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    Cleanliness Issues
    Anon_32563 posted:
    My mom who is in the sixth stage of Alzheimers and has parkinson-like symptoms is refusing to go to the hairdressers (even if we pay), refusing to wash her hair, and refusing assistance from us. She has lived with us for 1 1/2 years and is very ornery and independent. However, the disease has now progressed to a point where she is becoming very feeble and needs the help but won't accept it. Her instability makes her afraid to get into the specially made handicapped shower. I'd like to make this transition of us helping her more in a graceful and respectful manner, but her stubbornness is going to be very difficult. I would appreciate any suggestions you have. Thanks.
    cjh1203 responded:
    I'm really sorry about the difficulty with your mom.

    One thing that can make a difference is the approach you take about things the patient doesn't want to do. If you ask if she'd like to get her hair cut or if she's ready to get in the shower, her response is more likely to be negative than if you say something like, "We're going to get your hair cut now, and then we'll get some lunch" or "It's time for your shower, and then we'll have a piece of cake". She probably doesn't have the capacity any more to make the right decision about things she should be doing but doesn't want to, so stating rather than asking can make things go more smoothly.

    Are there mirrors where your mother's shower is? People with Alzheimer's often don't recognize the person in the mirror as themselves, and the thought that a stranger is watching them get undressed and shower can be very upsetting.

    Are you in a position to bring in a nurse's aide part time to help with showering and some of the other daily routines? My uncle had Alzheimer's, and when my aunt couldn't handle all of his care and started talking about bringing in help, he would get very upset and tell her no. Once she just went ahead and hired someone, though, he loved having the new person there. He looked forward to seeing her, and he was very cooperative about the things that he had given my aunt a hard time about.

    Stubbornness from Alzheimer's patients is often actually fear or over-stimulation, and it can be tricky to try to figure out what's causing those feelings.

    Probably the best thing you can do is join a local Alzheimer's support group. They can give you a lot of practical advice, because they've all dealt with the same kinds of things, and they can also give you great moral support, and let you know that you're not alone.

    I hope you'll continue to post here and let us know how you and your mother are doing.

    Best wishes.
    7grands replied to cjh1203's response:
    Thank you, Carol. I will definitely try your suggestions. My mom ended up at the hospital this past weekend, so I wasn't able to read your response until now. She took a very big step down in her health and is more confused than ever. I'm hoping it's not a permanent change. Glad you're available to give some wisdom!
    cjh1203 replied to 7grands's response:
    I'm so sorry about your mother's hospitalization. Do you mind my asking what she was hospitalized for? I hope she'll begin to improve.

    Are you getting some breaks for yourself, and getting some help in caring for your mother?

    Judith L London, PhD replied to 7grands's response:

    Hope your Mom is more stable now.

    Whenever you see a sudden change in someone's behavior, it often signals a medical problem on top of the Alzheimer's.
    Going to the hospital is aggravating for anyone so your Mom's reaction is not surprising. Try to be as reassuring as possible. She may not remember that she was in the hospital when she comes home.

    If there still is a problem about showering when she returns home, I hope you will consider obtaining a nurse's aide to assist you with her care. Showers can be problematic. You have so much to do that if you can, get some help for you to have some free time, too.

    If she is able to, both of you arrange to have your hair washed at the same place side by sided so that it becomes a 'ladies day out.'

    There are other ways of approaching clealiness without going through the shower and shampoo process. Dry shampoos help out, as do sponge baths where she gets to hold a washcloth and soap up along with you doing it for her. Playing her favorite music also helps, as well as soothing reminiscences while she washes up.

    Hope the situation has improved,

    7grands replied to cjh1203's response:
    Mom had a mini-vascular event sort of like a mini-stroke. It has affected her balance and coordination. We have a nurse coming once a week and a PT coming twice a week to help her get stronger. Her doctor has 'tweaked' her meds and today she seemed a little better than the last four days since coming home. She didn't remember the ambulance ride by the next morning. She knows she was in the hospital, but I don't think she really remembers it much.
    cjh1203 replied to 7grands's response:
    I'm sorry that you and she have to deal with yet more health problems. I know it's frustrating and heartbreaking to see something new on top of everything else. I'm glad she seems better, though, and hope the PT will help. It's great that that can be done at home.

    Is she accepting of the nurse and PT? If she is, maybe it's a good time to try to get someone in a few mornings a week to help with showers and so on.

    Thank you for continuing to post. I hope you're getting a break now and then from your caregiving duties.

