Personal Hygeine.

[Grannie G]

My husband now refuses a daily bath, `it`s too much trouble`. I am OK with that, when I was a child it was `Friday night, bath night`, and nobody died.

But now, when I go into the bathroom after him in the morning, although I know he`s had a shave [electric shaver] and brushed his teeth, the soap and face cloth are dry.

He always washes his hands after going to the toilet, but just forgets in the morning.

Everything I touch is sticky and I hate it.

I don`t know whether or not I`m being too `picky`. Should I should remind him, and risk offending him, for he`ll see it as a criticism, or let it go, and continue walking around with a damp cloth in my hand.

 

[Skye]

I don`t know whether or not I`m being too `picky`. Should I should remind him, and risk offending him, for he`ll see it as a criticism, or let it go, and continue walking around with a damp cloth in my hand.

No, you're not being too picky. I remember one of my first posts here was about the fact that my once so fastidious husband no longer cared about keeping clean. And he wasn't even washing his hands after using the toilet! YUK!

I'm afraid it's another stage, and knowing how touchy Dhiren is about any suggestion that he can't look after himself, I'd avoid the reminder. It doesn't work anyway (or it didn't in my case).

I think the 'damp cloth' is in order. I go through a shipping order of antiseptic wipes every month!

Sorry!

 

[Grannie G]

Thanks Hazel.

I hate to be disloyal but some of the habits aren`t easy to accept. I had to laugh, reading your post, as my online shop recently offered BOGOF on Anti-septic wipes, and I stocked up, as if for the Plague.

We have a tiled hall. When Dhiren vacs, and he still insists on doing it every day, not only does he put the rug in the hall, whilst he vacs, but he gives it a good shake too. I don`t know if, because it isn`t carpeted, he thinks it`s OK, but I cringe everytime, thinking of the dust clinging to the wallpaper.
This must be a legacy of days before vaccuum cleaners, when rugs were taken outside and beaten.

 

[connie]

Dear Sylvia, have to agree with Hazel - so it's 'wet wipes' damp cloths to the ready.

When I was telling my DIL about going in to help bath Lionel, (her mum is in same care home now) she was saying that the carers have been unable to get her to bath or shower. Of course, they cannot insist either.

So you see it is a problem with a lot of people. Don't know what to suggest, maybe just gently cajoling once a week perhaps......if it does not work, leave it.

Thinking of you,

 

[Josh]

Hi Sylvia,

This is something we have been having difficulties with also, its hard especially when the person has always been so clean and took such a pride in their appearance.

What we have done (my self and my mother) is when we notice my Gran becoming a little “stinky” and she refuses a shower or a wash, is simply leave it for a little while. then after a short time, whilst in her company say “ewww I’m a little Stinky I need a shower” and normally before we even have chance to get up and go upstairs, she’ll say “me too can I have one first” , Doesn’t always work but seams to plant to seed of thought in her mind so to speak.

Wishing you well.

Josh
- x -

 

[Tender Face]

......if it does not work, leave it.

I think that's brilliant advice for so many situations - unless something is a threat to health, safety and general well-being ... why try to push anything?

I know my mum would give almost anything to 'soak in a bath' but her mobility hasn't allowed her to for a long, long time .... and 'good washes' and showers with a lot of help are the best she can do .....

In terms of 'hygiene' - for her own health needs - I know she is 'clean' .....yet many days when I arrive she has clearly forgotten what a comb is for .... but if it's doing no-one any harm ... why stress her?????

This is how it is. This is how she is. I am the one who has to adapt - not create unrealistic expectations of her and then put pressure on myself as well as her when she can't possibly meet them - but instead be thrilled when she can manage what independence she still has. So when I know (because I drop in and 'spot-check!) she remembers to brush her teeth in the morning and take her medication without prompting, that is a big plus .... that she forgets to put a comb through her hair .... well, it's not the end of the world ....

Sylvia, I think Connie's advice is spot on - and more importantly what you've already done is to find a 'coping strategy' for yourself .... even if that is a job lot of 'wet-wipes' ......

'Stickiness' and dust are enemies can easily be erased............

Love, Karen, x

 

[jeanierec]

I`ve been worrying about how to approach these issues with mum for ages so I`m so pleased that we`re talking about it on TP. Don`t know when mum last had a bath but it must be a long time ( she doesn`t have a shower and she can`t physically get in the bath ) so I thought she was just probably having like a strip wash but there are bits that she isn`t going to be able to reach.

