What Do You Do When Your Elderly Parent Refuses To Bathe
Why Does My Parent Refuse To Bathe ? Make the process more enjoyable Keep the bathroom warm, play soothing music, have your parents favorite grooming brands and scents available. Simplify the bath Keep the steps involved in bathing as few as possible. Safety Devices If they are afraid of falling add safety bars and a shower chair.
What To Do When A Senior With Dementia Refuses To Change Clothes
Learn gentle dementia care tips for difficult situations.
Caring for someone with Alzheimers disease or another form of dementia requires creativity, patience, and empathy, the ability to step outside of your individual reasoning and logic and understand why a certain behavior is occurring, and then to know the best way to successfully manage it. That is certainly the case when an older adult with dementia refuses to change clothes, in spite of how unkempt or dirty an outfit has become.
There are lots of reasons why an individual with Alzheimers disease may insist on wearing exactly the same outfit, including:
- Judgment or memory problems, for example, losing track of time or thinking the clothes were recently changed
- The comfort and familiarity of a particular piece of clothing
- A desire to maintain control
- Difficulty with the task of changing clothes
- Feeling stressed by the choices related to selecting an outfit
- Physical pain and/or fatigue
- The inability to detect scent or even to clearly see stains on clothes
Our Alzheimers care team has some strategies to assist:
What Are Disinhibited Behaviours
Disinhibited behaviours are actions which seem tactless, rude or even offensive. They occur when people dont follow the usual social rules about what or where to say or do something.
Disinhibited behaviours can place enormous strain on families and carers. They can be particularly upsetting when someone, who has previously been private and sensitive, behaves in a disinhibited way.
Disinhibited behaviours may include any of the following:
- Tactless or rude remarks – A person with dementia may comment tactlessly about another persons appearance for instance. They appear to have lost their social manners, and it can look as if they are trying to deliberately embarrass or harass the other person.
- Bold behaviour – A person with dementia may inappropriately flirt with someone or make sexual comments.
- Exposure – A person with dementia may take some, or all of their clothes off at inappropriate times or in inappropriate settings.
- Fondling – Forgetting social rules, a person with dementia may publicly fondle themselves or masturbate in front of others.
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Where To Get Help
- Your local community health centre
- National Dementia Helpline Alzheimers Australia Tel. 1800 100 500
- Independent Living Centre Advisory Service Tel. 1300 885 886
- Dementia Behaviour Management Advisory Service Tel. 1800 699 799 for 24-hour telephone advice for carers and care workers
- Carers Victoria Tel. 1800 242 636
- Commonwealth Respite and Carelink Centres Tel. 1800 052 222
Alma And Silvias Story
Alma had been forgetful for years, but even after her family knew that Alzheimers disease was the cause of her forgetfulness, they never talked about what the future would bring. As time passed and the disease eroded Almas memory and ability to think and speak, she became less and less able to share her concerns and wishes with those close to her.
This made it hard for her daughter Silvia to know what Alma needed or wanted. When the doctors asked about feeding tubes or antibiotics to treat pneumonia, Silvia didnt know how to best reflect her mothers wishes. Her decisions had to be based on what she knew about her moms values, rather than on what Alma actually said she wanted.
Quality of life is an important issue when making healthcare decisions for people with dementia. For example, medicines are available that may delay or keep symptoms from becoming worse for a little while. Medicines also may help control some behavioral symptoms in people with mild-to-moderate Alzheimers disease.
However, some caregivers might not want drugs prescribed for people in the later stages of Alzheimers. They may believe that the persons quality of life is already so poor that the medicine is unlikely to make a difference. If the drug has serious side effects, they may be even more likely to decide against it.
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Repetitive Speech Or Actions
People with dementia will often repeat a word, statement, question, or activity over and over. While this type of behavior is usually harmless for the person with dementia, it can be annoying and stressful to caregivers. Sometimes the behavior is triggered by anxiety, boredom, fear, or environmental factors.
- Provide plenty of reassurance and comfort, both in words and in touch.
- Try distracting with a snack or activity.
- Avoid reminding them that they just asked the same question. Try ignoring the behavior or question, and instead try refocusing the person into an activity such as singing or âhelpingâ you with a chore.
- Donât discuss plans with a confused person until immediately prior to an event.
- You may want to try placing a sign on the kitchen table, such as, âDinner is at 6:30â or âLois comes home at 5:00â to remove anxiety and uncertainty about anticipated events.
- Learn to recognize certain behaviors. An agitated state or pulling at clothing, for example, could indicate a need to use the bathroom.
