cks1646 Asked September 2015
How to address personal hygiene tactfully?
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We have a new problem, but it could have been going on for a while. Dad has his own bathroom so I am not sure when it started but he is not using toilet paper to wipe. How do I know? I finally caught on and marked the roll and left one spare roll. His undies are always bad both ways so that wasn't new. But how do you tactfully approach someone with dementia that they have to wipe their butt? I have a cleaning lady that comes in so I was not noticing the roll being the same until recently... He is also starting to (again) take a shower and put the same underwear back on which in itself is nasty but add in the incontinence issue and it's just bad.
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My parents are the children of the Great Depression thus they didn't want to spend the money on new personal care products. And they weren't going through the toilet paper very quickly as it would be months before Mom would place an order with me to buy some next grocery trip.
When I saw the above, I told Dad "don't reuse your Depends, otherwise you will get a bladder infection".... I don't know if that is true or not, but it did get Dad's attention. With Mom not in the house, I got the caregivers back and they are keeping a tighter rein on Dad.
I speak to my clients and tell them that it is very important to be clean. I then explain what I must do. I apologize evrytime because a person with dementia cannot remember from one moment to another what is going on. I am gentle but thorough.
If you have had children it is easier to accept this chore as you probably can remember doing this for your babies.
This is actually the only way to handle this problem. It is one of the biggest expenses; purchasing wet wipes and having gloves at all times.
It is also important to have the individual wash their hands just like a doctor or nurse would. I say this and also monitor the washing.
One of my clients is also blind and has severe Alzheimer's but she is at peace when I perform this task.
Unfortunately, we are so averse to such things as a society it really leaves elders with too many urinary tract infections which can cause more confusion and hospital stays.
As for his not wiping well enough, express to him that you're concerned about his cleaning himself properly after using the bathroom. Let him know that you're concerned about his health and that not wiping could cause skin problems in an area where he really doesn't want skin problems.
Since he has dementia what you talk to him about may not sink in but at least you will have tried.
When my dad moved in with me he didn't have dementia but we agreed that going forward we would have to be able to have conversations that were uncomfortable at times and we did have to have some uncomfortable discussions but they were all in the spirit of my taking good care of him. You're taking good care of your dad and this is just a discussion you have to have.
My husband became angry when I noticed something he didn't. He was unaware of his errors, mistakes, challenges, whatever you want to call them. But he could not acknowledge that he had done anything incorrrectly. Consequently eveything wrong wih him had to be my fault. It was a most difficult early stage of Alzheimer's disease.It was a time when the balance in our relationship shifted. I finally became the nagging wife he was accusing me of being.
If I had it to do over, I would not argue with him or tell him to change, merely hold his hand, lead him to the bathroom, hand him clean clothing and help him remove the soiled. No words, done as if nothing had transpired.
The other option would be if he has arm or hand restriction and he cannot clean himself due to that. If that is the case, then insist that he rinse somehow in the shower after BM. There are also hand held devices that help you reach. But, if it's not limited reach, but mental decline, then it may be that you have to start monitoring him more closely. Is there someone there to do that?
With dementia, you have to move past the point of being embarrassed, timid or reserved with your protection. Being subtle, making suggestions, etc. isn't likely to help. Even if you pointblank tell dad what needs to happen, it's not likely to help. The brain doesn't work right and he's not likely to remember your instruction. It's not likely a talk from his doctor will work either. And the logica; reasoning that his normal self would have after a BM, isn't occurring. So, he's not going to have a BM and then recall that his doctor and adult child told him to wipe well. The only other option that I am aware of is to supervise him after each BM. That means always accompanying him to the bathroom each time and insisting that he clean himself. You could stand near and see if he can do it. If not, do it for him. I know of adult daughters who have to change their father's Depends after they get dementia, but they get used to it. I'm not sure I could do it, but I regularly hear of about it. If it is dementia, he will progress and is likely to need depends at some point.
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