Have we reached the point of residential care?

[ResidentialCare]

FIL 90, diagnosed with Alzheimer's and living alone. He used to wash himself, but no longer does. Carers attend every morning, but FIL point blank refuses to allow them to help him wash. He does have a step in shower, but cannot get in and out safely. It would therefore be a strip wash at the bathroom sink we are hoping for carers to help with.
DH has gone over to try and encourage his Dad to agree to help with personal care, but FIL point blank refused to wash. He is having another go this weekend, to see if he can persuade him.
I don't think that FIL has had a wash for about 6 months. The carers ensure he at least puts clean clothes on. We are worried about possible skin infections FIL is likely to develop if he never washes.
My question is have we reached the point where residential care would be better for him? The carers can't tie him down and make him wash in his own home. They have done their best to persuade/cajole him to wash, but so far have been unsuccessful.
Presumable in a care home, the carers would be able to ensure that he has a wash?
Thanks in advance for any advice.

How would the carer’s be able to wash him in a different setting? They cannot force people. I wouldn’t even mention the bath. Just get the basin of hot water and flannels set up and lead him into bathroom talking about something else. Muscle memory may kick in and he will automatically have a wash.

I sympathise - my mother similarly refuses to be washed by her carers much of the time, although they do manage to cajole her from time to time.

I personally doubt that being in a residential home would make much/any difference - the carers there would still expect residents to be washing and dressing themselves if able to and would probably have even less 1-1 time to persuade reluctant individuals to be washed and to do it for them if they are physically capable of doing it themselves.

Carers sorry plural so no apostrophe

Excellent idea to try. Thank you so much!

I wonder if a nursing home would be suitable then? Presumably they would carry out personal care rather than giving the person the option to decline?

I’m an elderly nurse and this isn’t really how it works. If they have capacity they can’t be forced. Even without capacity we can’t really force washing if they’re lashing out and it’s causing them distress, we can’t try in best interests if they don’t have capacity however but any distress and lashing out and we’d leave it to try again later. They would need a nursing need to be in a nursing home rather than residential with medical needs that can’t be met by a residential setting

My dad eventually allowed help with washing IF AND ONLY IF the carer was male. The male carer took my dad his meals for a few days, then progressed to help him shave and finally helped him into the shower, then out of shower when dad called that he was ready. Took about three weeks to build the rapport.

This is quite a common problem with elderly people but I can see why you are worried about possible infection. I've heard that even in care homes if a resident doesn't want to shower they aren't forced. Getting male carers is a good idea.

That is interesting. There aren’t any male carers going in at present. We could ask care agency if any are available.

That is interesting. Thank you for posting.

I very much hope that one of the ideas I have been given on the thread helps. Otherwise, I fear that there is no solution.

Yeah I hope you have some joy with it all! It’s so difficult isn’t it as we know they need a wash, skin already gets dry and vulnerable in old age and they are vulnerable to infection in broken skin, sores from incontinence but they don’t see it that way.

I do often think it must be scary for them when they don’t know what’s going on and someone comes towards them and tries to remove their clothes and wash them and many of them are so independently minded. I do agree with other posters though as some will say no but might not necessarily mean no, so in the meantime I would encourage with a bowl of soapy water and clean clothes which might help prompt him. If he absoloutely won’t, could wipes be a compromise for him for now to try and get him to use the wipes for a little freshen up? I know in hospital where I work if we’re met with a no, we do say how about hands and face and a quick freshen up of your bits so we can check pressure areas at the same time and they do often agree to that rather than a full wash

Do people actually get skin infections from not washing? Is he able to toilet and wipe himself ok? I understand that he may well get very smelly, but I’m not sure that is a health issue 🤷‍♀️

does he wash his hands after using the toilet?

have you asked why he doesn’t want to wash / take a shower?

i agree it’s frustrating (FIL is a bit the same and in the same situation) but I don’t think it’s a trigger for residential care in itself.

It's worth trying the suggestions above. A male carer is a good idea if one is available.

If you do consider a care home, your dad has dementia so he needs a dementia care home. My mother was in a dementia care home for years and the carers definitely didn't expect the residents to wash themselves. They helped them wash, brush their teeth, brush their hair, dress them (as necessary). And they were good at getting residents to do things they didn't want to do through perseverance and humour. They have the advantage of being on site constantly, rather than having to get the task done within a short visit.

The other issue at home is that he will have to have a strip wash. Whereas a care home will have bathrooms set up specifically for those with severe mobility problems so it would be a more comfortable experience.

Do people actually get skin infections from not washing? Is he able to toilet and wipe himself ok?

Yes, they can. Poor hygiene puts them at risk of UTIs and their skin can be tissue thin and break down easily if it's not washed and creamed and bacteria can enter causing infections. By that age their immune systems arent great either, add in dehydration and it can cause quite serious illness.

I think trying to arrange a male carer is a good suggestion to try.

Dementia is terrible. Sorry for your fil and family 💐

Yes wasnt there some massive investigation some time ago into a care home where peopl ewere being neglected and they died from skin sores, that might have been a combination of it all of course, not turning over, not getting up and not being washed. Cant remember what it was called.