Can’t Remember How Many Days It Has Been Since Showering
When Mom was wearing her Thanksgiving dinner dress three days later , we had to keep reminding her that it had been so many days since the holiday.
One of the hard things about caring for an Alzheimers patient is to join them in the lack of time reference. Suggesting that it has been so many days since Thanksgiving really has no frame of reference when she resets about every 20 minutes.
Toilet Problems Continence And Dementia
Read our guide to toilet problems and incontinence, including causes, solutions and how this might affect a person with dementia.
Continence and using the toilet
Its common for people to have more difficulties using the toilet as they get older, particularly if they have dementia.
Accidents and incontinence can cause problems, especially as a persons condition progresses. This can be upsetting for the person with dementia and difficult when youre supporting them.
Many people find it difficult to talk about these issues. However, support is available. With the right help and advice, incontinence and toilet problems can be managed or sometimes prevented.
Why Won’t Alzheimers & Dementia Patients Take Showers
So first a little background about me I take a shower every day! I love showers and have washed myself everyday since I can remember. My shower is filled with pretty smelling soaps and gels oh and I get away from my 3 kids, 2 dogs, 2 cats and the turtle in there. It is my super special alone place.
Well, come to find out, many people, especially older people, don’t have that same feeling about a shower. My friend Tena D who is from South Dakota said they never took showers as children and there was only one bath day
Saturday night! They would fill the tub, everyone would hop in and out, warming the water occasionally and bam, clean for the week.
Come to think of it, my Mother, who died in her late 50s and who would have been 80 now did weekly bath thing she never showered.
Doh. No wonder Mom won’t take a shower she may have never showered before in her life.
Even though it would be SO MUCH EASIER, the thought of a shower is super foreign to her!
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What Health Problems Can It Cause
Not getting enough to eat or drink can lead to:
- Dehydration: To make sure they get enough fluids, give them drinks that are easy to drink and they like. Try flavored water, juices, sport drinks, lemonade, or Popsicles. Itâs common for people with advanced Alzheimerâs disease to stop drinking to the point of dehydration. This is often part of the process at the end of life. If your loved one gets dehydrated often or theyâre in the advanced stages of Alzheimerâs, you should have a plan about whether to use feeding tubes or an IV.
- Weight loss: This can be a sign of other problems, but if someone doesnât eat, this is the most likely cause. If your loved one has lost more than 5 pounds in a week or 10 pounds in a month, they should see a doctor. To help them keep weight on, skip low-fat or low-calorie foods. Serve high-calorie foods, like milkshakes, protein drinks, ice cream, and smoothies. If the weight loss continues, talk to their doctor.
Sponge Or Towel Baths
In the late stages of Alzheimers, a sponge or towel bath can be an excellent alternative to full baths. For someone who is still able to walk, sponge baths can be done in a plumbed lavatory or at a free standing basin of water. A shower chair can be placed in front of the basin or in a lavatory and a washcloth, soap, and towel made available.
If individuals are able to wash their own private parts, they should be encouraged to do so. If not, they can be seated on a shower chair and given assistance. Wear gloves and use a separate washcloth or sponge to wash the genital area, then pour clean water over the area. Be sure to tell them what you are doing, seeking permission just as for any other bath.
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Getting The Right Support
Supporting a person with dementia to wash, bathe and dress can be emotionally and physically challenging. Even if youve been close to the person for many years, looking after a persons personal care can be a big step in your caring role. It is common to need extra emotional and practical support at this stage.
You could consider arranging a professional carer to take over this side of their care. You can arrange a needs assessment through your local authority to see what support can be put in place.
Making Washing And Dressing A Positive Experience
Washing, bathing and dressing, although personal and private, can be a positive experience for a person who needs support. Focus on what they can still do, rather than what they cant. This will keep up their confidence, as well as skills.
You may have to simplify some choices so that they can make decisions, but try to support them to choose, rather than choosing for them. For example, instead of deciding what the person will wear, ask them to choose between two tops that youve picked out.
Try to keep choices simple, so the person does not feel overwhelmed. You may find that different approaches work depending on the persons mood or how clearly they can think, which may change throughout the day.
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Mild Alzheimers Or Moderate Decline
Stage 4 lasts about two years and marks the beginning of diagnosable Alzheimers disease. You or your loved one will have more trouble with complex but everyday tasks. Mood changes such as withdrawal and denial are more evident. Decreased emotional response is also frequent, especially in a challenging situation.
