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Seeking advice on keeping 93 y/o ALZ combative mom clean
Posted: Tuesday, June 11, 2019 12:34 PM
Joined: 2/13/2018
Posts: 10

Hello all,

Some background which may or may not help: Three weeks ago mom began bowel incontinence alternating with constipation. We met with the nutritionist and ended up with
Senna 4.3mg (1/2 tab,) full tab caused explosion(s), x1 250mg
Geri-Care Probiotic, 1 4oz glass prune juice and x1 Citrucel combo which has gotten us to only an every other day constipation from 3-4 days of constipation. Thank God, because you can just imagine the accidents after 3-4 days. Even this might not be so bad if she weren't the 4'6" Al Capone of hygiene. 

Part of her brain doesn't like the feel of anything wet on her skin. This has made bathing, washing her hands, etc. a battle. And now getting her clean after an accident even worse. She tries to leave the rest room before she's even clean. My brother has to block the doorway while I clean her up which she fights all the way.

Yesterday's fiasco was one of the worst. Managed to get her as clean as I could after she had an accident while napping. I have tried everything, reassuring her that it happens to us all, reminding her that I'm her daughter and I'm happy to help her, just us girls, etc. She snaps at me and says, "I don't care! I just want to get out of here, I don't have time for this, etc." After this, the only way to get her to wash her hands was to tell her no dinner until she did wash her hands. She complied, but verbal battle through that too.

Today was our once a week hospice day. Her aide is wonderful and sometimes she can get her to take a shower, but most of the time it's sponge bath. No matter who is bathing her it's at the very least a verbal battle. She told us that if she keeps refusing she won't be able to come anymore. They are not supposed to force them. Keep in mind that I have been reading and trying everything. Playing music, making sure the room is warm, distracting mom by asking her to dry herself with a towel, trying to time her sponge baths when she's in a good mood. Promising a treat afterwards. Nothing can minimize her hatred of  the "it's wet; get it off me!"

Today mom grabbed hold of her arm and unintentionally or intentionally scratched her. Her finger nails grow like crazy. It's really sad and frustrating because she used to enjoy my giving her a manicure, painting her nails, etc. Now even that is a battle. I know she's declining as she can't use a fork any longer only a spoon at meal times. She's not as engaged verbally as she used to be. The only time she's understandable is when angry?

Any advice for this kind of situation would be greatly appreciated. Thank you and hugs.



Posted: Tuesday, June 11, 2019 1:01 PM
Joined: 5/16/2017
Posts: 400

It is so sad that this is so prevalent among our LOs with dementia.   To be perfectly honest, I would look into possibly medicating her to calm her down on the morning she is to take a shower.(Valium?).  I doubt whether she is going to be agreeable about it regardless, but maybe it will make her more tractable
Eric L
Posted: Tuesday, June 11, 2019 1:54 PM
Joined: 12/5/2014
Posts: 1078

Up until fairly recently, we had to medicate MIL to get her in the shower. It was still a battle sometimes, but she wasn't nearly as agitated.
Posted: Tuesday, June 11, 2019 2:47 PM
Joined: 2/13/2018
Posts: 10

Thank you Terei and Eric,

I've been thinking about this option too. Maybe a low dose daily as I need to clean her up from the bowel incontinence and that is not predictable. I ask her every two hours do you need to use the restroom? Bless her, she doesn't even know there has been an accident. 

God help us she's already on 5 rx's including Trazodone plus two vitamin supplements. In addition to the ALZ, she has 3rd stage renal disease, diabetes, and blood pressure issues. All of these are under control which I look at as a testament to diligence between my dad, brother, GP, Hospice and myself. 

I realize that it's some kind of miracle she hasn't had a UTI yet, but that's because I've been hyper vigilant about keeping her undercarriage clean. Even with that, she'll probably get one at some point because those are microbes that can't be seen with the naked eye.  I'm her Medical Surrogate and legally responsible for her care as well; at least that is my understanding?

I don't take my respite break except one night a week because she doesn't seem to have accidents in between dinner and bedtime. She'd be mortified if my brother pulled this duty and my 97 y/o dad has macular degeneration. 

All I can say is thank you and bless every caregiver everywhere. I helped my mom take care of my elderly grandma till she passed peacefully in our home, in her own bed, when I was 16. My Oma was a walk in the park compared to my mom. It's really disheartening for me. Though I try to hang onto the 'Notebook' moments which mom has (though very rarely now.) She comes out of  'ALZ world' and is my mom again sometimes only for a half hour, but when it gets frustrating and too much I mentally try to focus on those moments instead of all this heartache.  

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