Fighting the carers

[DOTTYCO]

Hi. I was wondering if anyone has experience of caring for someone who fights with the carers on a daily basis when they are trying to dress and wash him.
My husband and I look after my father-in-law who is totally bed bound with Parkinson's and dementia (probably Lewy body dementia).
We have carers in 3 times a day for about 30 mins each visit to clean and dress him. He has a contracture of his right hand meaning that it is tightly balled into a fist and he has trouble relaxing the fingers to allow any sort of hand care. (He's had botox to relax the muscles and has a carrot splint. His fingers can uncurl quite a bit when he isn't fighting!) When the carers try to wash and dry his hands he fights them off and tries to bite them. When they try to put on his t-shirt or apply deodorant under his arms or change his external catheter it is a similar story. It's becoming harder and harder for the carers to do their jobs.
We try singing with him, pet therapy, paracetamol if we think his hand is hurting but nothing seems to work.
I realise I probably need to speak to his GP but it seems to be impossible to get through at the moment. Wondering if anyone had any advice they could give which would tide us over until I can get hold of the GP.
Thank you!

 

[Shedrech]

Hello @DOTTYCO
A warm welcome to posting on DTP

You are doing so well by your father in law .... sadly what you describe will be familiar to members .... I guess being disturbed for personal care is just not what he wants, I know my dad did not like being moved ... and the home carers are under a time constraint so can't necessarily pick a moment that's better for him

I'd suggest that as little is done as possible ... As long as he is clean and comfortable ...maybe leave out the deodorant, dad hated that ... find clothes that are as easy to put on as possible, and are big and stretchy so lots of room ... dad didn't understand that t-shirts had to go over his head and became frightened by that ... maybe slowly and gently massage his hands before trying to wash, possibly using handwash as it's slippy ... talk him through each small step explaining what is about to be done so there's as little surprise as possible

I agree that music, warmth and maybe some soothing lavender scent in the air may help ... and with paracetamol or some relaxant

Sorry if you have covered all of that .. I don't think there's a magical formula

Sadly, it may be time to consider residential care as staff then have more opportunity to fit personal care with how the resident is feeling at the time, and aren't necessarily kept to a given timescale

 

[Mr.A]

It sounds very much as if your FIL should be in residential care. From experience I doubt very much if 30 minutes is enough time to do what is obviously required. My wife was in care and very often when I visited each day I would have to wait in the lounge while the carers attended to her personal hygeine. This invariably took longer than 30 minutes because she too would fight them off. She had severe contracture and took up a foetal position in bed which made it very difficult to move her. she was also susceptible to skin tears which only made things even harder. After much shouting and fighting which I could often hear the carers would emerge from her room and say that she was ready. She would on most occasions be lying there quite comfortable and all was forgotten except that she knew she had performed and expressed her worry that she might have hurt them and say how sorry she was. The carers were only concerned that they hadn't done her any harm and were quite forgiving of her behaviour which of course they fully understand and experience this from others as well. She was bedridden for 15 months and the care and attention she received was second to none. What wonderful people.
Unfortunately there is little that you can do and it is best left to the carers anyway to do the moving etc. What I did manage to do was to form a firm bond with my wife; although I wasn't recognised as her husband most of the time; and she came to trust and rely upon me to call for assistance when she needed it and she seemed to accept when I gently explained to her that whilst I was there to help her all I could but there were certain times when even I needed help from other people in order to help her. It is a very difficult situation but not one that can be handled alone and I think you need to seek advice in regard to his ongoing care. My thoughts are with you and I hope you find a satisfactory solution. Don't hesitate because quite honestly and unfortunately things are not going to improve.

 

[DOTTYCO]

Thank you so much for your reply Shedrech. It makes me feel less alone knowing others have been through similar struggles.
You're right, timing does make a difference. When we cut his nails we can choose a time when he's relaxed and in a good mood. We manage to get them done without too much of a fight.
Sometimes I think he has a bit of fun being awkward for the carers. They give him some water to rinse out his mouth after they've cleaned his teeth. They then tell him to spit it out and he always turns his head and tries to spit it all over them!

 

[DOTTYCO]

Thank you Mr A. It's lovely that you still had a firm bond with your wife even though she didn't recognise you as her husband.
We are thinking about residential care but it seems such a big step to take. I think both of us would feel guilty if father-in-law deteriorated suddenly after going into a care home.

 

[Mr.A]

Think carefully about the situation. Your Father- in Law may well deteriorate if he goes into a home but to be perfectly honest and facing reality, things are not going to get any better. Any deterioration will inevitably happen whatever. I'm afraid with relatives in this sort of situation things do not improve. That might sound hard but unfortunately it is a fact which has to be faced. You must do what you think is best for him. I know exactly what you are both going through and it's horrible and can feel so selfish and self preserving. But please ensure that whatever you decide your Father-in-Law is going to receive the best possible care and receives the attention he deserves in the latter days of his life. You obviously think a lot of him and would only want the best for him.

 

[DOTTYCO]

Thank you Mr. A. It's certainly given me something to think about.