How can I get my husband to take a shower?
This is a toughie. It's not always clear why people with dementia all of a sudden take a dislike to bathing. Sometimes it's that they've simply forgotten, or that their sense of smell isn't as good as it used to be. Sometimes the issue could be depression. Maybe you could blame it on the fact that years ago, people didn't bathe every day like they do now, and people with dementia tend to live a lot in the past. Another cause could be simple fear - they may have slipped in the tub or scalded themselves with hot water; they may have forgotten how to operate the faucets, or developed an unreasonable fear of the drain sucking them down. Remember, these are people whose brains aren't working the way they used to.
Whatever the reason, the one thing you must NOT do is nag! Do not try to cajole, threaten, shame, explain why, or force a person with dementia into bathing. It is counterproductive and will make things worse. Try the casual approach first: "Ed, after you've had your shower/bath, let's treat ourselves to some ice cream." Give him the chance to make his own decision: "Do you want to take your shower/bath tonight or tomorrow?" Or make it conspiratorial: "I'm going to go take a shower and then fix myself some ice cream. Want to join me?" Remember that dementia steals a person's initiative; it's hard for you to understand this, but it's possible that your husband has simply forgotten how to get started, so that the act of bathing has become unfamiliar and frightening. You can offer to help without appearing to do so by saying, "I'll bet you'd like for me to scrub your back for you like I did when we were first married" or "The faucet in this bathroom hasn't been working properly. Let me turn it on and get the water the way you like it." Don't over-explain. If your approach works, great; if not, back off and try again tomorrow...or even in fifteen minutes.
If he seems more fearful than just stubborn, you might need to provide a bit more guidance. Be sure the bathroom is warm, the shower or tub easy to get in and out of. Let him feel the water temperature before stepping in. Using a shower chair and a hand-held showerhead can help ease fears about falling or having water poured over his head. Sometimes a brightly-colored bathmat makes it easier to know where to stand. If modesty is an issue for either you or the person, try having them wear a swimsuit or wrap a towel or robe around themselves. If appropriate, make light of the situation: "Honey, you still look sexy in your swim trunks!" Try to be matter-of-fact and casual, like this is an activity you enjoy doing together rather than a chore you have to get done.
If you've tried everything and he still won't budge, it might be time to bring in some outside help. Often, a person who has steadfastly refused to take a bath for a family member will be surprisingly cooperative with someone he views as a "professional," especially if he thinks it's on doctor's orders. Many home care agencies will arrange for someone to come to your home just to provide this service. Some people have even taken their loved ones to their golf club, gym, or pool to use the shower facilities. Whatever works!
Finally, be aware that you may need to relax your standards a bit. Although you know that your husband would never have gone around unwashed in his former life, you must understand that he now has a disease that interferes with his judgment. As with many strange and unsettling behaviors caused by dementia, this one may stop as mysteriously as it began, if you can just be patient. Remember that no one ever died from not taking a bath. As long as he isn't endangering himself or his health, you may need to file this under the "Let It Go" section of your caregiving concerns!
What do I say when my wife asks me the same question a dozen times an hour?
Repetition is a very common behavior in the early stages of memory loss, and is extremely frustrating for caregivers. Maybe it would help if you understood why she does this.
Dementia impairs a person's ability to process language and to store new information. This means that not only does she have trouble understanding what you said, but also that her brain can't retain it. The information has no place to go. For instance, when you tell her that she has a doctor's appointment on Tuesday at 2:00, all she is likely to remember is that she's going to the doctor sometime. Because she knows this is important, she asks you about it and you answer her - but because she can't retain the information, she has to ask you again. And again. And again. It's frustrating for her, and maddening for you.
The last thing you want to do is admonish her that she's already asked you this a dozen times. She is not doing this just to aggravate you. Her brain simply won't cooperate.
You could try answering the question each time it's asked, but this approach uses up a lot of patience. Or you could try writing the information on a card or posting it on the wall, but then your wife has to remember where to look for it - and asking her to remember information is where the whole problem started! Instead of continually giving her answers and expecting her to eventually remember them, try simply reassuring her that everything's under control and that she has nothing to worry about: "Honey, I have the doctor's appointment written down on my calendar, and I'm planning to take you," or "I know it's important for you to go to the doctor (or attend your book club, or see your sister when she's in town, etc.), and I'll make sure you get there on time."
Your wife is aware that she can't keep up with details the way she used to, and she's frightened that she'll miss something important. When she asks the same questions over and over, she is probably trying to be sure that someone besides her is taking care of those details. A little reassurance might go a long way in helping her relax.
My mother has just moved into an Assisted Living facility. She asks us nearly every day, "When can I go home?" We bring her back to her house at least once a week to visit, but she asks the same thing even when she's there. What should we do?
"I want to go home" is probably the number one most common phrase that people with dementia will say...and it's probably one of the most difficult for their caregivers to hear. Especially in instances where the people are no longer living in their homes, families will guiltily assume that Mom is begging to return- yet are perplexed when they take her there and she doesn't seem to recognize it.
But here's the good news: Mom is, in all likelihood, not talking about that house at all. Instead, she's probably referring to a time and place from much earlier in her life. Most memory loss is of recent places, people, and events; however, memories from the distant past are often intact. Childhood, for most of us, was a time when we felt safe, when "home" was a place of family and security. People with dementia lose that feeling of security, of who they are. As the disease progresses and they lose more and more of themselves, they long to get it back. When you realize that, and realize that your mother is yearning not so much for a place as for a time, then you'll be better able to understand what she means when she asks to go "home."
So try to change the way you answer that question. Instead of explaining, "this is your home now" or "you haven't lived in that house for years," instead of taking her back to her former home and thinking that will make everything all right, let her talk about what SHE means by "home." The next time she says, "I want to go home," say to her, "Yes, Mom, home is a good place, isn't it? Tell me what you love most about home." Her answer may surprise you. And rather than trying to convince her that she's living in a different home now, tell her often that "you're safe here" and "we all love you," and see if she doesn't become calmer.
Families nearly always feel guilty when the time comes that their loved one can no longer be cared for safely at home - so they will do all they can to avoid talking about "home" in front of them. Actually talking about "home" with your mother, understanding the real meaning behind the words, lets you to help her feel that "home is where the heart is."
Educational Workshop on Dementia Screening in the Primary Care Setting:
To View or copy the screening tools click on the appropriate button:
The AD8 Dementia Screening Interview
The Time and Change Test
A Limited supply of the video recording of the workshop presented by MemoryCare staff physician Dr. Tom Kaluzynski and Misty Haire, RN is available- please call the MemoryCare office at 828-771-2219 to find out if a DVD copy is available and/or if you would like a copy of the materials with a reference list related to the screening tools covered in the workshop.