However she said to me out of the blue " do I smell " I reassured her that she doesn`t and said if ever she needed help she mustn`t let her pride stand in the way it wouldn`t be a problem and I could help her she wasn`t impressed and quite frankly she won`t remember the conversation.

I also asked her yet again if I could take her washing for her to which she replied that there wasn`t any which I can appreciate as she wears clothes badly stained all the time and I don`t even want to go down the knicker road.

When I first started posting on here it was after mum had a fall , I think she fell asleep and woke up to find she`d wet herself and whilst trying to take her pants off fell over .....I`m finding this really hard to talk about `cos I feel disloyal talking about such private things but the problem is the chair she sits in smells so much of amonia because of the wetting herself incident that we are trying to devise a plan to get her to part with it without taking away from her dignity ( I`m wondering if the "do I smell " question is as a result of the smell from the chair )

So as ever I and everyone else on here wonders if we are doing the right thing and I can almost answer my own question the most important thing to me is to preserve mums dignity as long as possible and if that means letting her hygiene standards slip then so be it.....but I would really appreciate anyone elses views.

Jeanie x

 

[Ashburton]

This is an issue I am having to deal with now, my Mum is very uneasy about taking a bath, to such an extent that I do not want to push her as it has led to her getting very upset and taking it out on me, this has only started over the last few days so is not a huge issue at the moment, I have bought wet wipes and we have used these once, without any problem, but have to say am concerned as would prefer she does take a bath even if it is once a week, but it seems it might be best not to push the issue.

 

[Taffy]

Everything I touch is sticky and I hate it.

I don`t know whether or not I`m being too `picky`.

Hi Sylvia, no this feeling only too well. Mum use to put the cat food from the can into the cat bowl with a spoon, then mix it all up with her fingers, then wipe her hands on her clothes. I was for ever telling her we were having visitors and she'd better change her clothes, sometimes it worked, she would however, forget about the visitors. I don't think your been too 'picky'. You may like to know that after the not washing her hands episode passed,she was constantly washing her hands and it was a very welcome relief. Take Care. Taffy.

 

[Brucie]

There is an Alzheimer's Society Fact Sheet that may provide some additional information http://www.alzheimers.org.uk/Caring_for_someone_with_dementia/Everyday_care/advice_washing.htm

All Fact Sheets can be found at http://www.alzheimers.org.uk/Facts_about_dementia/factsheets.htm

 

[Margarita]

I went though those days , that your having now with your husband Sylvia .


those link that bruce left are good, I am at the stage with the incontinent now.

Absorbent undersheets Reusable undersheets are available for beds and chair beds. They enable the person to lie or sit on a dry surface

(Not sure what that means above )

Now that sound good , as all I have is a plastic sheet that seen to crack & slit when put in washing machine or not ( Lucky I got a few of them ) District nurse pop around , gave me some pads left saying she come back , never to be seen again.

I also don't think your being picky . My daughters always use to remind my mother to wash her hands after going to the toilet , at the beginning when if all started

I did not say to much to mum , because I new she just forgets , when we did mum would just turn around and wash her hands .

Those wet wipes sound good for the hands also I get them for the toilet wipes as I am forever wiping toilet seat after mum been to the toilet .

where with a cloth you have to keep them gathering bacteria even if you wash them after, then leaving them behind toilet .

where with hygienic toilet wipes you have the cleaning agent in them already & they can be throw them away , even down the toilet if you get the right one .

PS I am glad we have 2 toilet in new house now , as now one is use just for my mother , as my daughter where forever moaning about toilet after mum use it .

they can use mum toilet under they pearl because I may have forgotten to wipe toilet set after mum use it .

 

[Grannie G]

. Mum use to put the cat food from the can into the cat bowl with a spoon, then mix it all up with her fingers, then wipe her hands on her clothes. Taffy.

We don`t have a cat, but Dhiren eats a tin of sardines every day` for his brain`.
If I can get there first, I mash them up and put them on toast for him. If not, he eats them whole, using his fingers, and wipes them anywhere and everywhere.
Wherever I go, I smell sardines.

I hesitated to start this thread, feeling so disloyal, but the response shows how these problems need to be aired, as they are common to all carers.

