Issue: Hygiene for a 70 yr old woman with two strokes and probable undiagnosed Autism or Schizophrenia.
My mother's hygiene is very poor -- if left alone, she will not wipe herself after peeing or pooping. I have recently taken her out of assisted living due to high cost, and plan on returning her back to her house with aides coming to visit twice a day for a couple hours each time.
My biggest concern with placing her back in her own home was her safety, but since she primarily watches TV and naps, I feel confident that she will be safe.
This cleanliness issue is my newest concern placing her back in her home, so my question is, what is acceptable regarding her hygiene? Since she does not wipe herself, and sometime uses her Depend as the toilet (at least with pee, sometimes poop), should I be concerned with this to the point that someone should be with her all the time to make sure she uses the bathroom correctly (so that is is always spotlessly clean)? She does not care at all if she has pee/poop on her as she will sit for hours and hours in this condition. I know this is not ideal, but we do not have the finances to afford an aide 24/7. Considering her care at assisted living, I do not see it as any different from how she lived there -- the staff only checked her diaper once, possibly twice, a day to see if it was clean. Otherwise, she, as well as the other residents, went about their day and relied on the diaper to keep the pee/poop contained until they got around to checking it again.
Is it okay to let her be in a soiled condition for 2-6 hours at a time between cleanings?
All advice is very much appreciated.
How much they would help in this situation is questionable. If the poor hygiene is consequence of poor balance or poor flexibility obstructing the reach around, then yes a preemptive bidet squirt helps reach spots that may be missed.
Bidets are also a welcome preemptive strike before a caregiver has to assist clean up.
In the case were someone as described is doing number one and two in diapers and sitting in it, I do not think they would be able or willing to go to the toilet/bidet.
Are they able to get to and enter (walker? Wheelchair?) the bathroom?
If they did, are they capable of changing and tossing the depends on their own?
Will they wash their hands?
This is one of the things insurance companies look to qualify for a ALF claim, because it is critical to quality of life.
I just just discovered an attachable bidet on this website under the Senior Care Products section (I went on Amazon, too, and saw at least 10 other similar models). It has me wondering if that could be the answer to my problem, so that she doesn't have to stretch her arm around to wipe with toilet paper. Anyone have experience with bidets?
Thanks!
What you are describing will likely result in rashes, sores and infections. This would not be acceptable in a facility, so I do not think it will work out.
I know you are making tough choices.
Good Luck
L
The question is, is that good enough?
She is not unusual in not being aware of/concerned about her dirty hands and general poor hygiene. This is pretty common for impaired elders. This is a health risk for her, and for others in contact with her. Being in a soiled disposable undie for hours risks skin problems and UTIs.
Is it possible that she really needs more supervision than assisted living includes? I don't know what her mental symptoms are that make you think she has something that hasn't been diagnosed yet. Would now be a good time to have a full evaluation and try to determine a diagnosis?
What is her financial status? What is her monthly income? What assets does she have (other than a car and house)? If she might qualify for Medicaid, start looking into that as soon as possible. Even if she doesn't need a nursing home yet, chances are very good she will at some point (and maybe that point is now). Even if she can get by with in-home care, Medicaid can cover that.
My heart really goes out to you, sahk1942. You really want to do what is best for Mother, within the financial constraints you have to deal with, and no "operator's manual" with guidelines for basic necessities. You are doing the best you can. Feel good about that, at least.
I hope others will have more specific hygiene guidelines for you.