1. sandrah

    sandrah Registered User

    Jul 11, 2007
    19
    west midlands
    Does anyone have any tips on how to get my dad to wash without a battle. He has not had a bath for months and no one can give me any advise on how to get him to have one. Every morning I take the bowl soap etc up to him in bed " I don't need this nonsense I'm not dirty" is what he says most times. at best I can wash his hands and face sometimes his feet. A lot of times he just pushes it away, it is a miracle he does not smell, but most times I do get him to change his clothes. He will not let anyone else wash him either and after he had been in respite for two weeks they said they could not have him back as he wouldnt wash or let anyone wash him. Any ideas would be welcome
    thanks
    Sandra :)
     
  2. Canadian Joanne

    Canadian Joanne Volunteer Moderator

    Apr 8, 2005
    16,102
    Toronto, Canada
    This may sound silly but does he like swimming? Taking him to a pool would at least help alleviate things. Perhaps a shower?

    I had lots of problems with my mother and she DID reek to high heaven. It was awful. And she was in a nursing home when she went through her worst phase of not wanting to bathe.

    I'm sorry I don't have anything more concrete to offer, it must be very difficult trying to wash him. Why don't you try telling him he smells? I know it sounds horrible but try anything.

    Good luck!
     
  3. sandrah

    sandrah Registered User

    Jul 11, 2007
    19
    west midlands
    Hi Joanne
    Show him water and he runs a mile (if he could) :rolleyes: I have tried telling him he smells that he is a dirty old man anything !! but he just shrugs says he is not bothered . he was obstinate before now he is doubly so. Thanks anyway Sandra :)
     
  4. Canadian Joanne

    Canadian Joanne Volunteer Moderator

    Apr 8, 2005
    16,102
    Toronto, Canada
    Isn't it charming how AD can reinforce some of those not so pleasant character traits? My mother was always very stubborn & during the worst times she made mules look like the sweetest things.
     
  5. mel

    mel Registered User

    Apr 30, 2006
    1,656
    Sheffield
    Hi Sandra
    I used to have the same problem with mum........she always told me she'd already had a bath(she hadn't). I tried all sorts of bribery tactics.....have a bath and we'll go out/the doctor says you must bathe or your skin will get infected/
    I had better success with showers.......a little easier anyway:eek:

    I remember trying to be as diplomatic as possible once, telling her she didn't smell very pleasant.......she told me it wasn't HER......it was ME:eek: :eek: :eek:
     
  6. Geoffrey

    Geoffrey Registered User

    Mar 15, 2008
    14
    Venezuela
    Obstinacy is a problem

    Obstinacy is unlikely to be overcome with logic as that is one of the first casualties. The problem you have is my nightmare which i try to overcome by having routines which are not questioned!!!
    In my experience it is important to not to let problem pracitices become established in the first place. (not always possible)
    Washing is a particular problem as it can be seen as discomfort and something to be avoided.
    Suggestion:
    Treat the problems such as these like training your dog. Try just wiping face with a warm damp cloth without making it an issue. (no preparation or bowl of water) Hopefully he will find it soothing and pleasant. Go from there slowly slowly. If you get resistance then do not make an issue of it. Try later.
    Geoffrey
     
  7. connie

    connie Registered User

    Mar 7, 2004
    9,519
    Frinton-on-Sea
    Dear sandrah, What can I asy to help?

    I never encountered these problems at home, as when things became too much for me to handle on my own, I employed a wonderful care, who assisted me evry, single step of the way.

    Cut back to Wednesday last, in Lionels care home: Lots of shouting, and general upheaval.

    My DIL's mum, who is a resident in the home, came up to me in very high dungeon: "Are these people friends of yours?"

    She was upset. Slightly against her will, she had been 'bathed'. One unhappy lady.

    One hour later she was telling me what 'lovely girls' she had around her.

    There is no easy answer.
     
  8. Geoffrey

    Geoffrey Registered User

    Mar 15, 2008
    14
    Venezuela
    Coercion in your case could be a mistake

    A little concerned at the input from Connie. I do not disagree so much with what Connie said or implied as a possible solution but what was not said by way of qualification.

    In principle, especially in the home, it is important to create a non confrontational atmosphere and avoid any incident or situation that could provoke confrontational emotional responses that could lead to a downward spiral.
    I would be cautious using coercion in dealing with your fathers problem as he could not only become more resistant but may react in an adverse way that is not just verbal. It is worth bearing in mind a characteristic of Alzheimer's is loss of restraint and that can be a problem.
    All things considered one is not dealing with a 'whole' person who understands what they are doing or saying and situations such as the one you describe has to be resolved if you are to succeed in provide care.

    When all fails and coercion is seen as the last resort it must be thought through and planned.

