1. Expert Q&A: Protecting a person with dementia from financial abuse - Weds 26 June, 3:30-4:30 pm

    Financial abuse can have serious consequences for a person with dementia. Find out how to protect a person with dementia from financial abuse.

    Sam, our Knowledge Officer (Legal and Welfare Rights) is our expert on this topic. She will be here to answer your questions on Wednesday 26 June between 3:30 - 4:30 pm.

    You can either post questions >here< or email them to us at talkingpoint@alzheimers.org.uk and we'll answer as many as we can on the day.

  1. VBees

    VBees Registered User

    Sep 20, 2015
    13
    I see there is another thread on here around this, but I'm trying to understand what happens in care homes when residents won't allow themselves to be washed? Our mother is still living at home, but me and my sister are having a lot of trouble coaxing her into the bath. A carer comes twice a day but they don't even try to get her to wash. She's incredibly stubborn and aggressive about it, but surely this is another Alzheimers symptom which the professionals must be trained to deal with? All the professionals we have met so far simply say " We can't force her", but don't seem to have any other strategies or suggestions.
    Apart from the anti-social aspects of this, this lack of hygiene predisposes her to UTIs.

    What are other people's experiences with professional help with this?
     
  2. canary

    canary Registered User

    Feb 25, 2014
    9,336
    Female
    South coast
    TBH Ive no idea how the CH staff manage it, but mostly they do.
    I get the odd day when the carers say what a bad mood mum is in and she hasnt had a shower, but usually she is clean.
     
  3. jaymor

    jaymor Volunteer Moderator

    Jul 14, 2006
    12,237
    Female
    England
    They are right, they cannot force a person but they can try to persuade and keep trying.

    My husband's nursing home try to bath, shower or bed bath each man before breakfast but it never works for all of them. Some prefer breakfast first and then to bathe and get dressed. Some don't get round to it until afternoon but the staff keep trying and nine times out of ten they get results.

    Care homes, nursing homes probably have more success than carers coming in for an hour and not having time to continue to try.
     
  4. canary

    canary Registered User

    Feb 25, 2014
    9,336
    Female
    South coast
    Also, I suspect that carers in a dementia CH generally have better dementia training and experience than carers that visit the home.
     
  5. Katrine

    Katrine Registered User

    Jan 20, 2011
    2,852
    England
    #5 Katrine, Sep 20, 2015
    Last edited: Sep 20, 2015
    Why do people in a CH accept more assistance with personal care?

    When you are in your own home you have a perception that you are in charge and can choose what to do.
    I think some people are more compliant with bathing in hospital or in a CH because they (more or less) accept that someone else has the authority to make the decisions.

    When she first left her own home MIL was not keen to accept supervised ablutions, because "it should be private". She would get indignant and angry, and try to distract carers as much as she could so that they would forget about the subject. She always was very skilled at misdirection. :rolleyes:

    Unfortunately she wasn't able to manage by herself any more so it wasn't an option to leave her to it, however much she tried to negotiate on the matter. An acceptable compromise was reached, with a carer watching through the door of her en suite and assisting with her morning and evening wash and brush-up by encouraging her, and reminding her of the sequence of actions that she needs to perform. As time has gone on she has needed more hands-on assistance, depending on how she is feeling. On a tired confused day she needs full assistance.

    With regard to her weekly bath and hair wash, this is always assisted, with two carers. The bath is raised, and has a lifting chair thingy, so she couldn't get in and out by herself anyway. I am told that she now enjoys her bath. She always comes out smiling and the carers are great at making her feel special and pampered.
     
  6. Linbrusco

    Linbrusco Registered User

    Mar 4, 2013
    1,539
    Female
    Auckland...... New Zealand
    Just lovely Katrine :)
     
  7. Witzend

    Witzend Registered User

    Aug 29, 2007
    4,282
    SW London
    We had terrible trouble with my mother at home - it was so difficult getting her to shower or wash her hair. But the care home staff always seemed to manage it fine - she was always clean, with nice clean hair, and the same goes for all the other residents.

    I think it must be a different thing for the person in a care home - it's not their own family in their own home trying to make them do what they don't want to, and I think it's especially so when it's their own children 'bossing' them. Also, care home staff aren't carrying all the emotional baggage that family members do - they can be much more matter of fact about it and they have to find a way, or they'd have a whole home full of smelly residents, given that this problem is so common.

    Carers visiting someone at home are I think in a more difficult position - obviously they can't force and often won't have time to spend ages trying to coax someone who is very stubborn.
     