Thank you for the fact sheet links Bruce. It didn`t occur to me to see of there were factsheets on Hygeine. I suppose I felt I was the only one with the problem.

But really Hygeine re washing and bathing is just one area of hygeine. Finding food fingerprints on soft furniture, door handles, under the table top and everywhere else, has turned me into Miss Marple.

 

[Skye]

Finding food fingerprints on soft furniture, door handles, under the table top and everywhere else, has turned me into Miss Marple.

Sylvia. I know exactly what you mean!

Jeannie, would your mum wear incontinence pants? They're fairly unobtrusive, and much easier to manage than pads. Although someone said recently that women manage pads better than men (obvious reasons?)

You can also buy disposable sheets to put on chairs, though your mum may not like that. The washable sheets for the bed (kylie sheets) are very good, and quite comfortable to sleep on, they have a fleecy surface. I had to buy a couple, they're not supplied here, but it was well worth it. I believe some areas supply them, it's worth asking.

As for the smell, there is a spray available from pet shops which takes away urine smells from upholstery. It's for pet accidents really, I used gallons of it when Skye was a baby, but it might be worth trying?

I agree with you all, it's the problem of dignity that makes all this so much harder. A baby doesn't mind having his bottom wiped, but a husband?

 

[Grannie G]

Sylvia. I know exactly what you mean!
:

Well, Hazel, that in itself, is a comfort.

 

[Nebiroth]

My Dad has become reluctant to wash or shave - to be brutally frank a lot of this seems to be from pure laziness in that he just can't be bothered. It doesn;t help that he never goes anywhere or sees anyone so doesn't see the point. Fortunately he doesn;t ever seem to smell but does tend to look scruffy, it doesn't bother me. Why go through all the aggro of rows by pushing the point? I'm afraid I have adopted the attitude "no skin off my nose". If Dad wants to look like a tramp then that is up to him and I have said so. We do push more if we have a visitor due the threat of "you don't want the nurse to report you as being unable to care for yourself do you?" works wonders!

Of course, not washing/bathing/shaving etc is unpleasant but as the saying goes I don;t think anyone ever died from it (when you think that regular bathing is really a fairly modern invention). Of course we watch for skin infections and UTI's.

Weirdly, Dad insists on changing his socks every days, and jumpers and shirts quite often, but is happy to wear the same underwear until it is just about ready to walk itself to the washing machine...!

If he did not we would wait until he was asleep and then switch the clothes, probably he would not notice!

He does tend to "miss" the loo quite often, so puddles are order of the day, this is less so since I moved the frame out of the bathroom that was to help getting on and off the seat, but I'm convinced he can't see properly but he flatly refuses to have an eye test.

 

[Grannie G]

My Dad has become reluctant to wash or shave - to be brutally frank a lot of this seems to be from pure laziness in that he just can't be bothered It doesn;t help that he never goes anywhere or sees anyone so doesn't see the point. .

With regard to bathing and changing clothes, I know two things about my husband.

One, the organization of a bath, and fear of slipping, even with a bath seat, causes his reluctance. Like so many activities, there is no longer any spontaneity, everything he does has to be thought about and aided.

Two, he always, without fail, says he feels wonderful after a bath. `Clean`, `refreshed` and `like a new man` are expressions he uses. Even though he hardly goes anywhere, and sees only close family, it does help his ever decreasing self esteem to feel clean and fresh.

This is why I persuade, and when the timing is right, I succeed. When the timing is wrong, I fail. I know it is different for everyone, the time may well come when I give up, and then I`ll have no alternative but to accept the situation.

Thank goodness he still gets clean clothes out every day.

 

[Skye]

John has a shower every morning as a matter of routine. He sits on a shower stool and I wash him. I also dress him in clean clothes. I hope to keep to this routine as long as possible. One day I'm sure he'll rebel. My only problem so far is with toileting.

But I do recognise that this is much more difficult in the parent/child relationship, and even more so when they are not living in the same house.

All anyone can do is their best.

 

[Grommit]

Jean has now started rebelling against the baths she used to luxuriate in. You know the sort of thing where half the local chemists shop was poured in there and the bathroom was out of bounds for at least an hour.

Now, anything deeper than the wartime 4 inches and is above tepid, is just not acceptable. She does like bubbles still, but neutral smelling ones, not perfumed.

She will not go near the shower under any circumstances and stands there petrified if I manage to persuade her in.

