When a person with Alzheimer's will not wash

[WitsEnd129]

Posting in AIBU for traffic as dealing with a very tricky situation. FIL has Alzheimer's and personal care is a major issue. He has carers in the morning. He isn't safe to get in and out of shower, so the carers are meant to be giving him a strip wash twice a week. Since the care package started 2 months ago, he has only had one strip wash. That was only because DH was there with the carer to try an persuade him into doing it. On all of the other occasions, FIL says he has already had a wash and probably believes this himself. DH has tried to attend on wash days on a number of occasions, but his Dad just says no to a wash, saying he had already done it.

We are worried that he is going to get infections if he carries on without ever washing.

I appreciate that the carers can't make him wash. Would FIL fare any better in a care home in terms of keeping him clean or would it be the same problem that the care home couldn't make him do anything he doesn't want to do?

From someone with experience of this awful awful disease I have no advice but to say that in our situation this was one of many "phases" in the long journey (in our situation it didn't make a difference where XX was when it came to personal hygiene ) sending you love OP and hopefully someone can come along with something more meaningful. Just know that you are not alone x

Yes probably. You can keep trying, or finding work arounds, but in my experience unless you are able to be super flexible about being around at the time FIL will either fancy a wash or agree to a wash, it is pretty impossible to get the person with dementia to wash at a set time.

If he is self funding, you could try a few respite weeks and see how well he responds then.

And as @Notashamed13 has said it is just part of the journey with dementia, sadly. It won't get better so it probably is time to start exploring options, even if you don't activate them just yet.

It's really hard and my dad ended up with sepsis from an infection from not washing. He is in respite in a care home and they work miracles getting him clean!

We had chewed food "hiding", soiled clothes "hiding", lots of things, although the aforementioned were before diagnosis...it is definitely a journey, and as much as I hate to say it, we eventually couldn't cope and had to resort to a care home, the initial settling in period was horrendous, but I will still say it was 100 the best thing we could have done as they had "familier" faces 24/7 and we didnt need to worry whilst at work etc.xx

The difference with the care home is they have more opportunities to go back to him and try again. They’ll get to know him better and find ways to get round him. Carers that come in just don’t have the time, there’s also a lot of important places that breed infection that get missed with a strip wash. Once someone elderly gets infected sores it’s very difficult to get rid of them, it’s also an important chance to check the skin overall.
I know it’s a difficult choice but sometimes a care home is best to get full time care. 💐

When I worked in a care home years ago, we had a day patient who came in 2 days a week and had a bath on those days.
She didn’t like showers at home as she got too cold. We used to get the bathroom a nice warm temp, use a nice bubble bath and she would enjoy a soak in the tub with a cuppa and the radio on. The bathroom had a hoist to help her in and out.
Her husband said she liked the baths whereas at home it was hard to get her showered or washed without quite a challenge.

maybe there is somewhere similar that FIL could go for a regular, nice bath?

Thank you all for your posts. I very much appreciate each one of them.

My grandmother is the same but in a care home. She still won’t let them take her to the shower. So the care home won’t be any better.

The trigger for my mum moving into a care home was her forgetting how to get out of a bath and needing 3 people to help her wash. It was a nightmare. The care home managed her beautifully - wet rooms instead of baths.

I'm sorry for what your fil in going through. It's a truly terrible disease.

That is interesting. I did wonder if the care home wouldn’t be able to resolve the problem.

FIL wouldn't have a bath if there were female carers - it embarassed him. He was happy to let male carers do it

So from my experience I suggest...

Being blunt, you're smelling a bit dad you need the wash, it's not optional when you smell that bad.

Don't forget you are seeing x later, you said you wanted to look and smell your best (obviously just use who he would want to impress most and by the time it is done, he would have forgotten you said he was going to see x).

I know you don't want a wash but this is a new carer, so can you be kind and let her learn on you how hot the water should be, how gentle etc. Just make it out like he is doing a favour by being practiced on.

