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I care for a 76yr old retired nurse, she has had 5 hip surgeries and is on Prestiq. She is very 'edgy', to put it nicely, when I have to rouse her in the mornings. Her son requests that she be showered at least every other day. There is NO railing in the bathroom. The last time I took her in for a shower, she slapped me on the head when I tried to get her from the toilet to the shower. I know she is frustrated w/herself for no longer being 100% mobile. I also know that the morning emotional issues are from the Prestiq. However, her son is more of a 'Get it done and move on' kinda person. He's bigger than I am, and can just DO IT. I cannot. I also have a back issue. The woman stumbled 2 days ago, and I DID catch her, no problem. I do have my own confidence issues w/her in the shower situation. I also HATE having to take her in to the shower. She wears 2 Depends each night, and does need to shower usually almost daily, she can't go weekly. Short of having her son do this one task, anyone have any advise on how to manage this chore?
She can be rather cantankerous throughout the day, never conversational.
At best, my telling her I am only here to HELP and to make her more comfortable has been my own best approach. Appealing to her nurse's past is NOT a good idea. I think that makes her madder.
Thanks!

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I am a paid caregiver and my recent charge sounds very much like your RN... it is easier said than done when someone says to let it roll off your back, when you are the one that is being targeted all day, no offense JG, but it is very hard to detach sometimes.... so I do understand Blessing, and I have been where you are... what I finally did with M, is set her down and talk to her woman to woman... telling her I have no idea how hard it must be to let someone come into your home and do all the things you have always done..... but this is more than a JOB to me, I can get a JOB anywhere..... I had to show her my human side, that she does hurt my feelings at times, that just because I am PAID does not mean I am paid to be treated ugly... but I also pushed with the family to have her evaluated for depression... BINGO... I see a marked difference in her, but also if RN is on the one med, I don't know how meds for depression would work....if there would be a drug interaction..
And M would reject any encourgement also. now I am able to say to her, 'don't be so negative, you know you are making progress', but that took time and patience and consistency on my part... there are times she still doesn't trust me.... but your RN sounds as if her trust has been horribly betrayed and now she just expects the worst so she won't learn to depend on anyone in case you turn out like the others... keep doing what you are doing... just be good to her.... she is afraid.... respect her fear, she has reason to not trust paid caregivers.... and I'm sure she is hurt that her son felt this was needed, even tho it is.... I try to put myself in her place... she is of sound mind, so she sets the schedule, she says what she wants to eat, ect.... I know this is her home.... her safe place, and I am always a guest there, no matter if I am working or not... you sound like you know what you are doing, and it is good that you are fearful about the shower..... you have been given great suggestions.... and sometimes we have to figure out a way to approach the familes without offending anyone.... I don't think good in home caregivers are given the credit they deserve for having such a balanceing act we have to do between our charges and the familes that expect so much out of us... it's a hard job no matter what, plus being the 'stranger' taking care of their loved one.... and we don't get paid near enough... so hang in there... your heart is in the right place.... you are doing an awesome job under the circumstances and asking for help only validates that...... if you didn't care, you wouldn't be trying to figure this out.... lots of hugs and respect sent to you...
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Do you have a shower stool? If not have Mr. Get it done get you the one that allows her to slide in position, It is just a rally big seat with rails. Also a removable shower head so you can get her clean no other way to say her privates so sores do not develope. Also with a han wond she might feel free to hold some herself. He also needs to put handrails for her.Are you family oe hired assistance. Do not really like the way he approaches you. I would say if he is family to get a grip. Good Luck
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(((((((((((((Blessing))))))))))))) It may well be best that she does not know about her granddaughter. I commend you for wanting Betty to be happy, but I really wonder if that is possible. Comfortable. maybe, clean, hopefully, properly nourished, yes, but happy? It might be good for you to lower your sights to looking after the basics. I don't think anyone can make Betty happy. I do think it would be good to mention to John that his mum may need an evaluation, and meds adjustment, as it could make her easier to manage, and also make her life more pleasant. The meds (too much or not enugh) may be contributing to her not wanting to get out of bed. He may not want to do that, but at least you have tried. She is on Prestique and Seroquel - pretty heavy meds for depression and bipolar disease I believe. Traditionally bipolar disease is very difficult to manage. She is a senior, so side effects of these drugs may greater. A friend of mine (since deceased) was a professor of Pharmacoloogy. He visited his mum to find her lying in bed with her face to the wall. He reviewed her meds, and found she was grossly over medicated. Once her meds were corrected she came back to herself. There may be a parallel here. Whether or not a med adjustment would have any effect on her temperament, I don't know.
I am really sorry about your injury, and know it will take time before you get a settlement. You are in a very different situation compared to what you were before - looking after, presumably, normal kids. Yes, detaching and letting the nastiness roll of your back is difficult - no question of that. However, detaching will help you survive, if you want to keep this job. Again, I commend you for seeking to find answers to a very difficult situation. Good luck, and keep us updated.
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Once an elderly person falls, they develop a fear of falling again and her fears should not be ignored or taken for granted. she might still have pain, loss of balance, etc due ot the hip problems or other problems like blood pressure and fear is made worse in a slippery environment. You should insist that a shower grab bar be installed. and a shower spray hose if there in not one already. I don't know if the bathroom has a tub or a walk in shower but if walk in and large enough, I suggest having her walk in with the walker, have her sit on a shower chair (one with arms preferably so she can push up on the arms to get up, i actually use a commode without the bucket but it does tend to rust) and then most of the washing should be done while she is sitting. Then for places you can't clean while sitting, first rise the soap off the other parts just washed, and dry her hands and then bring a walker into the shower (you can put plastic bags over the legs with tape to keep water out of the holes). there should be a rubber drain mat with holes on the floor placed for no slipping but also should be large enough for no tripping. Then she can stand and hold on to the walker to complete the bath, rinse and let her sit back in the shower chair and dry her before walking her out. hen, The shower hose (with a lever to turn on and off at the sprayer) helps control the situation.

