Our Ma has Alzheimer's and dementia, but she's also 89yo and up until recently, was able to do most things for herself when it came to toilet use, but recently on occasion it seems impossible to get her to clean/wipe herself well enough, so I help her. Hubby (& it's his actual Ma) thinks I might be making her less independent by this. When is it time to step in and over their (Ma & hubby's) embarassment in the name of cleanliness & good hygeine? & Any suggestions on how to soften the blows of all this sort of negative/gross-but-real talk?? Any advice is greatly appreciated
We have used Brondell for years.
Zero UTI since 2015.
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Use sopping terrycloth washcloths. We use a cloth corner to corner draw from front to back, both groins. Then a fresh cloth for the center.
Always check for fecal smear at the backdoor. Sometimes there is stuff at the door and it is uncomfortable as well as full of bacteria. It also indicates bowel distress.
(The bidet also helps stimulate the gate, when you have a stubborn one)
No underwear. no briefs. Long dresses and nightshirts.
Sit and sleep on washable bedpads covered with cotton sheet.
She can be allowed and encouraged to participate in any/all activities, the more the better, even if it takes a long time or isn't done to perfection (includes needing a do-over later, when she isn't around to see it.) Keeping her active and busy is good and will help make her feel independent, useful and preserve some dignity.
You're living it, you know her abilities. Use your common sense and good judgement to make the right choice for everyone. If they don’t like it, invite them to step in and handle it. All. Not pick and choose. All. You’d be surprised how quickly they decide you probably know what’s best ;-)
Best of luck!
I don't think it is speeding up her dementia, but I do know that they will lose remembered skills over time if they do not use them. Some of it is just the eventual progress of the disease. The loss of brain function and things fall away bit by bit like losing puzzle pieces.
If she is struggling with something by all means help her, don't just let her struggle and get frustrated. If it is anything to do with cleanliness or hygiene you really must help if they can't do it themselves. When I have to do things like this for my mom I try to make it as "clinical," for lack of a better word as I can. Meaning I try to behave as if I were a health professional taking care of something for her. No, not cold or brusk, but I just try to get it done in the most compassionate and efficient way possible. That seems to ease at least some of the embarrassment. Over time that embarrassment will go away.
Offer to step in if you sense she needs help because she is struggling and/or getting frustrated with a task, but offer and wait for response, don't just take over. The only real exception is probably the bathroom issue and that is mainly for hygiene purposes - who needs to deal with UTI and all the fun that goes with it?!?!?! She still has independence to get to the bathroom and do her biz, just needs a little assistance cleaning up.
Hubby needs to understand that female "plumbing" is very different and if clean up is not done properly, the results will be difficult or worse! I would as nicely and discreetly as possible continue to help Ma with bathroom cleanup.
(bidets and wipes may be nice, but those with dementia might not grasp the bidet or even if they remember to use the wipes, they may not remember to not flush the wipes!)
Ignore husbands comments. Her brain is breaking. As it breaks she will no longer able to do things anymore. Just like car. The more parts that break, the car is no longer able to work like it used to. Broke is broke.
Do keep her brain active and have her do things she can for as long as possible.
Now please go watch Teepa. 😊
You can also get a bidet (seat/water that installs on any commode - take the old seat off and replace it with bidet unit) and they work pretty well IF she is willing to use it. Check out the Brondell bidets
Betty
I want to take a moment to say how much I admire what you did for your husband. I wasn't always so patient with my dear hubby (he passed away last June) and I regret it to this day. Can't take it back now, but I wish I could have had the patience and grace you had with your husband. God bless you!
My mother’s doctor and nurses have always stressed the importance of good hygiene. You are stating an important message to the OP. Thanks for sharing your experience. Sorry about your stepdad. Hugs!
My mom doesn’t have dementia but does have a neurological disease, Parkinson’s disease and she needs help bathing and help with other things too.
When she had home health her occupational therapist and physical therapist, plus her nurse told me after her evaluations what she was capable of doing on her own and did instruct me to back off because physical movements are important and if she stopped all movements that she would lose muscle mass.
So from a physical point of view don’t do things for her what she is capable of doing on her own.
We get so used to doing for them we go on autopilot and don't even realize it.
Plus in my mom’s case with Parkinson’s disease, her movements are so slow and rigid that it was quicker if I did it myself which wasn’t the best thing for mom, kind of like allowing a child to grow to do things for themselves. It is necessary for a child to learn to do things in order to grow and become independent. Well, it’s necessary for the elderly so they won’t lose muscle mass.
For Christy, we have to rely on the sound of the water spray hitting crevices, but she is always clean.
A wipe with a dampened terry washcloth reveals no residue.
Terry washcloths go into a proper bleach solution to be washed.
Toilet paper just spreads bacteria.
Your finger might tear through toilet paper
I had to use wipes when I was in the hospital. Why do we do that?
I started having the nurses leave a stack of terry cloths near the toilet.
A wet terry cloth would be better for everyone and plumbing.
Christy has not had a hint of UTI since 2015
The bidet spray also can stimulate the anus to release stubborn turds.
https://www.brondell.com/bidets/bidet-toilet-seats/
Prior to my Mom getting dementia she always cleaned up after herself, now she's simply not aware of the messes she makes (including her sheets).
Right now my Mom does walk into the kitchen to get herself a piece of cake and either water or apple juice. I help her when she really needs it then there are times when I ask her if she could get what she wants by herself (tasks that I know she is capable of doing).
The only problem I have been having with her hygiene is getting her to take a bath (she hates showers). And the reason is because she wants to take a bath herself without my help which is too dangerous (I know she hates depending on me for everything as she has expressed to me that she is losing control of her life). I tell her that I do not want her to fall down and end up in the hospital and she's happy with that explanation.
Doing things for our parents has nothing to do with speeding up the progression of Alzheimer's or dementia IMO.
Not just toileting but any activity. I’ve concluded that for a given situation or activity there are 3 points in time: 1 when the potential problem is first observed, 2 when intervention MUST be performed, 3 an intermediate area where intervention should occur.
I think of it in terms of stress. If the problem is let go till it must be alleviated the stress builds up and gets absorbed over all that time. I visualize a straight line curve of stress vs time and the stress absorbed equals the area under that curve. If the problem is resolved at some intermediate point then the curve is shortened and the absorbed stress is much much less. Multiply all that times the number of problems = total stress you absorb during your care giving career. Less is best, right?
The observation is one point on the plot (Initial point); the must point is also one point on that plot (End point); The should position is variable ie has finite length. So the intervention may be a bit too soon or a bit too late for one particular problem but the goal (mine) is to outlast the whole thing by minimizing the total absorbed stress over time. Selfish? Not really because if you lose it it’s all over for both the care giver and the care givee.
Cleaning up bowel movements is very important for avoiding UTIs, and there are lots of posts about it. They include using wipes (which can do a better job than toilet paper, but please don’t put them in the plumbing as they cause fatbergs), and a whole range of bidet-type attachments for the toilet. You might even find it worth the expense of getting a real bidet – I love mine, partly for this reason. If you click on ‘care topics’ on the top right of the screen, you will get an alphabetic list. Scroll down to Toileting, and you should find lots of suggestions that might help.
Good luck, and please say to Ma that at age 71 it is an issue for me too. It's just something to cope with as our bodies get older.
You can't let her hygiene go, that is one of the 1st things that suffers with dementia.
Help her do everything she can to the best of her ability and then step in to ensure cleanliness and hygiene are good. Tell hubby that UTIs are a nasty result of bad bathroom hygiene and it is easier to deal with a clean up then a nutted out system full of infection that can be deadly.