New signs of decline that appear in stage 4 may include:
- losing memory of personal history
- trouble with handling finances and bills
- inability to count backward from 100 by 7s
A clinician will also look for a decline in areas mentioned in stage 3, but theres often no change since then.
Caregiver support: Itll still be possible for someone to recall weather conditions, important events, and addresses. But they may ask for help with other tasks such as writing checks, ordering food, and buying groceries.
Very Mild Impairment Or Normal Forgetfulness
Alzheimers disease affects mainly older adults, over the age of 65 years. At this age, its common to have slight functional difficulties like forgetfulness.
But for stage 2 Alzheimers, the decline will happen at a greater rate than similarly aged people without Alzheimers. For example, they may forget familiar words, a family members name, or where they placed something.
Caregiver support: Symptoms at stage 2 wont interfere with work or social activities. Memory troubles are still very mild and may not be apparent to friends and family.
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Overcome The Poor Hygiene Power Struggle
If you find yourself in a power struggle with an elder who refuses to be bossed around, a little well-intended trickery can come in handy. See if you can get a close friend to call and extend an invitation out to lunch or some other gathering that requires a bit of primping. A reason to get cleaned up for someone besides family can sometimes do the trick. Bribery may seem childish, but the promise of a special treat, such as dinner at their favorite restaurant on their weekly bath day, can also be a powerful motivator.
Tips To Make Bathing Easier
While bathing can be more difficult for people with Alzheimers, certain strategies can help make it achievable. As a caregiver, you should stay calm and adapt to different situations during the bathing process. Also, help the person have some independence by allowing him to do as much as he can and assisting when needed. You can do a full bath two to three times a week with sponge baths in between.
Always put safety first as well. You can make the bathroom safer with tools like grab bars, a bath chair or bench, a handheld shower head and floor mats that stay in place. Further, keep the water from getting too hot and make sure the room has enough light. Never leave the person alone in the bathroom during bathing.
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Some More Tips & Tools For Getting Your Loved One To Bathe
Give them choices
Rather than instructions, begin a conversation by asking whether theyd like to bathe or shower? Try giving them the option of bathing right away or after having their breakfast or watching their favorite TV program.
Study their reaction
When you take your loved one to the bathroom, fill the tub with 2-3 inches of wateror turn on the showerand wait for their reaction. If they become agitated, drop the idea of bathing them that day. If, however, they seem comfortable, fill in more water after theyve gotten in.
A soothing distraction
Patients suffering from Alzheimers can find bathing threatening. Sometimes, planning a distraction ahead of timesomething as simple as soothing musiccan calm them down.
Respect their privacy
While helping our loved ones bathe, respect their privacy and keep them covered with a towel or robe. Be flexible and understanding. If a parent wants to get into the tub with their clothes on, let them. The goal is to get them involved in the experience. When theyre engaged, they will enjoy bath time.
Use Their Doctor As A Resource
In some cases, a loved ones doctor can be a powerful ally. For example, a doctor can help determine if depression is a factor and whether antidepressants may lift their spirits and give them more energy, thereby helping to resolve the self-care issue. A renewed interest in life may make a senior more aware of needing to shower/bathe and wear clean clothes. Medical professionals can also rule out other factors that may be affecting their ability and/or willingness to care for themselves and recommend next steps. Keep in mind that our elders often place doctors on a pedestal and may take their official recommendations more seriously than a family members pleading and nagging.
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Does Alzheimer’s Disease Affect Your Ability To Walk
Claudia Chaves, MD, is board-certified in cerebrovascular disease and neurology with a subspecialty certification in vascular neurology.
Alzheimer’s disease does not just affect the brainit has an effect on the body as well. Historically, the emphasis and study of the symptoms of Alzheimer’s disease were focused almost solely on cognitive issues, looking at what type of impairments develop such as memory, language, and behavior and what interventions and treatments were most helpful.
More recently, however, there is an increasing awareness of the physical effects of Alzheimer’s disease, especially on one’s gait in walking. Understanding the physical impact of the disease is important for knowing what treatments and care might be required as the disease progresses.
Taking Too Many Or Too Few Medications
Alzheimer’s caregivers have to be creative when giving medication for Alzheimer’s symptoms or other conditions. Loved ones who insist that they missed a dose can be shown their medication dispenser or a chart, or even be given a placebo, such as a tic tac. On the flip side, those who refuse to take their meds might need to be given them in liquid formulations that can be added to favorite foods or drinks check with the prescribing physician to find out what foods are compatible. If pills are required, you’ll have to watch to make sure they are swallowed.
