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Original poster

When a person with dementia fails to look after themselves properly

50 replies

InsulationFoam · 14/02/2025 07:48

FIL is 89, has dementia, lives alone and his ability to look after himself has be deteriorating.
He gets himself dressed, but he is too unsteady on his feet to get in the shower. We are unsure as to what he does in the bathroom, but think he is giving himself some kind of wash at the bathroom sink. He emerges from the bathroom with his hair combed and wetted with water at least.

He is having meals on wheels for lunch, but has been otherwise independent apart from my SIL doing his washing and shopping.

Recently, he has been failing to get out of bed and is still in bed when meals on wheels arrive at 11:30am. This has meant he has been failing to take his morning medication which is for heart failure and to control blood pressure and prevent strokes. It has also recently become apparent that he is not reliably taking his evening medication.

We have recently got carers to come in the mornings to get him up, make him breakfast and to check he has taken his medication. Evening visits for a carer to give evening meal and check medication are going to to start in the next few days.

The question is that if he's stops maintaining the cursory strip wash he does at the bathroom sink, what we do next? The morning carers offer to help with washing, but he declines. The carers say they can't insist on helping him to wash if he doesn't want it.

It's OK for now to carry on as he is. I guess people have maintained personal hygiene by strip washing for time immemorial. However, if he starts not being able to do it and looking dirty and dishevelled, what do you do if someone refuses help with care?

Any thoughts would be greatly appreciated.

OP posts:
CherryBake · 14/02/2025 07:52

He needs adult social care to come and give him an assessment .
Phone and make an appointment citing your concerns .
Also make sure one of you is there so you know what's going on .

DustyLee123 · 14/02/2025 07:53

I’d ask for a social services review,they can help if he’s reluctant to go into care when the time comes. They were great at ‘forcing’ care on my FIL who needed it, but refused.

user6432879631 · 14/02/2025 07:57

At 89, I wouldn't be making a big issue of the medication. If it was me, a heart attack would be preferable to the dementia, but maybe you feel differently.

With the hygiene issues I think you just have to muddle on the best you can, keep offering the help and hope he accepts. You may find that he will. The carers will be used to similar situations.
I would start looking at your local options for care homes if you are self funding, or start the process with social services if not, there will come a point when this horrible disease is too much to cope with at home.

Interested in this thread?

Then you might like threads about these subjects:

Care homes Dementia & alzheimer's
Original poster
InsulationFoam · 14/02/2025 08:04

Thank you all. Your thoughts on this have been insightful.
We were aware of the possibility of having a social care assessment, but we haven't as yet asked for one. FIL has £70000 savings so we knew he wouldn't get help with funding carers.

OP posts:
DustyLee123 · 14/02/2025 08:31

My FIL had savings and a house, but they still helped.

user1471505356 · 14/02/2025 08:34

This may seem extreme would a family member be acceptable to him with a wash once a week?

MerlinsButler · 14/02/2025 09:34

My partner has fitted a number of fold down chairs in shower recently for customers who can't stand up anymore. Could you maybe try this. He got customers to use a garden chair as a test to see if it would work for them before he went ahead.

MerlinsButler · 14/02/2025 09:36

@InsulationFoam sorry he also fitted grab rails so that they could leverage themselves out of the chair and I think some kind of non-slip mat.

Sorry I don't have more details.

Original poster
InsulationFoam · 14/02/2025 09:51

DustyLee123 · 14/02/2025 08:31

My FIL had savings and a house, but they still helped.

Think if you have over £23000 savings, you have to self fund care.

OP posts:
Oldraver · 14/02/2025 09:56

InsulationFoam · 14/02/2025 09:51

Think if you have over £23000 savings, you have to self fund care.

Show quote history

Yes but Social Services can still do an assesment and maybe point out things you hadn't thought of (but you will have to fund)

gatheryerosebuds · 14/02/2025 09:58

To be honest I think a lot of that generation has a strip wash rather than a shower. As long as he’s washing the essentials with a flannel, that’s probably fine.
Replace loo roll with flushable wet wipes. I know they’re awful for the environment, but needs must sometimes and he will clean himself better after the loo at least.
In terms of getting up, if he likes to sleep in the morning, then let him. Can he take the tablets at a different time? He’s obviously tired and to be honest, he perhaps feels that the day is too long otherwise.
If he’s combing his hair he obviously takes some pride in his appearance.
Maybe just have a lunchtime call

Twiglets1 · 14/02/2025 10:00

user6432879631 · 14/02/2025 07:57

At 89, I wouldn't be making a big issue of the medication. If it was me, a heart attack would be preferable to the dementia, but maybe you feel differently.

With the hygiene issues I think you just have to muddle on the best you can, keep offering the help and hope he accepts. You may find that he will. The carers will be used to similar situations.
I would start looking at your local options for care homes if you are self funding, or start the process with social services if not, there will come a point when this horrible disease is too much to cope with at home.

That’s how I feel. Once someone has such a low quality of life, does it really matter if they fail to take all the medication elderly people get prescribed to keep them alive?

Appreciate others feel very differently however.

GETTINGLIKEMYMOTHER · 14/02/2025 10:07

It was extremely difficult to get my mother (dementia) who’d previously been so fastidious, to have a shower or wash her hair - TBH there was so much resistance/tears, I almost gave up. However my sister, who lived much further away and visited less often, was able to be much tougher. She simply wouldn’t take no for an answer - ‘Come on - you NEED a shower - you smell!’ (She did.)
Of course there were tears, but I’m sure she must have felt better afterwards.

