE know he hasnt changed his socks for a week and has had the same vest on for two!! Dad is unfortunate to suffer from false memory sydrome as well as dementia, so we have double the issues to deal with. Its often easier just to leave him unwashed and in the same clothes. He is not incontinent (yet), although he does have the odd accident every now and again.
With him being as he is, its easier not to upset him, especially as my mother is his main carer and has to suffer the aftermath of an outburst :(
 

Kathphlox

Registered User
Dec 16, 2009
1,088
0
Bolton
Dad has been imobile for many months now and we cannot get him up to the shower as he can't bear his own weight, we even had the stairlift removed as it was redundant.

At first I was unsure how we would cope as he is double incontinent so I bought Oasis Bedbath Wipes. You can heat them up in the microwave, so it makes the job really easy (i've seen them used in hospital too). They are really good, very gentle and you don't need towels. I stopped using them because dad had a very bad rash and tore at his skin, the doc thought it might be product related, but it turned out to be scabbies which he got while in respite care. Took me months to get him clear, and while we were trying to get his skin back to normal the doc said to stop using soap and use Aqueous cream in water and use a flanel, it did the trick, he's got better skin than me now :)

We don't use the Bedbath wipes or the Aqueous cream now, because all those months of using flanels kinda stuck and it's cheaper and of course the carers are the ones doing the job. But to be honest, I'd use the Bedbath wipes again if I had to do it myself.

Just a couple of suggestions of the things that helped us ;)
 

Nebiroth

Registered User
Aug 20, 2006
3,510
0
As the poster above pointed out, at the end of the day, being unwashed and wearing dirty clothes is more unpleasant than a major health risk. It's just not worth pressing the issue, espescially if the sufferer gets so distressed that they start to scream in terror.

For clothes, I can only suggest buying sets of identical articles and surrupticiously exchanging dirty ones for clean as the opportunity arises.

Obviously, incontinence - without pads - is a different matter, as spending long periods wet is not healthy for the skin, and soiling has to be removed as it is a health risk (not to mention extremely nasty for all involved)
 

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