My mother in law has early stage dementia and has live-in care provided by my brother-in-law. He knows she's not bathing as she should, but as a son, he's uncomfortable bringing it up or providing assistance, if that's what she needs. We're considering hiring a female aide to come part-time to get her to shower, and also provide some respite for him.
Does anyone have advice on how to address this with her? She is in complete denial of her memory issues; says she's driving, socially active, physically active, but none of that is true.
Dementia patients, don't remember if they did or didn't shower , when you ask, to not stress them out , it's best to not ask them questions, or explain to her, the need to shower.
That's my opinion and experience anyways.
💕🫂
Good luck.
Your BIL should hire a part time female aide who's got experience showering an elder suffering from dementia. I stress the word experience because it's very important. You need a woman who's got moxy, not a timid little thing who can't handle the job. This aide will also give your BIL respite and get MIL showered 2x a week. He can introduce her as a friend who's coming by to hang out if MIL is opposed to help. My mother insisted there was nothing at all wrong with her, and that SHE could help ME, until the day she died with advanced dementia and in a wheelchair at 95, speaking of anosognosia. But she loved "her girls" in Memory Care and would do whatever they asked her to do.
The shower thing can get tricky bc oftentimes the elder is afraid of something. In Mom's case it was "the slippery shower floor" which wasn't slippery but you don't argue with a broken mind. So we tried this that and the other thing which didn't work until the thought Water Shoes popped into my mind like a gift from God. They worked perfectly. You have to be very creative when dementia is at play. Some are afraid of mirrors and a towel must be put up over them. "Strangers" are in mirrors bc they don't recognize themselves sometimes.
Wishing you the best of luck with all of this.
My daddy-I had an aid come in A because my daddy was 6'2" and 250LBS and willful! But also, I am a female, his daughter and I felt that he needed that privacy. My brothers were not able to assist at that time. After I had him in a facility then the aids at the facility would just go in and he had no resistance to a shower.
I think because they approached it as -- ok this is what we are doing now no asking if they want it.
I also have a neighbor who has ALZ and I assist her caregiver with bathing and other chores. When its bathing time her caregiver gets everything ready and uses the words "let"s" or "time to do A, B, C".
My mom didn't bathe for months before we brought in caregivers. Even then we didn't know how to proceed. As her daughter she refused my help.
But the caregivers get the job done. Perhaps when interviewing, you could express your concerns, and hire someone who has experience in dementia patients who don't wish to bathe.
Hire a CNA/caregiver. Then tell your mother that because she refuses to bathe, shower, or wash-up her doctor is sending a nurse to come and do this with her. If she refuses, the doctor will have her admitted to the hospital and she will be moved to a nursing home from there.
Before the homecare CNA arrives, make sure they know to refer to themselves as 'the nurse sent by Dr. (your mother's doctor's name) to give her a shower and do skincare'. If the CNA is wearing scrubs and looks official, you should be okay.
Also, your brother-in-law is NOT providing live-in care if hecan't even bring up the issue of hygiene and washing in discussion with his mother. He needs to get over himself and his nonsense.
Never has a woman been given a free pass on the gross parts of caregiving due to their sex. The same should damn well apply to men as well.
Yes, hire a caregiver to come in 2 or 3 times a week. Give MIL a bath, or shower and personal grooming. that said....
If BIL is supposed to be a live in caregiver for his mom he should step up and be a caregiver. We don't pick and chose who we give care to. If he is uncomfortable giving his mom a bath or shower is he cleaning her after she toilets? Is he making sure that she is cleaning herself if she is still getting herself to the bathroom? If she is incontinent is he changing her soiled briefs and clothes and cleaning her after? If not who is?
If MIL is still able to shower herself, and she may be afraid to get into the shower. I suggest that you remove the shower doors (if they are the sliding kind) and put up a shower curtain. Put in a shower bench and then she can sit and be safer. He can remain behind the closed curtain but still monitor her. (I used a mirror to monitor my husband for a while until I had to take over fully)
The few days a week that the caregiver comes in is perfect for Respite for BIL.
I have CNA's that do hygiene visits only and the visit may take up to 2 hours. If the CNA gets it done before the two hour time limit, they are instructed to leave. They are paid what the pay is for a hygiene visit. The client pays a flat fee for it too even if it takes less than two hours. The hygiene CNA's are not there to visit, or to do housekeeping, or to elder-sitting. They are in the home for one reason only.
I find that this model works so well.
Wow. I'm sure your system works very well for your agency. Flat rate paid by family that would cover up to 2 hours of hygiene care for their loved one.
Not having the CNA coax or argue the patient into anything. Leaving when done if under 2 hours. If patient refuses hygiene care, as you said "that's it". But I'm sure the flat fee is still paid for their time there.
I absolutely know what I'm talking about when it comes to my husband's care. And that's what matters to me. He is bed-bound with Parkinson's Disease. His body is stiff and painful, even with appropriate medication. He has some cognitive issues. But he is a human being who is very loved by family. His aid is able to give him gentle care and still get his hygiene completed in under 2 hours.
Burnt, this is all I will say about this because you always want to be right and have the last word. So complain all you want, and throw in my face your 25 years of experience. I don't care.
I'd rather have 1 caregiver who possibly had less experience but who understands my husband is my loved one and that he needs to still be treated with respect and dignity. People who hire aids for their loved ones know it's through a business who needs to make $$$. But if the family could perform these tasks for their loved ones, with the care and dignity deserved, they would. Sometimes the family member is no longer the person who can best coax the patient into tasks they don't like. I wish I was still physically capable of doing my husband's hygiene tasks. I wish he would allow me to do them the way he allows our hired caregiver. But that's not the case. I thank God his caregiver is kind and gentle and will coax when needed. I just thank God for it.
"There but for the grace of God go I".
I understand the issues you present with tub baths. And yes, showers or bed baths may be safer for a patient. My husband has bed baths because he is bed-bound. But I have purchased body wash that lathers well and has a mild fragrance that is soothing to him without negatively affecting his skin.
I don't expect it to be a spa experience, but if the experience can be gentle and caring in any way, that's what I hope for.
I don't think it matters. Hire an aide to come weekly to help with bathing.
You've been considering this, so you already know that it is the next step. Just do it. Add some caregiving hours for respite. It would be great for the live in brother-in-law to get a break.
And, don't bother trying to re-connect her to reality that she no longer understands.