Hair washing and drying is still a fight, even after lessons from Mrs. Fartoo.

Finger and toenail cutting is a toil but at least the toenails cause some amusement as I tickle her feet.

 

[Margarita]

NebirothMy Dad has become reluctant to wash or shave - to be brutally frank a lot of this seems to be from pure laziness in that he just can't be bothered. It doesn;t help that he never goes anywhere or sees anyone so doesn't see the point.

I remember back when my mother was just like that reluctant to wash , hate saying this but she use to small & my teenager's use to tell me to wash mum , but could not understand that I could not get mum to wash .

I must admit I was also reluctant to wash mum myself ( as in a wash down ) she use to go into bath room alone and say she done it , but I small she had not .

( Did not mind if she got into bath , then I just give her the flannel she rub the soap on it and do the rest herself )

So next time I watch her do it wash down in sink ( because she did not like going into bath every day ) she was doing it all wrong , seem like she was loosing the skill in knowing how to wash herself .

Then when she was getting very sore under her breast & smelly they , because of not washing drying it right ( under her breast ) I new I had to take over .

I did not like it thought , , but mum must of know something was wrong that she could not do it herself . I did feel for her because my Teenager would not sit next to her because she was to smelly .


as further down the line , mum was finding it hard to get in out of bath, as that was the only way I did not mind washing her

that's when I ask if I could get someone in to wash mum , she did not like the idea of someone washing her beside me



then with me not liking to wash her in sink and mum not getting into bath every day , she new she had to get a wash or no one wanted to go near her ( thought I had forgotten those days)

Then I hit on the idea of a shower, so while they did the shower , mum did not mind me getting someone in to wash her down in sink .

walk in Shower was great , because she would go into it every day , shower unit would wash under mum breast , but I had to be careful because she hated the shower running above her head , she use to scream . I read somewhere its because they get confused and think they drowning. then mum got use to carer doing washing her ( which was great for me )

So Nebiroth I don't think its because your father laziness and that he just can't be bothered if you don't mind me saying . Just one of the symptoms of the diseases.

I say that because I have read of it happening to so many people on TP and also it happen to my mother . mind you when your living in it. I also thought that back then mum was being lazy dirty & why I never thought well she never use to be like this , is because I never had TP or know other people it had happen to , or I had they did not like talking about that side of it .

 

[Margarita]

I posted this back last year , just can't link the thread of that post to this thread .

Sorry Sylvia , for Jumping in with this .


Compassionate Communication with the Memory Impaired

by Liz Ayres
A Volunteer of the Alzheimer's Association and Former Caregiver

DON'T
Don’t reason.
Don’t argue.
Don’t confront.
Don’t remind them they forget.
Don’t question recent memory.
Don’t take it personally.



DO
Give short, one sentence explanations.
Allow plenty of time for comprehension, then triple it.
Repeat instructions or sentences exactly the same way.
Eliminate 'but' from your vocabulary; substitute 'nevertheless.'
Avoid insistence. Try again later
Agree with them or distract them to a different subject or activity
Accept blame when something’s wrong (even if it’s fantasy).
Leave the room, if necessary, to avoid confrontations.
Respond to feelings rather than words
Be patient and cheerful and reassuring. Do go with the flow.
Practice 100% forgiveness. Memory loss progresses daily.
My appeal to you: Please.elevate your level of generosity and graciousness.



Remember

You can’t control memory loss, only your reaction to it. Compassionate communication will significantly heighten quality of life.

They are not crazy or lazy. They say normal things, and do normal things, for a memory impaired, dementia individual. If they were deliberately trying to exasperate you, they would have a different diagnosis. Forgive them ... always. For example: they don’t hide things; they protect them in safe places... And then forget. Don’t take ‘stealing’ accusations personally.

Their disability is memory loss. Asking them to remember is like asking a blind person to read. (“Did you take your pills?” “What did you do today?”) Don’t ask and don’t test memory! A loss of this magnitude reduces the capacity to reason. Expecting them to be reasonable or to accept your conclusion is unrealistic. (“You need a shower.” “Day care will be fun.” “You can’t live alone.”) Don’t try to reason or convince them. Give a one sentence explanation or search for creative solutions. Memory loss produces unpredictable emotions, thought, and behavior, which you can alleviate by resolving all issues peacefully. Don’t argue, correct, contradict, confront, blame, or insist.

