I took dad out of independent living and into my home to care for him since he has frontal lobe dementia. I'm not ready to place him anywhere, I want to care for him as much as possible.
I just found although he showers every other day, he's not using the bodywash I provided nor the hand soap after he uses the toilet. I am sensing his frustration and animosity when I try getting him to do so. How can I alleviate him feeling this way? Do I need to suggest assistance? He isn't one to ask for help, or notify me if he needs help. I find out through his o.t. or p.t. people.
Part of dementia is the loss of the ability to do the ADL's (Activities of Daily Living) that we all do.
Hygiene, toileting, dressing is all part of this.
You can't "get him" to do something that he has lost the ability to do at all or properly.
You say he does not use the body soap when showering...does he shower properly or at all?
You say he does not use the hand soap after toileting...does he clean himself properly after toileting?
When we say "oh, I'm going to take a shower" it is an easy process for us. But to someone with dementia there are a LOT of steps to that simple task.
Undressing, getting the items you need (towels, soap, clothes...) now getting undressed, getting the water temperature right, getting wet, wetting the washcloth, putting soap on it....all this and we have just begun. Now you add fear to all this...what if I slip and fall, the loud noise, the water beating on my face and head, what do I do next....
He won't ask for help because he does not realize he needs it.
Don't suggest assistance just help. If you do not personally want to help him with his personal hygiene then you need a caregiver that will help him. But you will have to step in when the caregiver is gone.
It’s not that you need to learn how to get him to clean up. It’s more that you need to accept that he won’t be getting better, learning new skills or trying harder. And it’s pretty normal for them to resent someone telling them what to do. They have control of very little.
I changed linens more often, sheets, towels, throws. Used Clorox wipes often or Lysol on door knobs, light switches, telephone, tables, coffee pot, appliance handles, faucets, anything he touches, doesn’t take long and keeps things clean.
Offer a wet, warm wash cloth lightly soaped when he sits down to eat for him to wash his hands. Keep his nails clean. Remember he is going backwards, forgetting, not learning new skills. Gentle touch, soft voice.
Don’t talk about the cleaning, just do it while you talk about something else that interests him…like dessert.
If he has traditional Medicare with part B you could probably get home health. He would be considered home bound at this point. You will have to let the nurse do something for him like set up his pills, as an example. As long as she is seeing him then she can also order a cna to bath him or help him with his bath a couple of times a week. You may have this already since you mentioned pt/ot.
My family members who had this had CNAs who would also change their bed linens, help them dress etc.
Also watch his diet to prevent problems with his bowels.
Hygiene issues and incontinence are in the future of most dementia patients though there are some exceptions. It just depends on how the brain is affected.
Caring for dad at home is going to be a lot different than you thought it would be. He probably will never comply completely. He'll resist brushing teeth because he doesn't want to or doesn't remember how or doesn't know what his toothbrush is and he's afraid of it. These are things you need to know that you perhaps had no idea about before you took dad into your home.
Shaving will frighten him, his falling will produce injuries and blood that you'll be dealing with. He may forget what the toilet is and what it's for. He may throw things in the toilet because it fascinates him to do so. He might wrap up food and sneakily hide it around the house. He may eat things, like potpourri and toothpicks. Be wary and aware of everything every minute, 24/7.
He will at some point be unable to learn new things. Thus it's pointless to correct him, instruct him, or expect him to improve or change his ways. He won't respond to your anger except perhaps with his own anger. This may bring on physical repercussions toward you. Once that starts, it is abuse, and you'll have to do something to protect yourself because you won't know when he will do it again, or for what reason.
I wish you the best in what you're trying to do. Good luck.
He now is learning how to live with an adult child treating him like he's now the child.
How can you alleviate his feelings of frustration and animosity? Stop telling him how to wash his hands.
Place a bar of soap in the shower, along with a clean washcloth. He's of an older generation. He probably doesn't know what to do with the bodywash.
You ask if you need to suggest assistance. What kind of assistance are you envisioning? Someone to help him in the bathroom and help him wash his hands? If he has OT people coming in, THEY SHOULD BE ASSISTING WITH THIS. Or at least, Prompting. That is their job. If they see and report he is not washing properly, then what are they doing about it? If your dad is willing to accept it, he may need some help with showering. As people get older, and especially with dementia setting in, they become afraid of the shower, afraid of falling, afraid of the water spray, and what used to be simple becomes a huge chore for them. You can hire bath aides to come once or twice a week.
Oh, and you don't ASK dad if he needs assistance. You just provide it. If you ask, the answer will be "NO", and once said, he will stubbornly dig in his heels, leading you to argue about it with him. Avoid the argument, Just hire someone anyway.
Lastly, compromise your idea of cleanliness. This is one of the hardest things to manage when caring for an elder with dementia. It will get worse, and at some point you just have to accept that it is "good enough". Be glad he's getting in the shower every other day! If he sees a bar of soap, he may just use it!
I'm sorry about your dad's diagnosis. Do you know what variant of FTD he has?
1) Body wash in the shower – I have never used it in my life. Soap is more ‘normal’. If he drops it, soap-on-a-rope helps.
2) Soap after using the toilet – I wouldn’t use it after just a quick (now frequent!) wee. I would only wash my hands after wiping feces, which isn’t often, and even then just use soap if it was messy.
There are far worse hygiene problems, stop bothering so much.
As far washing his hands after using the bathroom, have him use a pump of hand sanitizer instead. Or let it go. Pick your battles, in other words. Folks with dementia being aggravated or agitated all the time is a recipe for disaster. If you're going to care for dad at home long term, I think you'll have to make some concessions vs. getting dad upset all the time. Just my opinion, before anyone jumps down my throat.
Best of luck taking on this big job.
washing hands, brushing teeth, changing clothes — all the same story.
SteenaV — remember, he is going to continue to decline. You don’t know at what rate. But Whether that takes the form of active, obsessive resistance or passive resistance (or some combination) — it will get worse and no one and nothing can stop the decline. Sorry to be blunt, but it’s true.
And when a loved one has dementia you don't "suggest" anything, you just tell them what's going to be done.
Also you can use the extra large body wipes on your dad on the between shower days along with the waterless shampoo and conditioner caps for washing his hair to keep him good and clean.