And the every other day bath requirement? unless she is soiling herself in a way you can't clean her properly in bed (it's done all the time in hospitals and nursing homes) , once a week might be enough supplemented with bed baths. I was told by a dermatologist that fewer baths are better for the elderly so the skin does not dry out.
And if you have a back issue, should you be giving a woman who is unsteady a bath alone? how about the son and you doing it together? Maybe she senses, and rightfully so, your hesitance due to your back concerns? Her safety is the utmost importance so her son should cooperate to "get it done" safely.
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Instead of pulling depends down, why not rip them off, they are designed to be ripped and to avoid having her to stand balancing you could walk her back to the bed w/o the depends and put them on while she is lying down. there is a thing called a gait belt that might help to you have something to hold on to her with. Is she on medicare, maybe son can arrange for some in home physical therapy with someone who can train you and him how to properly transfer,etc? Regarding step down into shower. I had a carpenter come and build an insert made out of recyclable plastic that can be taken out for cleaning that makes the shower level with the floor. don't use wood b/c it will rot. would a small roll in shower chair work?
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Blessingpoetry, you need this job, and Retired Nurse (RN) needs your compassionate help. So hang in there! I admire you coming to this site and trying to figure out how to make things better.

I think your approach of talking to her and reassuring her of your good intentions is very appropriate. Try not to take her responses too personally. In that sense, you may need to detach a bit, too. Ask her what you can do to make her more comfortable. "I know you'd rather not do this at all, but since we have to do it, is there any way that would be more comfortable for you?" Surely as a nurse she is very familiar with having to do things the patients don't like. Without actually mentioning her career, maybe you can remind her of that. "I'm sorry, but sometimes helpers have to do things the person they are helping doesn't like. Let's get this over with as quickly as possible."

The notion of bringing in a physical and/or occupational therapist appeals to me. Son would have to ask her doctor to order a visit or two. The goal would be to learn how best to get RN into and out of the shower. This professional could also recommend (and perhaps order) an appropriate shower stool, grab bars, etc. Of course, just because RN has instructions of how to cooperate doesn't assure that she will cooperate. But it is worth a try!

