My husband has been in an Alzheimers care facility for several months and refuses to cooperate with showers, shaving, toothbrushing, bedtime etc. a few times I have managed to shower him there, but he is very resistant to the efforts of all of us. There is a suggestion that we use a stronger anti anxiety med (he doesn't appear anxious or stressed, just wants to avoid the above and is threatning when approached.) I am troubled about stronger medication but maybe those of you who have had experience with similar symptoms could comment on your experiences. Thank you
My husband also resisted showers, shaving etc when he was in a care facility. In a couple of cases, the care aides were rough (has anyone seen the movie "Amour?"). When I learned the two aides who weren't rough, I arranged to have them take care of him whenever possible. I asked the facility to decrease his showers from 3 to 2 a week, and I went over on those evenings, had dinner with him, stayed close by while he was being showered (making sure the water was the temperature he liked and then took him back to his room and put him to bed. He liked to be read to until he was ready for sleep. I tried to make showers enjoyable by using the best shampoos and soaps I could buy and by warming up his clean nightclothes for after the shower. The odd time I couldn't make it and he fought them showering, I told them to let him go without. I arranged to have him shaved by the woman who ran the beauty salon at the facility. She was pretty, she liked to joke and she flirted with him. Teeth brushing: I had to help him become more cooperative because he was developing gum problems, and he wanted to avoid the dentist. In case you think it was a piece of cake, it wasn't. But we did manage to keep his skin and dental problems at a minimum. Once I wondered why my husband seemed to be staggering when I took him to dinner and asked if they had given him something. Turned out they had given him something in anticipation of problems in showering. (It was a PRN order left over from when he had been admitted several months before.) I phoned the doctor and got rid of that order pronto. (He'd already had a spontaneous compression fracture of his coccyx.)
My husband is not in a care facility but was resistant to anything I tried to do for him. He was on Risperidol which made him worse and then Seroquel which made him dopy for 6 or 7 hours and then back to arguing when it wore off. The Dr put him back on the antidepressant (Celexa) he was on last year and then added Abilify to the mix. That made all the difference in the world. We are into the 6th week he has been on it and he is now compliant with changing clothes and showering. I was lucky to get him in the shower once a week. Now we get 4 or 5 a week. I guess its a matter of getting the right combination.
some do better showering in the early morning after breakfast others may do good at midday or other before bedtime. its a challenge to find the right timing. if they are doing it at one time, try changing up the routine and times. in a facility i would think they could also do a couple bed baths without the shower which would suffice til a real once is needed. whatever works -hes clean and more content is more important than schedules.
Hi skates, my husband also refused care when he was first placed. For the first few months I was the only one he would let help him shower, which was so odd because at home it was a guarantee I would end up on the floor. Their poor minds..... you just never know what to expect. Divvi makes a good point, Lynn showers much better after breakfast than he does at night. He gets bed-bathes daily and a full shower only once a week. That was my call, he is bedbound, not like he is getting filthy.
If it were me I would talk to the neuro- psychiatrist. I am not a big fan of over medicating just to make their lives easier, but if he is afraid, I would want to help him be more comfortable. It's a tough call, one we all eventually seem to face. ((hugs))
skates--If personal care issues are the only problems, I wouldn't recommend a stronger med until all possible behavioral approaches have been explored. Mary75*'s description of all the creative approaches taken with her husband is a good one.
My experience has been: when I placed Steve, I told them that he does much better with personal care in the evenings. Consequently, that's when they shower him--two aides do it as a team. As far as shaving, the aide does it in the a.m. when he's on the toilet (so he doesn't run away). Since he doesn't cooperate with tooth brushing, the dentist advised me to use the little brush picks to clean his teeth, which I do on my daily visits. For some reason, he allows me to do this and it has helped his gums considerably. He is already on anti psychotic and anti depressant meds, but by using these approaches, they didn't need to be increased.
Another idea (Divvi, surprised you didn't mention this--candy) is to feed him--to the extent possible--as a distraction. Steve was recently fitted with a protective helmet and they fed him 3 bananas while successfully putting it on him and adjusting it for the first time :) Of course, this would only work if the person with dementia likes to eat!
haha. yes marilyn we have talked about the treats ie candy-cookies, etc as distractions on so many other threads! i thought everyone knew about that one.. but you are correct, the newer members may not have tried this terrific tactic. a candy bar to eat while showering them is fabulous if they are into sweets, *and it appears the AD monster just loves sugar! * i can just see your dear steve getting fitted while stuffing those bananas.! aww. the things we have to do to keep them safe. glad its working out for him now. divvi
skates, it's not unsusal that our spice (plural for spouse) are resistive to assistance with adls. Actually Rich has always been but has gotten worse. The last visit to the geri-pysch resulted in an addition to .5mgs of clonopin in the am to make him compliant. It actually did work but after1 week he started walking like an old man-hunched over, walking slowly) after his morning routine and even started having difficulty getting up/down from the couch. Since he never exhibited those behaviors before the morning clonopin, I stopped it entirely. He's slowly returning to his physical state he was before the morning clonopin. We just tough it through the morning adls, but he is home and we have a FT aide.