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Refusing to be undressed/dressed/washed

Discussion in 'I care for a person with dementia' started by sweety1962, Sep 10, 2018.

  1. sweety1962

    sweety1962 Registered User

    Apr 1, 2014
    13
    #1 sweety1962, Sep 10, 2018
    Last edited: Sep 11, 2018
    Hello , I hope someone can help me........ I am in need of urgent advice regarding Mum, who I cared for at home for 3 years, but is now in a residential home with advanced AZ. She is fully self funding and pays £895 a week,receives Attendance Allowance, but no other help. The home has just received a 9 QCC rating.
    For the last year shes been well cared for, although shes lost about a stone in weight, which we put down to reduced appetite. When we visit I check her room to make sure her clothes and room/bathroom are clean and tidy, which they normally are. .
    This week, we have visited twice and she seems unusually dissheveled, with matted hair and stained clothes, which I found quite distressing. The team leader was on leave and the staff seemed unable to tell me why this was. Obviously it was upsetting, especially when I saw her eyes were quite sore and her nails were dirty. I asked that someone washed and changed her immediately, because it was so bad. We then discovered from one of the carers, that she has refused to be washed and dressed in the mornings, for the last couple of weeks and is getting more aggressive and sometimes violent, if they try to remove her clothing. It has transpired, that they have been leaving her, if she kicks off in the mornings and then they trying again in the afternoon. If she refused again, they are leaving her unwashed and in the same clothes until the next day. Shes also refused to leave her room most days, in the last month. The home just says they can't force her. There is a deprivation of liberties order in place, to allow the home to keep doors and windows locked, but there is nothing in place, for her to be given personal care against her will. I cannot believe that an 84 year old lady, suffering incontinence and Alzheimer's, is left soiled and dirty, just because she refuses care, when she has lost mental capacity. Surely something can be done. I'm at my wits end, almost out of funds for her care and feeling that she is being neglected. Do the home not have a duty of care, to make sure she is looked after properly?? I can't have her back home, as my husband has taken retirement on medical grounds. I love my Mum, but I feel I've let her down and am filled with guilt. What can I do to resolve these problems and has anyone eise experienced similar ? Thank you in advance
     
  2. Wedger

    Wedger Registered User

    Jul 24, 2018
    13
    Wow, that is really difficult to deal with. I have no experience, but just wanted to let you know that I am thinking of you and I hope you get some practical help from the forum.
     
  3. sweety1962

    sweety1962 Registered User

    Apr 1, 2014
    13
    Thank you, that's very kind. Have a nice evening :)
     
  4. PJ

    PJ Registered User

    Jan 26, 2017
    325
    Female
    Bristol
    Hi I can’t begin to imagine how upsetting it must be to see your mum in this state. I do hope someone on her can advise you.
    I do think you are right the home does have a duty of care.
     
  5. pixie2

    pixie2 Registered User

    Jul 21, 2018
    39
    This is my fear too. Mum terrified of standing aid, screams and shouts. Hates being washed etc. Don't get me wrong she has good days when it's ok and she thanks the staff. What happens when bad days turn into every day?. Its awful isn't it x
     
  6. karaokePete

    karaokePete Registered User

    Jul 23, 2017
    4,931
    N Ireland
    #6 karaokePete, Sep 10, 2018
    Last edited: Sep 10, 2018
    Given the continence issue I would think this does need to be resolved for health reasons. Maybe someone in the homes management needs to get involved.

    Would doing a single bit of the body and clothing at a time, rather than a complete body wash & change, be a possibility?

    Would your Mum and the Home allow you to assist with personal care.

    I notice this involves a residential home. I wonder if they have sufficient experience with dementia to be able to meet current needs.

    Maybe a care needs assessment is required. In the hope that they help, here are links to two Factsheets that may give you some tips
    https://www.alzheimers.org.uk/sites...assessment_for_care_in_support_in_england.pdf

    https://www.alzheimers.org.uk/sites...e/downloads/factsheet_washing_and_bathing.pdf
     
  7. sweety1962

    sweety1962 Registered User

    Apr 1, 2014
    13
    Does anyone know, if the care home can ask district nurses, or community nurses to visit the home, to help with her personal care, or is this only available if you are in your own home? If not, does anyone know, if there is any help we can get, to fund any nursing Mum needs within the care home, as we cannot afford to pay more, than the £895, a week, we are already paying. We have paid nearly £90K already, for her day care and then full time residential care......
     
  8. sweety1962

    sweety1962 Registered User

    Apr 1, 2014
    13
    Thank you so much, to everyone who has helped me or supported so far. To anyone who's also going through this difficult journey, with a much loved family nember, i send you all my best wishes. Any other information or guidance, will be much appreciated. Thank you!
     
  9. Louise7

    Louise7 Registered User

    Mar 25, 2016
    1,233
    Is your Mum self-funding or are you paying her fees? (it's not too clear). If her savings drop to below around £24,000 then she will be entitled to help with her care costs. You will not be expected to pay these.

    It wouldn't be usual for a care home to request a district / community nurse to deal with washing & dressing etc as these are not nursing needs. If your Mum does have nursing needs then a residential home is not the best place for her. I think you really need to have a frank chat with the home manager to see if they are now finding it difficult to meet your Mum's needs as it sounds like the home might not be used to dealing with dementia patients with challenging behaviour. Has she had a medical check recently? If her aggressiveness / violence is a recent development there could be underlying medical reasons for this, such as an infection.
     
