Dad refuses to let Mum wash him

[ppm]

My Dad has late-stage Alzheimer's. He no longer recognises anyone, and requires help with dressing, eating, washing, toilet needs, etc. My 93-year-old mother is his carer, and has so far refused to accept any help from a carer.
Mum is now struggling to keep Dad clean, which is a concern as he was recently hospitalised with a UTI. Sometimes he badly needs to be cleaned following a toilet visit, but he refuses to let her shower or bathe him, and gets very aggressive. Last night she spent a very fraught 3 hours in bathroom, trying to get him clean using the shower head in the batch (they have a riser seat fitted in the bath) but eventually had to give up - feeling very tired and frustrated. She tried all manner of persuasion and coercion, but nothing worked.
She has finally accepted that she would allow a carer to help her bathe him, but my question is: if my father strongly and aggressively resists being washed, is there anything that a carer could do? If not, does anyone have any other ideas for keeping Dad clean?

 

[karaokePete]

Carers really should be called in when this develops. People will often react well to a uniform and a carer of the same sex.

As recognition is now an issue your Dad may be resisting because he believes he is being abused - I know that isn't the case, but it is quite possibly what he believes.

 

[ppm]

Thanks for your feedback. Yes I think we'll need to try a carer. My only reservation is that when they had a couple of Hilton Nurses looking after him at home following a recent hospital visit they simply backed off when he resisted being showered - i.e. said that they couldn't help. So the concern is that this will be true of any carer if he resists aggressively. Since they would need to be booked on a schedule, there's also no guarantee of what sort of mood he will be in when they arrive.

 

[Rosettastone57]

Thanks for your feedback. Yes I think we'll need to try a carer. My only reservation is that when they had a couple of Hilton Nurses looking after him at home following a recent hospital visit they simply backed off when he resisted being showered - i.e. said that they couldn't help. So the concern is that this will be true of any carer if he resists aggressively. Since they would need to be booked on a schedule, there's also no guarantee of what sort of mood he will be in when they arrive.

My MIL had carers in privately but during the 3 years they came, she refused personal care . The carers would not force the issue, she had to agree. Once aggressive tactics come into play, it became a safety issue for them as well. Once my MIL went into a care home, the home had her bathed and hair washed in 48 hours. They had the time and experience to deal with her

 

[ppm]

My MIL had carers in privately but during the 3 years they came, she refused personal care . The carers would not force the issue, she had to agree. Once aggressive tactics come into play, it became a safety issue for them as well. Once my MIL went into a care home, the home had her bathed and hair washed in 48 hours. They had the time and experience to deal with her

That's interesting. Do you know if care home staff have fewer restrictions on what they are able to do - e.g. are in-home care agencies prevented from manhandling patients, whereas care home staff are not?

 

[canary]

That's interesting. Do you know if care home staff have fewer restrictions on what they are able to do - e.g. are in-home care agencies prevented from manhandling patients, whereas care home staff are not?

I think its a question of care home staff having the training and experience of knowing how to persuade someone with dementia. Often home care staff are told that that they have to ask permission - and asking someone with dementia usually results in the default reply "no", so they dont push it. Care home staff know how to cajole someone and never ask a question that can have a "no" default reply ie instead of saying do you want to......? they will say come on, lets........
Also care home carers can pick their time, so that if someone refuses they will try again later.

Mum too wasnt washing at home, but there were very few times when they couldnt get her showered once she moved to her care home. They never had to resort to man-handling anyone either.

 

[Susan11]

I think its a question of care home staff having the training and experience of knowing how to persuade someone with dementia. Often home care staff are told that that they have to ask permission - and asking someone with dementia usually results in the default reply "no", so they dont push it. Care home staff know how to cajole someone and never ask a question that can have a "no" default reply ie instead of saying do you want to......? they will say come on, lets........
Also care home carers can pick their time, so that if someone refuses they will try again later.

Mum too wasnt washing at home, but there were very few times when they couldnt get her showered once she moved to her care home. They never had to resort to man-handling anyone either.

Also everyone else in the home is having a bath so it's "just their turn "

 

[Rosettastone57]

That's interesting. Do you know if care home staff have fewer restrictions on what they are able to do - e.g. are in-home care agencies prevented from manhandling patients, whereas care home staff are not?

I don't think it's a case of special restrictions with care home staff. My MIL went into a care home for other reasons than personal care, this was just one of her issues.


But care staff never had to man handle her into the bath. They had the expertise to cajole residents and the time. If MIL refused a bath they either strip washed her or came back later to the issue . Remember there's a team looking after her not one carer coming to the house who is time restricted and rushing to the next call. Also my MIL didn't want to be seen as different from anyone else, so as other residents were doing this and carers were chatting about others being in the bath then all having breakfast ,she began to think this was normal.

 

[sarahg62]

My dad’s refusing and getting aggressive when his live in male carer tries to wash him, get him to take off his dirty pull up incontinence pants. He’s always refused but now it’s got to the point where the carer feels ta absolutely necessary for his well being. I trust the carer and I tell him I have power of attorney and I know he’ll be acting in my dads best interests to get him clean. He pulls the pants down and gives him a quick “wash” with Tena cream and sometimes he’s successful in doing a strip wash. This could be construed as forcing him because my dad hits the carer and gets very stressed. I’m considering looking for a home. I’d always wanted dad to stay at home. Has anyone experience of live in carers who successfully manage this situation?? Are any of them experienced enough? Do they always back off or manage to do it in the end?