Reminders are rarely kind. They tell the patient how disabled they are – over and over again. Reminders of the recent past imply, “I remember, I’m okay; you don’t, you’re not. ”Ouch! Refer to the present or the future. (If they’re hungry, don’t inform them they ate an hour ago, offer a snack or set a time to eat soon.) They may ask the same question repeatedly, believing each time is the first. Graciously respond as if it’s the first time. Some days may seem normal, but they are not. They live in a different reality. Reminders won’t bring them into yours. Note: For vascular dementia, giving clues may help their recall. If it doesn’t work, be kind ... don’t remind.

Ethical dilemmas may occur. If, for instance, the patient thinks a dead spouse is alive, and truthful reminders will create sadness, what should you do? To avoid distress, try these ways of kindness: 1) distract to another topic, or 2) start a fun activity, or 3) reminisce about their spouse, “I was just thinking about ______. How did you two meet?” You might even try, “He’s gone for a while. Let’s take our walk now.”

Open-ended questions (“Where shall we go?” “What do you want to eat/wear/do?”) are surprisingly complex and create anxiety. Give them a simple choice between two items or direct their choice, “You look great in the red blouse.”

They are scared all the time. Each patient reacts differently to fear. They may become passive, uncooperative, hostile, angry, agitated, verbally abusive, or physically combative. They may even do them all at different times, or alternate between them. Anxiety may compel them to shadow you (follow everywhere). Anxiety compels them to resist changes in routine, even pleasant ones. Your goal is to reduce anxiety whenever possible. Also, they can’t remember your reassurances. Keep saying them.

Examples

Don’t reason

Patient What doctor’s appointment? There’s nothing wrong with me.”
Don’t (reason) “You’ve been seeing the doctor every three months for the last two years. It’s written on the calendar and I told you about it yesterday and this morning.”
DO (short explanation) “It’s just a regular check-up.”
(accept blame) “I’m sorry if I forgot to tell you.”

Don’t argue

Patient “I didn’t write this check for $500. Someone at the bank is forging my signature.”
Don’t (argue) “What? Don’t be silly! The bank wouldn’t be forging your signature.”
DO (respond to feelings) “That’s a scary thought.”
(reassure) “I’ll make sure they don’t do that.”
(distract) “Would you help me fold the towels?”

Don’t confront
Patient “Nobody’s going to make decisions for me. You can go now ... and don’t come back!”
Don’t (confront) I’m not going anywhere and you can’t remember enough to make your own decisions.”
DO (accept blame or respond to feelings) “I’m sorry this is a tough time.”
(reassure) “I love you and we’re going to get through this together.”
(distract) “You know what? Don has a new job. He’s really excited about it.


Don’t remind them they forget
Patient: “Joe hasn’t called for a long time. I hope he’s okay.”
Don’t (remind) “Joe called yesterday and you talked to him for 15 minutes.”
DO (reassure) “You really like talking to Joe, don’t you?”
(distract) “Let’s call him when we get back from our walk.”



Don’t question recent memory

Patient “Hello, Mary. I see you’ve brought a friend with you.”
Don’t (question memory) “Hi, Mom. You remember Eric, don’t you? What did you do today?”
DO (short explanation) “Hi, Mom. You look wonderful! This is Eric. We work together.”



Don’t take it personally!

Patient “Who are you? Where’s my husband?”
Don’t (take it personally) “What do you mean – who’s your husband? I am!”
DO (go with the flow, reassure) “He’ll be here for dinner.”
(distract) “How about some milk and cookies?” .. Would you like chocolate chip or oatmeal?



Do repeat exactly

Patient "I'm going to the store for a newspaper."
Don’t (repeat differently) "Please put you shoes on."
"You'll need to put your shoes on."
DO (repeat exactly) "Please put your shoes on."
"Please put your shoes on."



Do eliminate "but", substitute "nevertheless"
Patient "I'm not eating this. I hate chicken."
Don’t (say "but") "I know chicken's not your favorite food, but it's what we're having for dinner."
DO (say "nevertheless") "I know chicken's not your favorite food, (smile) nevertheless I'd appreciate it if you'd eat a little bit."

Used with permission from Ellen Warner at Ageless Design

Summer 2001 www.agelessdesign.com

Liz has given her permission. Please provide a link back to the article on our web site.

Thank you,

Ellen Warner
__________________