    If your situation becomes totally beyond something you can tolerate or deal with then the sensible thing to do is seek outside assistance, as coercion may (inevitably) involve restraint if you are to succeed.
     
  9. Norman

    Norman Registered User

    Oct 9, 2003
    4,348
    Birmingham Hades
    Hi Geoffrey
    Welcome to Talking Point.
    I read your posts with great interest.
    There is a vast difference in careing for a partner,a Parent a friend or whatever.
    Whilst I can agree with some of your advice,except the dog training,I would be interested to know a little more about your own situation.
    Norman
     
  10. Geoffrey

    Geoffrey Registered User

    Mar 15, 2008
    14
    Venezuela
    Reply to Norman

    Norman
    In reply to your request. Yes the dog training analogy was a little tacktless but the sentiment is valid. The vast differencees you mention is in the emotional attachment of the carer not the patient or the required response to any given problem. This is a substantial issue that should be understood as it is central to success. I firmly believe emotions cloud the issue of care and often lead to the wrong response and are something that needs more educational attention.
    My view and approach, born by experience in being successful as a carer is to understand the reality of what happens to the 'person' without being sidetracked by the emotions of previous attachment. It is important to know that at some point the person one once knew is no longer and what one has to deal with is a person that is fundamentally different.
    There are many different paths dementia can take but they all result in loss of mental function which will manifest differently in any one individual depending on the persons fundamental tendencies, predispositions, character and the course of the disease.
    It is necessary to understand the psycological needs and changes that take place in the person and use that knowledge to ease the path of both the patient and carer. If the carer responds inappropriately, things go down hill fast.
    I have experience with Alzheimer's from my Step father and subsequently my mother who I have been caring for, for nearly 4 years. She is now at a stage where she requires nursing.
    My mother has gone through many stages and is now unable to communicate in any meaningful way. She likes to watch television and still laughs at mainly slapstick but surprisingly sometimes does get verbal humour.
    I care for my mother in Venezuela in a very remote but beautiful area. There is no state support so we have to cope with all that comes.
    I can say that through a careful and considered approach engendering security, routine, and an atmosphere of tranquility my mother has prospered and appears happy.
    This path is not always easy and sometimes it is necessary to rethink ones entire approach to what one would consider as normal responses to any given problem.
    I hope that brief outline provides an insight into my understanding and the way i approach the the provision of Alzheimer's care.
     
  11. Norman

    Norman Registered User

    Oct 9, 2003
    4,348
    Birmingham Hades
    Hi Geofrey
    I do not believe that one can generalise about Dementia patients,A true saying is "You have seen one dementia patient and you have seen one Dementia patient".
    We cannot know what happens in the head of a loved one,but they are still in there somewhere. and on occassions do come through.
    Those are precious moments,to be seized and cherished.
    It is very difficult,impossible in my case, to become detached from some one that one has loved for a lifetime,because they have Dementia.
    I cared for my dear wife for more than 13 years,she died in July last year,so I have completed the whole journey now.
    You will notice my mantra "Day by Day,I do not believe that one can make too many plans where Dementia is involved
    IMHO Norman
     
  12. zoet

    zoet Registered User

    edited by author....misunderstood post
     
  13. zoet

    zoet Registered User

    This is a bit contraversial I guess....but if he doesnt smell, and he has no infections, then maybe just do as you are, and wash his face, hands and feet; leave him be after that? Its how he perceives his body that really matters, and if he still has a sense of smell or a sense of what is sore, then he knows when he needs a wash. That sounds a bit odd I know, because we like to think of everything being clean as a standard of the care we give, but frankly, if someone tried to wash me, and I either didnt think I was dirty, or even if I couldnt be bothered, I wouldnt let them.
    The fact he lets you do his feet and hands and face is a compromise to the disease, he has to accept. Later things may change and he will not care either way. just a thought and sorry if its a bit unhelpful, it's all I could think of!:)
     
  14. Geoffrey

    Geoffrey Registered User

    Mar 15, 2008
    14
    Venezuela
    Grief and care

    Norman
    In this response I would like to address your issues and those of Sandrah as the two may have some relationship and this is her thread and I do not wish to userp it.

    I do not pretend to fully understand the depth of your feelings, who can, and what effect caring for a loved one for such a long period has and I guess you have not yet completed your journey. It is a considerable issue that sadly so many deal with alone in their moments of darkness.
    Fortunately it was an issue I came to terms with before I started; a course of action I would advocate. Perhaps it was easier for me as it was not my wife where the bond can be so much more profound and it creeps up on you like a thief in the night stealing everything one holds so dear.
    In my mother's case she is gone for good. What is left is not the person I originally formed the bond with when I was young even if she looks and sounds like her. To think otherwise would be self delusion. It may be shocking to some, but what I do now is provide care for a living, breathing, emotional individual (who is not my mother in the intellectual sense) that can still experience the difference between happiness and sadness out of compassion for what is left. Did I love my mother? Yes I did very much. Do I love the patient? My mother has left.
    I included that comment in the hope it helps someone because if you feel like that you are quite normal and others feel that way as well and there is no need to feel any guilt about it.

