Elderly DDad with Dementia refusing to be washed

[surffs]

My elderly dad has dementia, still living at home with the help of my Dsis who move in temporarily to help but needs to leave to go back to her job/flat 30 miles away but is trapped at home with dad because the state of care my dad is getting is inadequate.

Dad also gets 3 care visits from council funded carers as he has no savings (but does own his own home)

The morning carer (male and shows absolutely no caring qualities or attributes that I would expect in a carer when I've seen him at my Dads) is supposed to help my dad get washed and dressed in the morning and give him breakfast and meds.

All the carer does is give my dad a cup of tea, yogurt/blueberries/banana (which is what my dad has for breakfast) in bed with his meds which he watches my dad take.
Carer then asks my dad if he wants to get up and washed/dressed, my dad says no I'll just stay her and eat my breakfast in bed.
Carer then writes in the file that Dad is refusing to get up and washed and dressed and leaves.
This care visit is 30 mins.
My dad doesn't get another care visit (15 mins) until supper time. Where they make him a sandwich and give him his tablets.

He gets himself to bed.

My dad is double incontinence btw and wears pads. Not always bowel incontinent - but a few times a week. Urine incontinence a few times a day (he had prostate cancer a few years ago which didn't help).

Because of the dementia he has no concept that his clothes/pad are dirty and how to change them or where to find the new clothes and pad.

How do I get the council/care agency to take responsibility?
I think is horrific my dad will just never be washed or helped change his pad etc.

Dad has a strong wish to stay in his home (my DM died at same home when she had terminal cancer, but she was supported by nurses and professionals and it was managed beautifully).

My siblings and I have LPA (both).

Does my dad qualify for CHC as he is 'refusing' to have his basic health needs met (changing soiled pads)?

I am so upset that my dad isn't getting basic care needs and I live over 100 miles away and can't offer much practical support (job/family).

My father-in-law also had a book that the carer signed daily. However there was a phone number in the book for the Manager of the care team. I would phone them telling them what you said here. 2 carer visits a day doesnt sound much either, my fil had 4. He didn’t want to get washed either and the carers told him if he didn’t get himself in the shower during their visit they would wash him. He didn’t fancy that and did wash more often. If you have any phone numbers from when he got an assessment of needs I would phone them as well.

How do you expect the carers to wash your dad if he doesn't co-operate with them? Genuine question. How would YOU wash him if he refused to have a wash? Sorry sounds goady but am genuinely bemused as to what you want the carer to do.

My mum has had carers on occasion and I do agree that some do not seem caring, some just want to come in do their job and go. If he is refusing the carets support in dressing they can't do anything.
I do understand your concerns as my mum is severely incontinent and changes her pads up to 4/5 times a day on average.
I think if he is refusing treatment but you want him dressed etc, your next stage is a home with specialist dementia care
Good luck

The carers cannot force your Dad to wash or be physically persuasive and rightly so.

However! Dementia carers have their own special way of cajoling their clients to get washed, dressed etc.
Arrange a meeting with the manager and ask if they have specific carers with experience of Dementia.
Also explain the current male carer isn't working out and you would like a different carer.
We had this issue (Ireland) changed providers to AMAZING Carers.
MIL hadn't washed in a year, once the new carers started she was washed 3 times a week.

I'm a carer in a dementia home and even we can not force someone to wash. However we don't ask if they need help washing, we fill the bowl up get the flannels etc and say come on let's freshen you up. If they refuse point-blank we cannot force, however some gentle cajoling usually works.
Maybe the carer could wash him before offering breakfast. Why make him a lovely breakfast and then ask if he wants to abandon it for a wash!
Ring whatever agency he is with and tell them this isn't good enough care.

I have worked as a carer (not for many years) and have worked with some lovely people with dementia in their own homes.

A cheery manner and interpersonal skills can achieve a lot of Co-operation from people with dementia.

I do get there are lots of clients that would not have worked with and I respected their right to choose.

My Dad is a very happy and cheerful man, despite his dementia (or maybe because of it) and not remotely uncooperative or difficult or violent.

If the carer actually wanted the wash to happen I have no doubt they can suggest it in a way that my Dad would understand and respect.

Eg on a Sunday:

"it's Sunday and you are going church in an hour and do you think it would be a good idea to have a quick wash and clean clothes so you already ready when your friends pick you up?"

I'm 100% sure my Dad would cooperate with cheerful and confident staff who have some understanding of how to talk to people.

You put in a complaint and ask for an early review as care package is not meeting his needs as some carers are not using dementia strategies to encourage him to accept personal care when he needs it (given he is incontinent and has dementia) and would likely accept it. There are people who decline it and cannot be cajoled but it sounds like your dad isn't one of them

You need those strategies documented in his provider (care agency) care plan
"He will tend to decline personal care but he requires a cheery and even outgoing suggestion for eg if you say 'let's get the shower on so it is warm or bring the bowl to you and I'll get your clothes ready we'll together get you ready for the day Mr Jones.. No it's no trouble Mr Jones as that's what I'm here for as you feel so much better when you are clean and in fresh clothes .." he will tend to agree."

Mistype I meant
But he requires a cheery and encouraging suggestion

Not '
but he requires a cheery and even outgoing suggestion'!

If agency has to do documented early review , or has a complaint to them that Carer D doesn't wash him, they will look into what is going on with Carer D and whether he needs better training or is short cutting dementia clients

If it doesn't resolve after contacting care agency senior or managers in first instance then put a complaint into adult social services or they are funding

• if they are funding

Why arent they getting him washed before they give him breakfast ? Seems logical to me.

Hello @ZekeZeke , I have a parent in Ireland getting older and looking for care. Can I ask what provider you changed to? I am very happy to be PMd if easier.

(apologies, I didn't want to derail thread and hope it was OK to post)

Hi,
MIL is based in Wicklow, the carers work for the local consortium in Bray.

Hi there,
My advice, the first port of call is the GP.

Ask them to contact the PHN for a care needs assessment (If one is required, if your parent is fit and healthy skip this step)
The PHN will determine if your parent is entitled to care.
All of this is free.
You then get to choose from a list of HSE providers in the area. You meet with the manager of the provider you choose. And you explain what you want assistance with.(dressing, washing, meal prep, light housework).
Also, meals on wheels-check the local service. They can deliver a meal 3/4 times a week for around €4. They are really nutritional

My exh is in a wheelchair, has a catheter & has carers 4 times a day, 45 mins at breakfast so they can shower him, help him dress & have breakfast, take meds, 15 mins lunch, take meds & tea, take meds, 30 mins bedtime to undress, have a drink, take meds & bed. He is lucky if they shower him once a week, the morning & bed carers are double ones with 2 carers. The care system is falling apart, ds often ends up helping him shower.

Thanks for this, @ZekeZeke - warmly appreciated, and sorry again for any derailment of the thread.