Why Do Dementia Patients Just Sit And Stare
They Might Be Bored
Is your friend with dementia staring zoning out and staring off into space? Sure, it might be because their ability to process information is decreased. However, it might also be that they need something other than Bingo to fill their time. Make sure they have something to do besides sit there.
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Where To Go What To Eat
For these types of behaviors it is best to keep the affected individual engaged mentally, socially or physically. Creating a structured program, nurturing the individual’s strengths and building self-esteem might lessen the destructive behaviors and give the individual with dementia a purpose for getting up each day.
Sometimes it is helpful to have a rummage box, with broken things like model cars, old phones and old toys. Leave a note in the box with instructions on what needs to be repaired. This could keep the affected individual occupied and thus lessen the tendency to tear up or destroy things.
If the individual is safe and the items or papers he or she is tearing up are not essential, then allow it. Give the individual old mail or scratch paper to rip up or old gadgets to take apart, and this might curb the compulsive behaviors. Old clothes also can be torn up for use as cleaning rags.
Overall, accept the behavior for what it is. It might be a phase and once he or she tires of the activity it will cease. Of course, if the destructive behaviors are getting out of hand or sudden changes are occurring, it is best to be seen by a physician for a full assessment.
Questions about Alzheimer’s disease or a related disorder can be sent to Dana Territo, the Memory Whisperer, director of services at Alzheimer’s Services of the Capital Area at or visit the organization at 3772 North Blvd., Baton Rouge.
How Hospice Can Help With End
In addition to helping you in recognizing the signs of dying in the elderly with dementia, bringing in hospice care will help with the physical and emotional demands of caregiving. Nurses will be able to adjust medication and care plans as the individuals needs change. Aides can help with bathing, grooming, and other personal care. Social workers can help organize resources for the patient and family. Chaplains and bereavement specials can help the family with any emotional or spiritual needs. Additionally, family members can contact hospice at any time, and do not need to wait until it is recommended by the patient’s physician.
To learn more about the criteria for hospice eligibility or to schedule a consultation, please contact Crossroads using the blue Help Center bar on this page for more information on how we can help provide support to individuals with dementia and their families.
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Causes Of Disinhibition In Dementia
Disinhibited behaviors are particularly common in frontotemporal dementia. They seem to be linked to the loss of white matter throughout the brain. When white matter is lost in certain regions of the brain, the result is apathy. When it is lost in other regions of the brain, the result is disinhibition. It is possible for a mixture of apathy and disinhibition to appear in a frontotemporal dementia patient.
While the biological causes of disinhibition may be different in different forms of dementia, optimal caregiver responses follow a consistent pattern. Here are some approaches that usually help.
What You Can Do For Your Loved One
As an individual with dementia declines, you can help them by providing a loving and supportive presence. Sit with them. Hold their hand. Play music they enjoy.
One of the greatest gifts you can give your loved one is helping to get their affairs in order. Ensure that financial and healthcare powers of attorney are put in place, so you can make decisions when your loved one is no longer able. Look into funeral arrangements before you need them, so you dont need to make important decisions in a time of crisis.
Talk to your loved ones physician about the possibility of palliative care support in the home and hospice care when your loved one is ready.
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Rapport Building Doesn’t End After The Examination
Arbaje advises physicians to “spend a little more time with the patient after the examination and not just walk out the door, leaving person as they are, half undressed or in a gown.”
In the case of an older person, this might involve helping patients get their shoes and socks on or helping them get off the table. “Spend some time closing the encounter, not just doing what you need to do and then leaving or leaving it for someone else or family to do, which can be very dehumanizing,” she said. Even a few minutes of human contact beyond the examination can enhance rapport and help the patient feel respected and more comfortable.
Some Examples Of Disinhibition In Dementia
What kinds of behavior are “disinhibited” in dementia? Some examples of the problem are relatively innocuous. A person with dementia may greet a visitor with “I hate your hair” and refer back to hating hair throughout the visit. Or they might take off their clothes in a day room or when the priest comes with Holy Communion. Or they may make an unwelcome sexual advance, or use racial epithets to describe staff who care for them. Sometimes people with dementia lose their inhibitions against pinching, biting, and taking a swing at caregivers and family members alike. There can be outbursts of shouting, screaming, singing, interacting inappropriately with strangers, stalking, repeated phone calls, and hoarding, hiding, and losing things.
How Often Should Elderly Bathe
At a minimum, bathing once or twice a week helps most seniors avoid skin breakdown and infections. Using warm washcloths to wipe armpits, groin, genitals, feet, and any skin folds also helps minimize body odor in between full baths. However, some dementia caregivers say its actually easier to bathe every day.