  8. exhausted 2015

    exhausted 2015 Registered User

    Jul 5, 2015
    624
    Female
    stoke on trent
    My dad has gone the other way he is obsessed about washing himself I quite often catch him using the water from the toilet to do it and then uses half a roll of paper to dry himself. Also he will sit in his chair fully clothed and give himself a top to tail imaginary wash using his handkerchief.. Over and over again. It so sad xx
     
  9. VBees

    VBees Registered User

    Sep 20, 2015
    13
    Sounds like others have had a more positive experience of care homes than we have - our mother had to go into one last year for respite care after breaking her arm and was not bathed once. This is one of the reasons we are trying to let her carry on living in her own home, but it's getting increasingly difficult.
     
  10. canary

    canary Registered User

    Feb 25, 2014
    9,336
    Female
    South coast
    Care Homes can vary a lot. It also makes a difference whether it is a general CH that is for none dementia, but will also accept people with dementia, or whether it is a dedicated dementia place.
    When you are looking at CHs you will be able to see (and smell!) whether the residents have regular baths/showers and I would recommend that you talk to the carers and ask them how they deal with people who refuse.
     
  11. Witzend

    Witzend Registered User

    Aug 29, 2007
    4,282
    SW London
    People have posted here before about care homes not bothering - or not bothering enough - with showering/bathing when someone is only there for a limited period. Presumably they take the attitude that it will not be their problem for long, so they won't waste time trying to coax or persuade. Personally I would strike any such CH off my own 'possibles' list.
    A good look around any CH should usually be enough to tell you whether residents are habitually kept clean and tidy. My FIL was also very stubborn about bathing - would only do it if my OH was there to use what I would call firm but jolly insistence - and OH was often away for weeks at a time. I could not even think of anything more than polite suggestion, since he was apt to fly into truly terrifying rages. I think he had a deep-rooted 'thing' about doing anything suggested by a woman - he could often be extremely stubborn with my poor MiL over the smallest things. He once continued to insist on wearing a very old, holey jumper even after she had spent ages knitting him a very nice new one. Just refused to wear it - and this was pre dementia.

    But again, the CH he finally moved into seemed to manage it very well. I wonder whether it's something to do with carers' uniforms - assuming they wear them - which gives them an aura of authority and perhaps makes them look like nurses?
     
  12. LYN T

    LYN T Registered User

    Aug 30, 2012
    6,967
    Brixham Devon
    When Pete went to a CH he became much cleaner than he had been at home. I know that it took two, sometimes three, members of staff to clean him up. There also came a spell of him being too sleepy to have a bath (he used to doze off) but he always had a thorough bed bath when that happened. The staff at Pete's CH had very good coping/coaxing strategies:)

    I think that sometimes the PWD can have some kind of feeling that 'it's just not right' to have a relative washing them.

    Love

    Lyn T XX
     
  13. Margarita

    Margarita Registered User

    Feb 17, 2006
    10,824
    london
    #13 Margarita, Sep 21, 2015
    Last edited: Sep 21, 2015
    I Do feel for you
    From my own personal experience ...

    when I had carers coming to my house to help me change my mother into her evening PJs have a wash down

    They where never trained in how to wash a person with dementia or not with challenging behaviours in washing .



    Aggression is a normal reaction because it’s a sigh that the person can not express communicate themselves Verbally.
    In something they are feeling so act out in aggression.

    When I notice a smell coming from my mother I just new she was not washing herself properly .
    My daughters would also comment about it also

    So I ask her if she did not mind showing me how she washes herself.
    I just stood back .

    My mother was at the stage that her memory went back in the days that we never had a bath in our house .
    So mum would wash herself in a bowl in the sink .

    Back into the present moment of time At our house while mum was living with us she would use bathroom sink .
    So mum was having a wash down .

    When mum showed me how she was washes her top half of herself she lifted her breasts up I notice underneath her breast where red raw.
    so mum was not drying herself properly
    That was where the smell was coming from .

    I can put myself in my mother shoes also anyone else that needs help with washing .
    Can imagine how humillating it must feel like.
    if a person can not communicated that feeling or the person is not getting acknowledgement of that feeling back from the person like I said before you're going to get aggression.

    So rather then helping talking over a person needs to wash themselves its more about promting them letting them do it themselves so they can keep their dignity .

    which can be done with
    Person-Centred Approach

    Learning that skill help me prompt , motivate my mother to wash herslef even get into the bath till she was physically able to .

    We ended up getting wet room .
    I learn never to put a shower head over my mother head to wash her hair .
    I had to tilt her head back .
     

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