 

[Rosettastone57]

My dad’s refusing and getting aggressive when his live in male carer tries to wash him, get him to take off his dirty pull up incontinence pants. He’s always refused but now it’s got to the point where the carer feels ta absolutely necessary for his well being. I trust the carer and I tell him I have power of attorney and I know he’ll be acting in my dads best interests to get him clean. He pulls the pants down and gives him a quick “wash” with Tena cream and sometimes he’s successful in doing a strip wash. This could be construed as forcing him because my dad hits the carer and gets very stressed. I’m considering looking for a home. I’d always wanted dad to stay at home. Has anyone experience of live in carers who successfully manage this situation?? Are any of them experienced enough? Do they always back off or manage to do it in the end?

I have no experience of this ,but you might get more responses if you start a new thread. Members can then see the post on first logging on

 

[marionq]

My dad’s refusing and getting aggressive when his live in male carer tries to wash him, get him to take off his dirty pull up incontinence pants. He’s always refused but now it’s got to the point where the carer feels ta absolutely necessary for his well being. I trust the carer and I tell him I have power of attorney and I know he’ll be acting in my dads best interests to get him clean. He pulls the pants down and gives him a quick “wash” with Tena cream and sometimes he’s successful in doing a strip wash. This could be construed as forcing him because my dad hits the carer and gets very stressed. I’m considering looking for a home. I’d always wanted dad to stay at home. Has anyone experience of live in carers who successfully manage this situation?? Are any of them experienced enough? Do they always back off or manage to do it in the end?

Your description is close to what s happening with my husband from time to time. He likes being clean but the getting out of bed and taking his clothes and pads off is an issue. I find that getting him up at an early hour eg 7.30 works better than letting him lie in. I also have to "trick" him into removing the trousers and pants which I don't like doing but he forgets immediately. He has aimed a few punches at me but with no malice behind them so I don't allow it but it doesn't upset me too much.

When he is in respite once a year they have no problem. Perhaps you could try a few weeks in a care home to see how it goes.

 

[TheBearsMummy]

Much to my astonishment one of our PWD's carers manages to get her into the shower.
It seems to be a combination of jolly nanny knows best manner and putting on a plastic apron and gloves whilst chivying her to hurry up we haven't got all day.
This morning the carer was teasing her that she is 19 (she constantly asks how old am I) and they are getting ready for a night on the tiles.

 

[Juniorjunior]

I would phrase the question back at you, what would you expect homecarers to do when someone is aggressively refusing to allow assistance. I think there is a big difference in being able to encourage and cajole someone to participate and someone who is aggressively acting out. It is absolutely the disease causing this behaviour , but aggression is still aggression.
I think other posters are right that care home staff have more time and facilities and options available to achieve higher success rates in this area.
I have certainly had mixed responses for either softly softly approach to this is what we are doing now and this is how we are going to do it.
Maybe accessing shower is no longer an option as sometimes this doesn't feel secure for the person ,even with equipment. It can feel alien and overwhelming. Maybe a strip wash at sink with distraction tasks for the person. It might not be a thorough or as quick or easy as shower but might be more acceptable for person to experience.
Sometimes people react better to someone in uniform and a bit of gentle bending of the truth that the "nurse" will need to help
Hope you get some helpful advice on here.

 

[Linda2017]

Thanks for your feedback. Yes I think we'll need to try a carer. My only reservation is that when they had a couple of Hilton Nurses looking after him at home following a recent hospital

I would phrase the question back at you, what would you expect homecarers to do when someone is aggressively refusing to allow assistance. I think there is a big difference in being able to encourage and cajole someone to participate and someone who is aggressively acting out. It is absolutely the disease causing this behaviour , but aggression is still aggression.
I think other posters are right that care home staff have more time and facilities and options available to achieve higher success rates in this area.
I have certainly had mixed responses for either softly softly approach to this is what we are doing now and this is how we are going to do it.
Maybe accessing shower is no longer an option as sometimes this doesn't feel secure for the person ,even with equipment. It can feel alien and overwhelming. Maybe a strip wash at sink with distraction tasks for the person. It might not be a thorough or as quick or easy as shower but might be more acceptable for person to experience.
Sometimes people react better to someone in uniform and a bit of gentle bending of the truth that the "nurse" will need to help
Hope you get some helpful advice on here.

my mum
visit they simply backed off when he resisted being showered - i.e. said that they couldn't help. So the concern is that this will be true of any carer if he resists aggressively. Since they would need to be booked on a schedule, there's also no guarantee of what sort of mood he will be in when they arrive.

 

[Linda2017]

My mum is in middle stage and recognises my dad, myself and my husband. She refuses to have a bath and we got a carer in but mum refuses with her too. Now she has a urine infection due to poor hygiene. What can we do? It seems an impossible situation.