Seeking Pleasure In Self
Fear of early death, all dreams and goals destroyed, being a burden to family members, not being able to earn money, being forced to become co-dependent, etc are some of the common worries an Alzheimers sufferer has on a daily basis there is only a limit up to which a person can be resilienteveryone cracks down eventually.
People who are constantly in a state of emotional pain desperately want an outlet, a way to get rid of these bad feelings and feel normal for a while.
Self-harm is their way to release that negative energy and also let others know about how they feel.
Although there is no evidence of this method being effective or useful for them, in a state of panic they turn towards harming themselves.
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Are People With Dementia Better In The Morning
When you are with someone who has Alzheimer’s disease, you may notice big changes in how they act in the late afternoon or early evening. Doctors call it sundowning, or sundown syndrome. Fading light seems to be the trigger. The symptoms can get worse as the night goes on and usually get better by morning.
What To Watch For
If your loved one doesnât get what they want or you try to stop their behavior, they may get angry and hit, push, curse, or scream. Itâs rare for people with Alzheimerâs disease to abuse those who take care of them. But if they abuse you and you canât stop them, talk with a doctor or counselor.
People who take their clothes off or rub themselves often can get skin irritation or infections. If your loved one has either of these and it doesnât get better in a few days with home care, talk with their doctor.
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Choosing The Best Gownwhen Necessary
Is it necessary for patients to disrobe and put on a gown especially in light of the fact that research suggests that wearing a gown can induce psychological distress?
Danielle Ofri, MD, PhD, clinical professor, Department of Medicine, NYU Grossman School of Medicine, New York City, said that in her practice, patients wear street clothes unless the patient is to undergo a full physical exam.
Even an abdominal exam can be conducted by loosening and slightly lowering the pants. Ofri stresses that patients should retain full control over how much to expose: “The patient should always take the lead in adjusting or opening clothing for a focused physical exam. And, of course, we always need to ask permission before starting any part of the exam.”
A gown is more conducive for certain exams, such as pelvic or breast exams. Ransone said that cloth gowns are preferable to paper gowns, which can tear more easily and so lead to unnecessary exposure. Gowns that hang open at the back should be avoided. If that’s the only type available, a second gown can be provided so as to cover the backside.
This is especially important if the examination involves walking across the room for example, to evaluate gait or standing on the scale. Alternatively, the patient can be given a sheet to drape over the gown, which can be moved around during the examination.
How To Handle Different Situations
If your loved one takes off their clothes, touches themselves, or masturbates in front of others: This may not mean they want sex. Itâs often a sign that theyâre uncomfortable or need to use the restroom. It could also be that they used to walk around naked or masturbate when they lived alone, and itâs only a problem now that theyâre around others more.
Stay calm. If theyâve taken off their clothes, help them put them back on. To distract them, give them something to do with their hands, offer them a snack, or get them involved with an activity they like. If this doesnât work, take them somewhere private. Ask others around you to excuse their behavior. Donât fight or hold them back — this could make them angry and cause them to act out.
If this happens more than once, try to figure out why. Are they too hot or cold? Do they need to use the bathroom? Do they have skin irritation? Are they uncomfortable in their clothes? Are they in pain? Are they confused about where they are?
You could try to have them wear clothes that donât have a zipper or that close in the back. It might be helpful to give them private time each day when they can masturbate or go nude. If you notice signs of pain, discomfort, or skin irritation that donât get better, call your doctor.
Donât hold your loved one back unless you have to. This could hurt you or them, and could make them angrier.
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Men Face Unique Challenges
Men have “unique needs and challenges” when it comes to healthcare, said Brott, an advisory board member of the Men’s Health Network.
Brott cited research showing that men do not seek healthcare as frequently as women do. “So it’s already hard to get men in the door of a doctor, no matter what the provider’s gender is,” he said. Notably, men are even less likely to seek medical care when the clinician is female, owing to discomfort at having to undergo an intimate exam.
“I think that many men have issues about sexuality and of becoming aroused during an exam if it’s a female practitioner doing the exam,” said Brott. “I’m sure this is something physicians and nurses are accustomed to, but for the patient, it’s extremely embarrassing. The man may worry that he’ll be perceived as making unwanted sexual overtures to the practitioner.”
The way to mitigate these concerns is through communication, according to Brott. He recalled his own experience during a catherization conducted by a female practitioner he had never met. “She came in and started dealing with me as if I wasn’t even a person. She didn’t say much. It would have helped if she had created some type of human connection and talked to me something like, ‘I’ve done this a thousand times and here’s what you’ll be feeling,’ or, “Would you like me to describe what I’m doing, or just do it as quickly as possible?'”