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Creating A Familiar Pleasant Environment
A familiar caregiver with a pleasant, calm manner should assist with bathing. Caregivers should not leave the person unattended in the bath, shower, or potentially hazardous area, or allow themselves to be distracted for extended periods of time.
Having some familiar and pleasant objects in the room can help to relax and comfort the person. For example, place flowers in a vase that the person likes on the bathroom counter, put out preferred soaps and lotions, and display appealing objects such as wall art, plants, and colorful towels.
Dont forget to consider the sounds, smells and lighting in the environment. Try playing calming or preferred music, or leave the room quiet. Use relaxing fragrances, such as lavender or Melissa oil . Studies have shown that using relaxing fragrances with massage, such as of the arms and face, can help reduce agitation and anxiety.
It is important to provide good lighting, without glare or shadows that can confuse or frighten the person. If someone is confused by reflections or becomes frustrated by the inability to recognize ones face, cover or remove mirrors.
Paranoia In Alzheimer’s Patients
“Paranoia is a misperception in their mind of an actual event occurring,” Rubinstein explains. Alzheimer’s caregivers shouldn’t argue, she suggests. Instead, look for a seed of truth. For example, if today’s accusation is that you stole a favorite item, and you actually do have a history of borrowing things, consider that there is some validity to your loved one’s feelings. “They need reassurance that everything is okay,” Rubinstein says. Instead of getting defensive when facing this Alzheimer’s symptom, apologize for “losing” the item and promise to replace it soon.
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Why Do Alzheimer’s Patients Stop Bathing
Bathing can be a challenge because people living with Alzheimer’s may be uncomfortable receiving assistance with such an intimate activity. They may also have depth perception problems that make it scary to step into water. They may not perceive a need to bathe or may find it a cold, uncomfortable experience.
Aggression In Alzheimer’s Patients
“Oftentimes, aggressiveness is just frustration because they aren’t getting their point across,” Rubinstein explains. Dementia results in increasing difficulty with communication, so figuring out how best to communicate with your Alzheimer’s patient will help. Alzheimer’s caregivers might create a picture book or photo menu to help your loved one point out what they want to eat or drink or who they are thinking about. Keep air horns around the house and blast them to stop physical aggression in its tracks, and don’t hesitate to call 9-1-1 for help if this Alzheimer’s symptom turns dangerous.
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Tips To Encourage Washing Hands
For individuals that may not like to wash their hands after using the restroom, here are some simple tips that may help: Make sure the individual has all of the needed supplies for handwashing. Try giving simple cues turn on the water, pick up the soap, rub your hands together.Read More
Clue Into Visual Cues
You probably have no idea that body language is a powerful conversation tool even when you are talking to someone without Alzheimers. When talking to a patient who has stopped talking, physical indicators can be especially important. Since they are unable to verbally communicate their happiness or frustration, pay attention to facial expressions and body positioning to help you determine their disposition.
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Establish A Weekly Routine
I read on the Alzheimer Association website they suggest that having a routine for bathing would be a good idea. I agree it would and we do this with our kids. We simple say, time for your shower to our kids and they trot right into the bathroom and get clean.
Now, this might work for your loved one, and what makes giving advice about Alzheimers so hard! The way they said this so happy like, I thought that would be great. We would just get into a routine of every other day or every third day and BAM, good to go! This did not work for my Mom at all. She honestly couldn’t give a crap about what day it is and that it was time for her bird bath or shower.
That said, because Alzheimer and dementia patients live so much in the past, if they grew up with a Saturday Bath routine you might be able to get them to wash up every Saturday pretty easily!
Staying On The Toilet Too Long
Many older people were taught to have two bowel movements a day, Rubinstein says. But they might forget if they have had one already and end up sitting on the toilet too long. This can cause hemorrhoids, which result in ongoing pressure that needs relief a vicious cycle that can further harm senior health. One effective option for Alzheimer’s caregivers is to turn off water to the toilet, so that you can show your loved one they already had a bowel movement.
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How You Can Help
- It is important to note that people with dementia can have problems with walking that are not associated with dementia. Exhaustion and pain can limit how far a person can walk. Sometimes that pain can reflect an unattended problem in foot care or muscle fatigue.
- The person you care for may also require a mobility aid, such as a walking cane or a wheelchair in order to feel secure. Sometimes just being physically present can provide your loved one with the confidence and security to walk.
- Consider a physiotherapist: They can help with anything from exercises to strengthen muscles to walking aids.
It is not easy to care for someone with mobility constraints! Unfortunately, this issue is usually compounded with others, including constipation, blood clots, and pressure sores.