Male Personal Care

[uktoday]

My father has dementia. Physically fine but very stubborn. Very aggressive at any mention of personal care. Just wondered if anyone had any advice.

We accept he won't shower so understand a quick wipe down would work. Even to wash his face. But flatly refuse or we get aggression. Can't get him shaved. Refuses to take his teeth out or clean his teeth.

We have carers who come to help with personal care but they say they can't force him to do anything.

Has been a few months now. We have a doctor's team visiting next week to assess dad again.

Does anyone have any advice? I feel like knocking him out with tranquilizers so at least we can give him a wipe down.

 

[maryjoan]

This seems to be a common trait with dementia. At the moment my OH will only shower twice a week - which must sound like a lot to you - but my OH has a stoma and bag and the smell is awful. He also won't shave, or clean his teeth or use a deodorant, or change his clothes.....

Reading on here, it would seem that as their minds work differently now, these things are of no importance or relevance..... so we wish each other good luck!!

 

[marionq]

My husband not only likes a shower every day but if I don't watch him every second he takes his underwear back off and goes in for a second shower! I now have a carer in the four days he goes to daycare and with her he insisted on shaving three times.

Who knows what causes these oddities. I couldn't live with a smelly person - my mother was resistant to bathing in her latter years and it was a real problem. In her case there was physical pain in the effort though.

I am so impressed by the tolerance some of you show.

 

[uktoday]

This seems to be a common trait with dementia. At the moment my OH will only shower twice a week - which must sound like a lot to you - but my OH has a stoma and bag and the smell is awful. He also won't shave, or clean his teeth or use a deodorant, or change his clothes.....

Reading on here, it would seem that as their minds work differently now, these things are of no importance or relevance..... so we wish each other good luck!!

Twice a week is great. We are lucky for once a year But then I read further about your situation. Massive hug to you. I so wish there was a pill to make them clean!

 

[kindred]

Twice a week is great. We are lucky for once a year But then I read further about your situation. Massive hug to you. I so wish there was a pill to make them clean!

I gave in and used to have to do a strip wash for OH every day. Took forever. Gxx

 

[love.dad.but..]

The best that I could do with dad was attacking different body areas on different days and different times ie if he was calmer taking the opportunity concentrating on the groin area where he would get sores...I decided generally no one dies of underarm body odour unless open wounds and not worrying if I couldn't get certain bits done. I didn't ask...got everything ready in which ever room he was in...a lot of soap on a flannel or sponge so that if I only managed a whistle stop soapy contact with his skin hopefully enough to do the job in seconds and quickly followed with a towel rub and was very speedy while his arms were flapping at me so usually gave him something soft to hold so he couldn't whack me and a towel to cover his private area. Getting his clothes off were a constant battle and often I washed him inside his clothes! Lots of distraction me talking non stop about football..tv in the background to distract etc. There is no denying this problem is so difficult to resolve or reach a compromise.He never lost resistance to personal care in his NH but they did double handed care and whilst he was verbally aggressive and arms flapping one carer distracted and the other carer was quick. Changing pull ups when he reached that stage in his NH was very difficult but needs must....shaving and teeth cleaning not so much of a problem in the early and to moderate stage as with prompting instinct would kick in but eventually he rebelled against that as well. For dad...it was more about feeling frightened because of not understanding why people are trying to help him take off clothes etc and tbh it was futile from fairly on trying to explain. Interestingly although it was like a battleground and I was determined in my task...when done Dad always said thank you like a little boy whose mum had just helped him which is probably who he thought I was so I think deep down He realised the process made him feel more comfortable He was the same frightened resistant self with any medical checks etc.and I often had to hold him down for necessary emergency treatment. Monitoring health checks were either withdrawn or kept to a minimum.

He can't be forced but somewhere along the line a best interests in terms of self neglect needs to be considered. In the NH the most physically aggressive residents were given a light sedative to help which although not ideal at least achieved a certain degree of personal care was manageable.

As well as speaking candidly when the GP visits...I think I would have a frank discussion with the care agency in that you need a very experienced dementia carer or even double handed as the visits are not effective. They need to use strategies from their dementia training to try to get round the problem however....if they are poorly trained which is often the case or unable to apply theory to practice then it will co time to be difficult

 

[uktoday]

Thanks.

I so wish we could even attempt anything without full on aggression. Dad is very mobile. Physically he is fine.

Im at the point that sectioning seems the option as we have tried everything.

