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We increased my mother's aricept and I think now she is more argumentative and harder to get along with. The taking of a shower is still a big issue and today she said she wanted to bathe at night before bed. So we are going to give this a go. I asked the Care Director what would happen if she refused for weeks and she said if it became a health issue it would be a problem. Can they move her?

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Please don't beat yourself up over this, gingersmomma. Don't argue with her, you won't ever get the last word - it's part of the disease. Walk away and know that in a short while she will have forgotten all about it. She doesn't really need a shower every evening - a simple chair wash up will suffice. Stay out of the room while the aides are doing it - she will lash out at you; if she does it to the aides, they know how to handle such things - they are trained - as long as you know they are being kind, respectful and gentle with her. My husband sometimes was agitated and argumentative too, but it was all forgotten after he was shaved and dressed. He did not remember being upset. You are doing the best you can, believe me. It is not easy to watch and stand by while a person you love deteriorates. Perhaps it is time for a calming medication like Lorazipam (spelling) or something similar - talk to her doctor. The stages of dementia/Alz. are varied with each person - there are no two alike. If you have time, please read "The 36 Hour Day" found in any library. Also, check out any other books that deal with memory loss, you'll find several good ones written by people who have experienced it with a spouse or loved one. Blessings and prayers, you are doing what you can, but don't stress yourself out over this horrible disease that ravages millions of people. You need your strength, I've been there and it is exhausting.
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I originally posted the question about showering. I moved Momma to the evening schedule for a shower and have been happy with the aides that are working with her. Most of all I want to say that the arguing with her is just not worth it. I went home stressed, mad. She was upset with me, called me names and all I did was upset her over a shower. Still working on it but in a different manner.
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As a retired hairdresser, I often had clients from assisted Living Facilities or Nursing Homes, who came in periodically to get their hair done. And yes, I saw it all....! From heads that had layers of sebum buildup ( oil secreted from your pores), to open sores!! All of the clients were mostly in their late 80's & 90's. I tried many things so they did not get water in their ears, when I finally came up with a solution! I used 2 small foam coffee cups...cut them down to a little less than half and placed them over the ears while I shampooed! I would then ask my clients to help hold them in place. The clients were so thankful...they kept their ears dry and felt good that they were able to help me in the process. There is not enough empathy these days, especially in the " Care Giver " field, at least from what I have observed. What little effort you can put forth is all our elders get, 90% of the time, in most of this countries care facilities. What a shame we are so intolerant of our aged....just remember, everyone will be there one day.....! Maybe this will offer a hint on what can be done for the ' water in the ears" comment. God Bless
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gingersmomma, I went back and read your original post. I had missed the part about increasing her Aricept. If you google Aricept, you will find some interesting facts about side effects of that drug. My husband was on it for almost 5 years and I did not ever see anything good come of it. His Alz. continued to progress and we (his doctor and us) agreed to take him off of it. I would suggest to you that there may be another medication that will help her instead of Aricept. If she is anxious about herself, talk to her doctor and see if there is something else. Aricept is over rated and expensive. Just my opinion and others might have a different take on it, but it is only a suggestion. Blessings on caring and loving your Mom. Be sure to tell her you love her and hold her hand - that is most comforting to someone who has trouble remembering and is aware of it, making her more afraid and anxious.
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ConvaTec Inc., Skillman, NJ 08558, makes a cleansing foam 1 bathe and cleanse, multi-purpose perineal cleanser, body wash, shampoo, no rinse, pH balanced, cost is about $9-$11 for 8 fl oz. You can get it online, but many pharmacies sell it; don't buy a company brand i.e. Walgreens, CVS, Target or Wal-Mart, as they can order this one for you. Many hospitals use it. It is wonderful, gentle and soothing; you can put it on a damp warm washcloth and no rinse unless you want to or if the patient will let you. Again, maintaining the patient's dignity is the most important thing when bathing, even a chair bath. Be sure the room is warm and you have warm towels or a blanket to keep them covered. I wrote before that my husband did not like to be wet and showering or a bath in a bath tub was out of the question for him as his ALZ. progressed; he did well with a chair bath most of the time. I wish I could still be caregiving for him, but he died in July. This site is great for passing along helpful hints and I hope this one helps all of you who are caregiving. Tell the person who you are taking care of that you love them - every chance you get. Blessings.
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sharynmarie-- you are absolutely right! Once a week is all that is necessary for an inactive elderly person. Their skin is dry and paper thin and as you say they rarely perspire unless they are morbidly obese. As my mum's live-in caregiver, I give her a hot soapy chair bath once a week as that is all she will agree to, I wash her hair on a separate day because doing it all on the same day is too much for her. I soak her feet on yet another day and I have the foot care LPN come to the house every 8 weeks to cut her toenails, deal with any callouses and give her a foot massage.
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Something else comes to mind after my previous answer - - modesty. It may be SO embarrassing and humiliating for them to have someone in attendance as they bathe or shower that they refuse. These are people of a different era and modesty was a HUGE issue. It's all good and well to justify this or dismiss it, but that violates their RIGHT to dignity. Why not set up a tub of water for them to use alone and by themselves, with the bell for help close by if needed? Too many med workers have no clue about such issues and personal intimacy rights and needs. I honestly ACTUALLY had one IDIOT tech assistant remove a bloody sanitary pad from me for a test and place it at my feet - - uncovered and all displayed for the doc and all about to view. When I checked her on it, she got huffy and dismissive, as if I were just being difficult. Unfortunately such dismissive and degrading insensitivity is too damn common in medicine today.
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For the elderly, their skin can be very frail. Because they are not actively sweating, a bath once a week is what is recommended. In between a bath, use the pre-moisten disposable bath clothes. Most elderly will have thin, dry and frail skin. Bathing daily can damage their skin setting them up for skins sores.
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Get her off the extra meds!! I just asked the doctor to stop increasing mom's dementia meds and he oblidged- Half the time it is looked at "experimenting". I just want her to pass through this agitated paranoid phase of the disease. She's old, and will die and forgetting a bit more won't hurt when side effects outweigh the benefits.
Mom had to go on Assisted living status mainly to regulate her meds but still lives in a senior apt wing with my dad. She obsesses about not liking the baths they take her to even though they call it a "spa"- They leave the door open, people walk by and look in, so she says. I ask her to shower when I visit and ask Dad to do the same. Got her nice soap and lotions and cloths and a fluffy robe to sink into when she finished. Seemed to help.
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PS:
I have been told all my life not to get any water in my ears, as I am prone to infections and am now deaf in one ear and still must guard against infection, but every time some idiot INSISTS they will help me wash my hair and not get any water in them, the VERY FIRST thing they do is pour a bunch of water right into them. I think if I EVER end up in some facility (which I doubt, as they will likely kill me within days by ignoring my food allergies), I will just shave my head and keep it that way.