Maybe RN has had a lot of experience with neglect or disinterest and that is where her "you don't really care about me" attitude comes from. Consistently assuring her that you do care, and that you really want to do things the best possible way both for her sake and also for your professional pride, is all I can think of to overcome the attitude.
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She is not on the seroquel now. I was once on it, myself. I know that John has her on the minimal meds, which I personally agree with. I was overmedicated to the point of weighing 300lbs. I can't imagine what is going on inside her. I look into her eyes, and can SEE that someone is in there, but does she want out, does she want to GO and BE again? I have no idea. I only have my own horrendous experience with being over medicated to go on. A Friend told me to watch Patch Adams, and 'connect' with Betty, well. I do not foresee that happening. I know that she was an ICU nurse in LA forever, then when it got to be mostly AIDS patients, she went to the VA to be a nurse the last 8 or so yrs of her career. All of this is hard friggin work. Whatever she wants to eat, I will make her. I know a few things she kinda likes, and I make that on a rotation. I guess her being happy is not going to happen. Comfortable, and less annoyed with her self imposed confinement, maybe. Her son keeps telling me, its all her choice- he would have her in another situation, if she would do other things- books, crosswords, crochetting, all this would be at her disposal, if she mentioned it. She has tv. She doesn't even want it on. :( Thanks for the help...
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I agree with the others, there's some serious depression going on here and I don't see the woman cooperating, let alone progressing, until the depression is addressed. There are many, many signs in your posts of a major depression. My oldest daughter suffers from bi-polar disorder and it's truly amazing what the right cocktail of psych medicines will do for a person! Poor lady needs a mental eval as soon as possible, IMO.

I commend you on being such a caring, compassionate caregiver - hang in there!
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You are in a situation which is very difficult b/c this family is undergoing a lot of turmoil and it seems like the son is overwhelmed but trying to do the right thing. And you, not being a family member, have to walk on eggshells with your attempts to help out. This lady needs a good doctor who will listen to her and talk to her and try to find the right combination of things (low dosage antidepressant) physical therapy, etc to get her condition improved. When the dr comes to the home, does he communicate with her or talk over her to the son? Are you allowed to talk to the dr to tell him what you are observing? Have you tried asking your patient, since she is a nurse, what she thinks she needs to feel better and improve her situation? Have you asked her what you can do or her son can do to make the shower experience better? Have you asked her if she wants to try to put a bedside commode next to her bed so she can start trying to get up when she has to go so she won't have to walk so far? What about a wheelchair, does she have one? can you suggest you both go outside for fresh air? If she has severe depression she probably needs the right medication and right dosage to give her that boost to get back on her feet. I know from experience with my elderly family member that some of those drugs can make them act crazy, some make them sleep all the time. some make them sleepless. The magic one turned out to be a low dose of wellbutrin, after many failed tries. Would her son be open to suggestions if you find articles on the internet that talk about depression and the elderly and the different drugs and treatments and give them to him? And re his not being open to shower training. Tell him that things change with the elderly and she may be getting weaker from laying in bed all the time and need more support. Thus, my original suggestion to look into getting a good home therapist to come and evaluate her and offer some sessions. Medicare ususally covers it. She is too young to waste away in bed.
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She just came out, and had...uh...a shit blowout, as her son puts it. She sat down at her table, I smelled IT and got her to the toilet. It was..horrific. Stupid me, thought BABY WIPES! Hell no. Thank Buddha her son walked in. I told him, I need you to get her into the shower. He did, and she kinda fought him. She won't help, that's the issue, but he's like 6ft2, and linebacker from HS, College- he gets it done. HE sez, its ok, this is a team effort, if I'm here, I'll help. Thankfully. But she didn't even clean herself under his instruction, he had to turn the shower back on her, and tell her to do it again. I will attempt to talk to him tomorrow about all of these things you all have given me. she IS too young to just lay here. My dad is 77 and totally active. My friend's sister, from Visiting Angels, may come talk to me, too. That would totally help.
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