  10. sweety1962

    sweety1962 Registered User

    Apr 1, 2014
    13
    Yes, Mum's fully self funding. I will definitely ask for a medical assessment, as shes not had one for about 8 months and she has deteriorated. What sort of place you think she needs to be in, if shes become aggressive/violent ?? (She punched my arm today and told me to #$%@ off)
    This residential care home , stated that they specialised in dementia care, which is why we placed her there. It's been so so stressful and I feel like I'm letting Mum down. I just feel helpless to be honest......
     
  11. Linbrusco

    Linbrusco Registered User

    Mar 4, 2013
    1,578
    Female
    Auckland...... New Zealand
    Im not from the UK, but my Mum has Alz and in care 2 yrs.
    We have gone through periods like this, but generally triggered by a UTI and even once treated, she would go through periods of refusing all personal care for 3-4 days at a time. It was very distressing to see & hear, as even my sister and I copped it.
    Staff said they could not force her.
    In the end, between Mums agression and physical blows, hallucinations & delusions Mum was trialled on a few different medications. It was a low dose of anti psychotic Quetiapine that worked in the end.
    Whenever Mum starts to get aggro with personal care they know a Uti is brewing,
     
  12. sweety1962

    sweety1962 Registered User

    Apr 1, 2014
    13
    Thanks for replying x Yes, that's something I have considered, so I've rung the home and asked that the doctor visits her today. Also, I'm looking into more user friendly/accessible clothing too, because its all the pulling arms out and pulling things overhead, that distresses Mum. When you try to pull her arm out of a jumper or long sleeved nightdress, she screams "get off me" or "leave me alone". Any recommendations re clothing would be gratefully received......:)
     
  13. Bunpoots

    Bunpoots Registered User

    Apr 1, 2016
    3,035
    Nottinghamshire
    Hi. My dad has just (on Friday) been placed in a care home which "specialises in dementia". On Saturday morning he swore and threw his breakfast juice at another resident. He's never been violent before and I think it happened because the Carehome staff, lovely and hardworking as they are, do not know how to communicate with PWD.

    I have chosen a different Carehome which seems to understand dementia better but as SS have placed him in an assessment bed for 4 weeks I can't get him to that home yet.

    I have two suggestions which I hope might help:

    1 - watch Teepa Snow on YouTube as she is an expert in dementia and gives excellent advise on how to cope with various problems dementia throws up - including how to persuade someone with dementia to accept personal care (maybe Carehome staff could be persuaded to look her up too)

    2 - visit other homes unannounced. The one I've chosen for dad is an EMI home with a residential floor (which also houses people with early stage dementia) and the EMI floor which is for those with moderate to severe stage dementia. The atmosphere is calm and caring (unlike the one he is currently in which is chaotic) and it has no unpleasant smells and, although both homes have a CQC "good" rating in all areas I think the EMI home is far superior.

    I think it is totally unacceptable that your mum is not receiving proper personal care, although I do know how difficult it can be to achieve this.
     
  14. SKD

    SKD Registered User

    My Mum refused personal care for some time at the start of her time in the care home and it was distressing for my - my Mum had always been very particular about hygiene and neatness. As with you the home would try offering care at different times of day. She did allow me to shower her and wash her hair but as I live 200+ miles away that wasn't too frequent. It was linked to her also refusing her medication and I think was part of the disruption of the move into the care home. As she has settled with the medication and eating (and the weather has cooled down) she has also improved on personal care though still has days when she refuses anything. I would definitely check out the possibility of an infection and issues with medication. We still have issues about hair washing and she won't go to the home hairdresser - I suspect I will have to take a day off work to take her some time. I do feel for your distress - I know it was a point when I felt Mum really slipping away from me.
     
  15. sweety1962

    sweety1962 Registered User

    Apr 1, 2014
    13
    Hi, so sorry to hear about your Dad, it's such a distressing illness. The thing is, that you know the person they used to be, but the care home doesn't, so how can they possibly understand how the person 'ticks.......
    We have been in today, for a meeting with the home, who have agreed to try getting mum up earlier in the mornings, as she always preferred this, when she lived with me. I used to wake her with a cuppa about 7, get her to the bathroom about 7.30 and washed/dressed by 8ish. I know that it's different in the home, because they have about 18 people to wash and dress, so they are time poor. However, whatever happens, I will not allow Mum, to be left unwashed, in dirty clothes and soiled incontinence pants. It's up to these care homes, to ensure their staff are properly trained, when accepting Dementia patients. We have given the home 4 weeks, to get Mum into a routine, or we will have to look for an EMI home, but this will cost an extra £13K on top of the £36K a year we already pay.........
     
  16. sweety1962

    sweety1962 Registered User

    Apr 1, 2014
    13
    Hi, I'm so sorry to hear about your Mum, it seems like a familiar story :(
    The doctor is coming to check her later, so hopefully if somethings amiss, he will find out what. We've had a meeting with the home and a new care plan is starting tomorrow, so I hope this will help resolve everything.. ......fingers crossed
    (ps dry shampoo, is the way to go!! Or wipe a warm wet sponge over her head gently and then pat with a towel, before spraying hairbrush with body spray, to make the haur smell nice) x
     
  17. sweety1962

    sweety1962 Registered User

    Apr 1, 2014
    13
    Exactly, my fears are the same as yours. I'm so sorry to hear about your Mum.........all the best x
     
  18. sweety1962

    sweety1962 Registered User

    Apr 1, 2014
    13
     
  19. karaokePete

    karaokePete Registered User

    Jul 23, 2017
    4,931
    N Ireland
    I'm glad they helped and I hope you both get a result from the new care plan.
     
  20. sweety1962

    sweety1962 Registered User

    Apr 1, 2014
    13
    Thank you :) They managed to get Mum washed and dressed today, so that was a very positive. .........
     

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