"Nothing in the world is more dangerous than sincere ignorance and conscientious stupidity."
-Martin Luther King, Jr.
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Just wondering, has anyone ASKED her why she doesn't want to shower? Falling water on aging skin can be painful. Baths are healing, but are (lately) too hard to come by. It's like a joke, go in shower, get "Beat on" by slamming water from shower, or sprayed in face by too highly-mounted jets, or hurt wrist trying to control handheld with a mind of its own, or even claustrophobic in some tiny little closet shower hole with no room to wash without slamming arms into the wall. When will all these "Senior" places wise up. Step-in baths are now readily available, but . . . ..

I was once in a hospital where I begged for a bath and they looked at me like I was nuts. This was a teaching hospital, for God's sake and they thought I was nuts for wanting a bath over a shower.
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My husband with ALZ. did not want to be wet - he did not like having his head washed. So...we did a chair bath 3x's a week with the help of our Hospice CNA. It worked, sometimes easier than others, but I prepared him for the time. There is something about dementia/Alz. patients they fear being wet. It also makes them feel cold which is another thing that makes them uncomfortable. It is a puzzlement, but we were able to make it work because we were careful, loving and respectful of their dignity, most important of all. Bless you for caring.
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If the refusal is part of being disoriented that is one problem. However, bathing/showering the fragile elderly takes time, planning, proper equipment in the bathroom and lots of preplanning to eliminate all barriers to a safe trip in and out of the bathroom and shower. Perhaps she has a fear of falling or being dropped in the bathroom or shower? I would observe the process on who they attempt to administer the shower. Also hospitals are known for rushing the process which does work after age 85.
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In my opinion, I think a bath once a week is unacceptable. I think it's the assisted living or nursing home facility's job to figure out what is the best trigger or method to get a resident bathed. Recently, my husband, with Stage 6 dementia, was an inpatient in a pretty good nursing home/rehab center for two weeks. He refused to let them bathe him so I did it. I didn't press the issue because I was going there every day for several hours anyway - and I knew he would be coming home soon. But the nurses and aides in the facility really didn't try very hard. They have a one size fits all mentality and if the patient doesn't respond to their initial efforts, they give up. It's really unacceptable. My husband resists mightily every other day during bath time, but cleanliness is not an area where I'm willing to compromise. It took some time, but I figured out how and when he would respond the best, so why can't the facility do the same. I think a bath twice a week in a facility should be the absolute minimum. Everyone is different and as dementia progresses, the facility just needs to figure each resident out as to the best way to get them bathed. If they can't, they may be in the wrong business because this is a common issue with dementia/Alzheimer's and elderly patients.
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Believe it or not I had okay success when getting up first thing early in morning and using getting ready for work to take a shower while Mom was a bit disoriented. It was part of her everyday routine before the disease progressed. Some how latent memories helped. As it further progresses, this will not work. It was alot more difficult being male and her son to do this. Usually someone will have to take the lead for this activity. They will not do it on their own as the progression goes longer. Did not see benefits of extra pills, had issues with reactions and "new" issues during medication changes/increases.
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Nursing homes schedule a bath once a week. Going longer will result in nasty skin fungus. Assisted Living will, for the good health of others, suggest a "higher level of care" which means nursing home. Discuss her changing moods with her Neurologist and he may rotate to another medication or add one on.
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It's not likely to be a health issue for quite awhile, but I'd say bathe here whenever she's cooperative. Make it as pleasant as possible (temperature, relaxed atmosphere). Also, there are good wipes and dry shampoos that spray on so she can be freshened up.

As far as can they move her because of that, I suppose they can, but it may depend on where you live. You can check with the long-term care ombudsman for that area at ltcombudsman.org. Type in the AL Zip code. These people are experts on such topics.

Take care,
Carol
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