    Support is the current mantra that does not seem to quite get there, but in practice it can never quite reach into where we are. For my part I can say providing care outside the U.K. I have had a battle with authority back home from day one with little if any support whatsoever. It is a hard school and I have learned there often are no clear answers to the problems and questions that arise during the process of care which are not all to do with the patient. There are however often many choices but also clear mistakes to be avoided. This is essentially what I wished to convey to Sandrah.
    In Sandrah's particular case the answers will depend so much on precise circumstances. I do not believe however doing nothing is acceptable as some appear to suggest nor do messages of symnpathy do very much constructive. If sound opinion or advice can not be found, those seeking it will cease looking in that place.
    I nor anyone else who is not intimately familiar with the circumstances will be in a position to give specific advice but we can give a pointer how to approach the issue. If sandrah has reached a dead end then she must consult someone with experience on the spot. Failure to resolve this kind of issue could have unexpected consequences. The washing problem may be a reaction to how he is treated, it may be a phase that will pass as the disease progresses, but equally it could not or it could be a very long phase.

    What I try to convey is the conceptual difference between compassion as opposed to emotion and the differences that ensue from that, not only on how one reacts but the reaction on oneself. I regret it if I am misunderstood and welcome comment. I do not have all the answers but I am looking for a few.
     
  15. BeckyJan

    BeckyJan Registered User

    Nov 28, 2005
    18,972
    Derbyshire
    Sandrah:

    It seems that 'water' causes problems for dementia sufferers. I do wonder if you can get some of the foam spray that the hospitals use - it may be useful for the private parts to stop infection and soreness. Perhaps your father would spray himself (or let someone else do it) rather than use soap and water.

    My husband has been hospital 4 weeks now - no shower or bath - but he seems clean, no soreness and no smell.

    I feel certain there has been an earlier thread on a similar theme. Then there were some products mentioned. I will search for you and PM if there is anything useful.

    Good luck Jan
     
  16. Norman

    Norman Registered User

    Oct 9, 2003
    4,348
    Birmingham Hades
    Hi Geofrey

    [/QUOTE]
    Amongst many feelings I think that the feeling of being alone and crying out for help is one of the worst.
    How do you cope in a country where there is no help available.
    Is there any health service?
    Is there any medication available?
    Quote
    In my mother's case she is gone for good. What is left is not the person I originally formed the bond with when I was young even if she looks and sounds like her.
    Don't you ever see a flash of what mum was like,does she know you?
    Regarding the original issue of washing,it is a fact that dementia patients are scared by the water,whether it be the sound of running water who knows
    In my case we did away with the bath and had a double shower,that served us well.
    Norman
     
  17. geoffreyosborne

    geoffreyosborne Registered User

    Mar 20, 2008
    1
    highcliffe dorset






























    Sandra, Do you think your father would find it difficult to get in and out of the bath.He may have a fear of falling and hurting himself.I have a similar problem with my wife and firstly I have to make sure that the bathroom is very warm,being elderly she feels the cold,even more so that she comes straight out of bed.Once the water is in the bath and looking inviting she will then comply.Im sure as a carer you have tried everything and in a way I,m just perhaps showing that you are one of many with this problem and I hope these words can at least give you some respite of a problem shared.Good luck.
     
  18. christine_batch

    christine_batch Registered User

    Jul 31, 2007
    3,388
    Buckinghamshire
    Dear Sandra,
    When my husband was first diagnoised at 58 and needed help with washing, as his wife, Peter did allow me to bath him.
    When Carers had to come in and perform the tasks, he was very upset. Had a male Carer come in and Peter acceppted his help.
    So I put myself in Peter's place - How would I like someone of the opposite sex and a stranger wash me each day.
    As Peter deteriorated and with gentle voice the Carer who he really liked (female) was able to wash, shave and dress him.
    I wish you all the best as each individual is so different.
    Christine
     
  19. SueG

    SueG Registered User

    Jan 21, 2008
    9
    Port Talbot
    Hi Sandra,
    I have had the same problem with Mum for over 2years now and no matter what we say nothing seems to work. She happily tells everyone that she bathes every night (blatently untrue) and washes her hair regularly !!
    We have tried lots of things but with no success.I buy her face wipes and all thogh happy to use them in front of me they soon disappear off the face of the earth. She forgets what they are there for. Same applied to the anti bacterial hand cleanser that my sister bought.
    On Christmas eve my daughters and I worked out a plan that we would all have a pampering evening in preparation for the big day. We thought that mum would love to join in. How wrong we were She not only refused but got completely hysterical shouting abuse and threatening to walk home!
    It seems that this is one other thing that we are having to accept with this vie illness.
    She is refusing carers and it seems that there will be n o intervention until she will actually get an infection!
    Sorry I can't be more positive but I would feally love any other suggestions myself.
    SueG
     
  20. Geoffrey

    Geoffrey Registered User

    Mar 15, 2008
    14
    Venezuela
    Providing care unsupported.