The best that I could do with dad was attacking different body areas on different days and different times ie if he was calmer taking the opportunity. I didn't ask...got everything ready in which ever room he was in...and was speedy while his arms were flapping at me so usually gave him something soft to hold so He couldn't whack me. Lots of distraction me talking non stop about football..tv in the background to distract etc. He never lost resistance to personal care in his NH but they did double handed care and whilst he was verbally aggressive and arms flapping one carer distracted and the other carer was quick. Changing pull ups when he reached that stage in his NH was very difficult but needs must....shaving and teeth cleaning not so much of a problem in the early and to moderate stage as with prompting instinct would kick in but eventually he rebelled against that as well. For dad...it was more about feeling frightened because of not understanding why people are trying to help him take off clothes etc and tbh it was futile from fairly on trying to explain. Interestingly although it was like a battleground and I was determined in my task...when done Dad always said thank you like a little boy whose mum had just helped him which is probably who he thought I was so I think deep down He realised the process made him feel more comfortable He was the same frightened resistant self with any medical checks etc.and I often had to hold him down for necessary emergency treatment. Monitoring health checks were either withdrawn or kept to a minimum.

He can't be forced but somewhere along the line a best interests in terms of self neglect needs to be considered. In the NH the most physically aggressive residents were given a light sedative to help which although not ideal at least achieved a certain degree of personal care was manageable.

As well as speaking candidly when the GP visits...I think I would have a frank discussion with the care agency in that you need a very experienced dementia carer or even double handed as the visits are not effective. They need to use strategies from their dementia training to try to get round the problem however....if they are poorly trained which is often the case or unable to apply theory to practice then it will co time to be difficult

 

[maryjoan]

Twice a week is great. We are lucky for once a year But then I read further about your situation. Massive hug to you. I so wish there was a pill to make them clean!

I wondered about a trip to the car wash!!

 

[teetoe]

I am in the same boat with my OH. I've been told that no-one dies from not taking a shower but surely they need a wash occasionally around the privates. He hasn't showered for over a couple of weeks now and doesn't change. He doesn't wash hands, clean teeth, remove and clean dentures. He wears the same clothes to bed so I can't grab them and put them in the wash, nor sponge him. Funnily enough he doesn't smell that bad, and others may not notice that much. It is getting worse though. The other day he complained about pain in his mouth. I got him to remove his dentures which I soaked overnight and wash out his mouth with antiseptic mouth wash - and he spat out all this brown liquid. After a few more swishes eventually it ran clear. It is such a worry because he puts his hands into his food at times and lets the dog lick them.

He doesn't understand how to shave now and rubs his face with anything with a sharp edge, you would think it would hurt him. So I've bought an electric shaver and dry shave him - not perfect but I hope it makes him feel better. You would think that showering would also make him feel better, and wearing clean clothes. I don't feel like taking him out socially although friends do understand.

 

[rainbowcat]

My father is the same. He hasn't cleaned his teeth for probably at LEAST 9 months (since he was last in hospital) but I would say it's probably MUCH longer...maybe three years? Yet of course it's *MY* fault that he doesn't clean his teeth because I bought him the wrong toothpaste once.

Showers/washes - I'm battling with that at the moment. Care agency say they can't force him...NO, but they COULD change their approach! IF they could be bothered!! If you say to my dad "do you want a shower or not?" he will ALWAYS refuse. Likewise "do you want a wash or not?" will get a refusal.

I have repeatedly told the care agency that they MUST NOT give him the choice. On shower days, the carer needs to be "so it's shower day! Let's get you into the shower, off with those clothes!" etc...and if he THEN refuses, they should just bring him a bowl of water, a flannel, and a clean top and pants - but this doesn't ever happen because they "can't force him" !! In my book, "forcing" is them taking a cloth and rubbing it over his face while he complains he doesn't want it - NOT bringing him a bowl and letting him have a wash (which he DOES if the bowl is there in front of him!).

He does get sore - he's pretty much confined to his chair - so it's like nappy rash/urine burn, but that makes no difference to the "we can't force him" brigade.

 

[Bunpoots]

My dad is reluctant to wash but the carers we have manage to persuade him (so far) I'd say it's tantamount to neglect @rainbowcat to not try different strategies. Nappy rash can soon become infected and turn into something nasty.

"We can't force him" isn't helpful, but I can sympathise with the carers too.
It's never easy!