Get the water, flannels etc ready, then pass him the wet soapy flannel and ask is this a good temperature. If he says yes then try do you want to wash your face or shall I and then if he goes along with that just carry on like he had never refused, asking at each step do you want to wash this bit or shall I.

Good luck!

This may not solve intimate care issues right now but I remember when my Dad was in a care home, you could buy a waterless wash. So if you are desperate, at least you can try to keep him clean without the battle of trying to actually bathe him.
It’s a wicked disease for all involved.

One more sorry, I want to see if I can beat my personal best of getting a wash done in x minutes or I bet you I can get your wash done by the time we have finished singing whatever sing.

My dad has Alzheimer’s and has been living with me for 18 months now. He will not wash, change his clothes, brush his teeth or do anything for himself unless I am physically there to “make” him - I’ve had to develop a sort of brisk, cheerful but no-nonsense tone which sweeps him along, though he will pout and grumble and make remarks that would upset me if I let them. We’ve had a few horrible soiling incidents which are awful for all of us but I try to keep in mind that it’s much worse for him than it is for me, and I just try to deal with it quickly and as discreetly as possible and move on.

It’s a learning curve living with a dementia patient; for example, we only have one loo, so it’s imperative that Dad has his medication first, then the TV is switched off so he gets the idea that it’s time to go to bed and goes up first. If one of us goes first and the bathroom is occupied when he goes up, he pisses out of his bedroom window all over the doorstep and front door. I am very worried about how things are going to go as this disease progresses, I admit, but we can only take it one day at a time. I use a lot of “signalling” when I need him to do something - tv off and lights down means it’s bedtime, switching the shower on for him and giving him a towel means have a shower. It’s less confronting than just telling him to do stuff, and I always give him a bit of time to get used to the demand and overcome his resistance (he’s also autistic) 😆

They might not straight away, which is why a short stay might be a good option at first. But a good care home should have staff who understand this issue and can deploy a range of tactics and equipment. It is certainly something to discuss with them. I will be honest, in my experience this was just the first of many things that got more difficult so you may also want to explore how care home options handle increasing levels of the more challenging aspects of dementia.

Everyone's dementia journey is different, but in our case there aas increasing aggression the more the loved one receieved personal care.

FIL won’t allow the carers in, wont wash, shits and pisses everywhere. How have you PPs managed to get your relatives into a care home?

Have they had a Care Needs assessment @Halloweeeeeeeeenand were one of you present?

I would recommend starting your own thread though in the Elderly Parents section. They are usually a supportive and informative bunch in there

Would he tolerate a foam cleanser ?
When I was a nurse working in Dementia care we used to often use a cleaning foam called clinisan, to clean our patients.

Yes there’s a care team involved plus adult social services etc, he has a care plan at home but rejects them and is aggressive. They say we can’t move him to a home against his wishes.

Having cared for parent and PIL with dementia I sympathise.

Everyone’s experience is different. But in the end I accepted that dementia is part of the dying process. If someone with dementia gets an infection because they refuse to wash that is also part of the dying process. If they fall down and break a hip because they refuse to go into a care home that is part of the dying process. If they refuse to eat and drink that is also part of the dying process.

We try to preserve and lengthen these lives because we love the person and we are distressed by the changes this disease brings about. But in the end that is futile. We have to accept that the person we knew is fading away and will leave us.

This was also the trigger for my DM, I knew if she could see herself as she was she would want to be clean and smell nice.

So are you doing all of the care? If so, unfortunately the system causes us to make tough choices.

You can carry on until there is a crisis which necessitates a Hospital admission and then insist that he is not discharged to your care but instead assessed for his care needs.

You can call his SW and say that you’ve had enough and after 31st December you will no longer be providing care. Expect some guilt tripping from said SW.

You can see if he will agree to going into a home for a week for respite.

I’m sure though that other MNers will probably have other suggestions

I found my DM’s nursing home brilliant, that do a change face thing where if a carer has no luck getting my DM in the shower they’ll wait a bit and send someone else in. This usually works really well.