    Norman.
    You bring up a number of interesting issues that are of value being aired.
    Providing care in place where there is no support is something My partner and I have succeeded in doing for the duration and we have an experience that is worth sharing. I have thought of starting a thread specifically related to this subject to allow others in the same circumstances to learn from eachother and possibly gain valuable support. In England people have got used to the 'nanny state' with all it controls, procedures and interference and can not see how they could manage without it. The 'nanny state' do not cope with independence and different ideas very well either.

    In answer to your specific questions. No I see nothing in my mother that would suggest recognition of who I am nor do I see anything of my mother's personality that made her who she was, caring and nurturing me when I was young. Not even for a minute.
    Sometimes I look at her pathetic figure, wasted and incapable as she has become and that makes me sad but I do not dwell on it.

    Once I was an ambitious and successful Engineer. The experience has however changed my philosopy and understanding of what life means and what is important. It is not what one might expect. I am not a religious person, that kind of solace holds nothing for me but i do understand many might find comfort there.
    As I stated previously she has gone, slipped away somewhere when no one was looking. Alzheimer's is a gradual disease and who can say when such a thing happens but it does; it is inevitable at some point.
    Obviously I am a familiar figure and that is important as it is a part of the stability and familiarity that is necessary to alleviate the worry and frustration which leads to so many unsatisfactory consequences.
    My mother's responses can be deceptive to the uniniciated as they are so much like the artificial intelligence one sees on a computer. To given inputs there are responses that appear correct but behind them there is no substance or understanding. It is difficult for me to convey this but i am sure many will understand.

    Where we live there is no 'Health service' as you put it. There are hospitals but none nearer than 120km and doctors do not make house calls. All types of prescription medication is available over the counter from the Chemist. There are plenty of private clinics should a consultation be required. This is not a problem.
    In this country state care is just about non existent and the institutions where one might stay are mostly voluntary and the conditions, if one was to be kind are 'basic'. I can not speak for the capital city Caracas where there may be more available.
    In this country, it is the norm for extended families provide care within the home. If one is not able to care for oneself and no one cares for you or you have no money for medication then you may well be left to die in the street.

    With respect to water, it is my observation it is not so much fear of water itself as real or perceived discomfort and or nuisance. The parafinalea of getting undressed, wet, dried, dressed etc., I often see a hesitation in getting under the shower head and even an attempt to avoid getting wet. Once in , no problem but it is important to ensure it is a pleasant experience; warm, pampered and assisted and a regular one that is habit forming. In my experience it is important to ensure the experience (any experience) is not perceived as something to be avoided for whatever reason.
    Alzheimer's is a disease where all too often it can be seen restraint and safety's are off. For them there often are no consequences or none that are meaninful to them. Logic does not have any meaning so what is left is a largly emotional being. A difficult thing for most to comprehend what that means. In the end that last shred of inherited humanity also fades away.

    The strategy for being successful in providing care where there are no support services is to fully understand the task of caring for the patient and one's own needs, motivations and limitations. Motivation is something I suspect is not talked about much, it is just assumed and becomes one of those taboo subjects, but it is crutial. It is also necessary to have dealt with the issues involed in grief and loss before commencing. These can lead to clouded judgement, responses and will inevitably significantly add to potential stress.

    Providing for my mother has been a huge battle. Surprisingly perhaps not with coping with her but in dealing with the family who have no sympathy or understanding, palgued by jealousies and paranoia (to do with finance) and the Authorities back home who have little understanding of the circumstances under which we operate. Sadly they are more concerned with ticking the boxes and complying with practices that have no relevance here. The courts are also at fault as they overstep their authority where they have no jurisdiction.
    To put it bluntly I have had to 'beat them up' pretty regularly and remain focused, robust and determined over a long period to gain any headway. In the end it works but it is a battle that puts to shame the whole concept of support. To a less focused or determined and motivated individual it could all too easily be too much.
    The care we are able to provide here is far superior to anything available in U.K. due to a wonderful climate and surroundings. A situation where my mother has not had a day's illness in all the years she has been with us whereas when she was in England she was constantly ill. Contributing factors include people here are used to caring and of course our circumstances that enables us to provide a home, the like of which would not be possible elsewhere.
    It would not be possible to provide the level and quality of care we currently provide if we lived in England.
    Does anyone else have relevant experiences or have an input they would like to share?
     

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