Once she finally moved to the care home, she was always clean, with nice clean hair. How the staff managed it I don’t know, but they did. Possibly it was because the carers were in ‘nurse’ type uniform which gave them some sort of authority.
Would someone in nurse-type uniform perhaps make a difference to your FiL?

GETTINGLIKEMYMOTHER · 14/02/2025 10:08

Twiglets1 · 14/02/2025 10:00

That’s how I feel. Once someone has such a low quality of life, does it really matter if they fail to take all the medication elderly people get prescribed to keep them alive?

Appreciate others feel very differently however.

Show quote history

Having had far too much experience of dementia (both DM and FiL) I agree absolutely.

Developedanillness · 14/02/2025 10:10

GETTINGLIKEMYMOTHER · 14/02/2025 10:08

Having had far too much experience of dementia (both DM and FiL) I agree absolutely.

Show quote history

Also agree, my DF is like this, just moved into care

gatheryerosebuds · 14/02/2025 10:16

I also think showers can be quite exhausting. Maybe when the carers are there, run him a nice bath.
I remember being in hospital aged 40 and just didn’t have the energy for water pummelling me. I suspect that’s what it’s like being elderly

Original poster
InsulationFoam · 14/02/2025 10:31

MerlinsButler · 14/02/2025 09:36

@InsulationFoam sorry he also fitted grab rails so that they could leverage themselves out of the chair and I think some kind of non-slip mat.

Sorry I don't have more details.

I have sourced a shower chair for the shower. However FIL seems content to strip wash.
There are no family members to help. We live 1.5 hours away. BIL and SIL live around the corner from FIL. Don't know to what extent BIL (his son) would be prepared to help with personal care. SIL doesn't want to definitely.
I have sourced a shower chair for the shower. The equipment is there should FIL agree to have help to shower.

OP posts:
Original poster
InsulationFoam · 14/02/2025 10:33

gatheryerosebuds · 14/02/2025 10:16

I also think showers can be quite exhausting. Maybe when the carers are there, run him a nice bath.
I remember being in hospital aged 40 and just didn’t have the energy for water pummelling me. I suspect that’s what it’s like being elderly

He doesn't actually have a bath in his flat. However, he is unsteady on feet (back and heart issues) so unfortunately wouldn't be able to get in and out of a bath.

OP posts:
gatheryerosebuds · 14/02/2025 10:35

I wouldn’t worry unless he starts to really smell. A strip wash should be fine if he washes pits and bits. The carers can help him with that and get him to soak his feet in a bowl.

Original poster
InsulationFoam · 14/02/2025 10:36

GETTINGLIKEMYMOTHER · 14/02/2025 10:07

It was extremely difficult to get my mother (dementia) who’d previously been so fastidious, to have a shower or wash her hair - TBH there was so much resistance/tears, I almost gave up. However my sister, who lived much further away and visited less often, was able to be much tougher. She simply wouldn’t take no for an answer - ‘Come on - you NEED a shower - you smell!’ (She did.)
Of course there were tears, but I’m sure she must have felt better afterwards.

Once she finally moved to the care home, she was always clean, with nice clean hair. How the staff managed it I don’t know, but they did. Possibly it was because the carers were in ‘nurse’ type uniform which gave them some sort of authority.
Would someone in nurse-type uniform perhaps make a difference to your FiL?

Possibly! At the moment though, no one is forcing the issue as he is just about getting by with hygiene.

OP posts:
Original poster
InsulationFoam · 14/02/2025 10:38

gatheryerosebuds · 14/02/2025 10:35

I wouldn’t worry unless he starts to really smell. A strip wash should be fine if he washes pits and bits. The carers can help him with that and get him to soak his feet in a bowl.

Truth is that he disappears into the bathroom and we don't know what exactly he washes. He doesn't noticeably smell, so must be doing something in there!

OP posts:
CurbsideProphet · 14/02/2025 10:42

My grandad was exactly like this and also refused assistance with washing. My mum reasoned that as a child he likely had a weekly bath, so a daily shower felt completely excessive when he was just pottering around, in his mind anyway.
Is someone washing his clothes weekly? My mum and aunt bought new versions of his underwear and shirts, and made sure to be washing them every week.

Original poster
InsulationFoam · 14/02/2025 10:45

Oldraver · 14/02/2025 09:56

Yes but Social Services can still do an assesment and maybe point out things you hadn't thought of (but you will have to fund)

Show quote history

On Monday, we have got the Early Intervention Team coming in (following a fall he had) , so I think that they will hopefully flag up anything we haven't thought of. There is also a new pendant alarm with falls detection being installed Monday too.

OP posts:
Beamur · 14/02/2025 10:49

Good to have savings but look into Attendance Allowance if he's not claiming that. Also can be used towards fees in care home if needed. Not means tested.

Seeingadistance · 14/02/2025 10:50

GETTINGLIKEMYMOTHER · 14/02/2025 10:08

Having had far too much experience of dementia (both DM and FiL) I agree absolutely.

Show quote history

I also agree with this. My poor DF’s only ailment is Alzheimer’s which has reduced him to a living corpse. Heart failure would be a wonderful thing to have in that situation! I’m aware that sounds brutal and heartless but watching someone decline relentlessly over 10 years, the last 3 being late stage, is simply horrendous.