    7grands replied to cjh1203's response:
    Mom's condition has changed in the past week now to be semi-incontinent. Thus, showers are coming more frequently. She seems to understand the need at the moment of an accident and is not resistant to my help at that time. I guess 'my answer' has come in a way that I didn't expect. Now my challenge is getting her to wear what will keep her dry at those moments:) It's a growing experience for both of us.
    2010guardian replied to 7grands's response:
    I am relating to your comments on incontinents. Women have been very used to using protection. I would think it would be easier for a woman to accept. Call them sanitary panties or disposible panties. Also stress that the material will keep the wetness from her and she'll be more comfortable. I recently (this week) got my husband to wear the disposables. He was so surprised when he 'felt' dry. While searching for the right kind for him, I looked at the women's. There are some that are not bulky. I suggest you buy a small package and have them on hand to have her to check them out.
    I was afraid to approach my husband, but when I did, he said, "whatever it takes." He felt so bad about making all that extra work for me. I pray for an easy solution for you and your mother.
    7grands replied to 2010guardian's response:
    I just wrote and lost my letter ... ughh! OK, I'll start again:)

    My last 4 weeks have been very difficult with mom in the hospital 3 times - once for the mini-vascular event, once in the ER for x-rays for lower back discomfort, and once overnight for observation, x-rays, and MRI of her back and hips. Nothing broken, no hairline fractures. We don't know if she fell - she can't remember and we never heard anything, but her lower back still gives her occasional sharp pain. Maybe it is a nerve problem. Those three events have been so hard on Mom. I'm not sure if this change in her is permanent because of another 'step down' with the Alzheimer's or if this is temporary confusion. I feel like I am experiencing "Ground Hog Day" all the time. Mom starts between 9 or 10 in the morning trying to walk home to FL (we are in KS), realizes after walking to the end of the driveway (almost falling multiple times) that she can't do it, crying pitifully, walks to our rock garden, sits for about 30 minutes and then goes back inside. I am with her, keeping her from falling, etc. She has become very angry, agitated, and sometimes tries to hit and push when I try to rescue her from a fall. Five or ten minutes later we do it all over again ... all day long until about 7 p.m. when she finally tires out. My husband just put locks on the doors to keep her from being able to go outside at will, but that only means that she does the same kind of 'loop' inside the house. We have tried music, offering activities, others have visited her, hairdresser, etc., but she cannot break free from this loop. Today we were able to take her to church and then out to lunch. It was a wonderful time, but the moment we arrived at the house, her loop began again. The doctor has increased two of her meds to try to help. I'm going to try to approach her early tomorrow morning (like we did today) to take her out for a 'ladies day' (hairdresser). Any other words of advice? It's her crying that is most difficult - well, the angry responses and nasty words are no fun either. Thanks for your help.
    Judith L London, PhD replied to 7grands's response:
    What an unfortunate set of events. It sounds like the mini-stroke affected her memory. When I attended a workshop last week led by Dr. Nikita Katz, he suggested that people who have a mini vascular event be placed on 1-2 regular aspirin per day; check with her physician to see if that is appropriate in light of her other medications.

    So glad you have secured the outside doors. Not much you can do about the inside loop except to make sure that it is free of area rugs or anything else she might trip on. Close off the areas you want her to avoid. Consider walking with her and chatting together. The exercise may do you both good. You both could try walking sticks to aid her balance and keep her company. Ask her what she likes about walking. Distract her if you can after she has walked the loop a few times, perhaps by playing a favorite song or singing together.. Offer her a good snack she would like to break the pattern.

    When she cries, tell her that you know she is terribly sad, and that it makes you sad, too. People with Alzheimer's have feelings and may feel better when the feelings are acknowledged.

    Do try to get some extra help during this trying time,

    7grands replied to Judith L London, PhD's response:
    I'll check about the aspirin. Thank you. We have removed all area rugs, put up extra handrails all over the house, and added many safety items. The problem is that she is so angry. She only speaks of basically 2 topics: driving herself home and buying a parakeet. When she is not able to do those two things, she becomes angry, foul, and sometimes aggressive by hitting or shoving. To walk with her would only provoke her more. Changing the subject hasn't worked, nor music. She is refusing to eat anything we offer because she is so angry. My daughters have tried singing and gently playing on the guitar or piano. Mom has refused using a cane or walker. She is just so unhappy at this point. When I tell her how sad I am that she is unhappy, she becomes sarcastic and mocking. It's a hard situation. I'm waiting for a call from the doctor to see what she recommends.

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