Mum with dementia is naturally resistant towards showers, however due to her incontinence and skin allergies / sensitivity, it is a necessity.
the skin rashes/allergies have been pretty much her whole life. The incontinence, she had leakage problems before her dementia and then now she’s in full incontinence pants.
I am able to easily convince her to have a shower but under very specific conditions. She has the heating lamp on and a portable heater and the temp of the water needs to be just right. She has a bottoms / armpits only shower most of the time. We apply ointment on her rashes after shower. If I sense more resistance, I’ll play her favourite songs and make it a fun event. But usually it’s fine as long as the room is warm.
I wash her hair about once a 1.5-fortnight (depending on how dirty it is). I cannot use dry shampoo because again her sensitive skin but her hair gets oily very easily and thus smelly. I use a very mild shampoo. This particular shower is evidently a bit more challenging and she’ll have moments of tantrums. But once done, Mum loves her hair as I blow dry her hair pretty. The blow drying is also needed because she doesn’t like the wet hair as it makes her feel cold and it tends to last longer until the next clean. All in all she’s grateful after the shower and feeling much better.
My worry is that recently I enquired about respite worker coming in to shower Mum and they said, they would not push the idea of a shower unless she willingly went (Mum does require a pep talk to enter the shower and she doesn’t speak English). They also said the room needed to be comfortable for the worker not Mum,.. ie heating or heat lamps could not be used and they wouldn’t attempt other things like music to make Mum comfortable. This alone tells me that it simply wouldn’t work and that Mum would put great resistance on the matter. There is absolutely no way she’ll hop in the shower without the room being warm.
So now my worry is about aged care / memory care. Will they just allow mum to rot in her uncleanliness and apply similar rules? One would think being memory care, they’d work with what a dementia patient needs but the above has me in doubts.
Will I have to come in there to shower her with her specific needs armed with a portable heater? Will I be allowed to use the facilities like the employees to shower Mum?
How does it all work?
Her skin sensitivities are severe.
Do not give her an option, do not ask, just say shower time.
They were careful not to freeze her or scald her. They were actually amazing, because she would scream as loud as she could in protest but, once the shower was done she was fine.
I know people think this is cruel. It is the better option when dealing with UTI's, rashes and the genuine discomfort caused by being dirty. She was never hurt, just not happy with bathing.
As her advocate you have the right to say, get it done. You can show up and help, provide products and help make sure she is getting the best care possible in an impossible situation.
There are other ways to maintain adequate hygiene for your mother other than showering. There is a product called Bath-In-A-Bag. It's large disposable cloths pre-moistened with skin cleaner that is heated in a microwave and requires no rinsing. It's used in invalid care and for bedbound people.
A basin of warm water and soap while she sits on the toilet with a robe on can work too. The facility she's in knows these things and will do them. Just make sure to tell them.
I’m wondering if the doctor would write this into her care plan?
Might depend on the doctor and the facility?
Does her doctor know that she has these severe skin sensitivities?
Does the doctor presently treat her for these issues?
An ointment for a rash after being cleaned should be manageable in MC I would hope.
The loving ritual you have for your mother would be a challenge but the application of an ointment for a rash seems reasonable to me but I haven’t had a LO in MC.
My experience is ALL of the very old have sensitive skin and the skin is a challenge to protect. My mom made my dad “skin guards” from padded cloth diapers that she sewed into his shirt sleeves to keep the skin on his elbows protected from peeling off. I’m not sure what would have happened to him in a facility but an ointment to prevent a rash seems doable.
I worked for an elderly woman with dementia who had to have the heat in the house cranked up to 80 degrees or more and insisted that the heat lamp be going in the bathroom for her shower.
It was so hot in there, I passed out showering her one time. That's when there had to be a compromise made. I was not going to risk my health and safety because she had dementia and always thought she was cold.
The compromise was no more heat lamp and her daughter started assisting with showers.
Your mother is in a facility. It's not a one-on-one caregiver/client relationship like homecare. The CNA's cannot put in the time to coax and conjole a single elderly resident into the shower. They have a whole floor of elderly residents who have to be showered.
They will document in writing if a shower is refused. Then you will have to work out some kind of arrangement with the facility. It is very unlikely that any facility will allow a resident's family member to bring an electric heater into the shower room. They will however allow you to go with your mother and the aide who will be showering her. You being there will probably make it much easier.
I have no idea what to expect so it’s all new to me.
When my mother became petrified to get in the shower at her MC, I asked her a lot of questions and determined that she was afraid of slipping; she felt the floors were slippery in the shower and in her room (with hardwood floors). So I bought her a pair of water shoes and that did the trick immediately. So the key is to know your mother, translate her needs to the staff at intake, and also keep your eyes & ears open for issues that may pop up that YOU can solve FOR your mother b/c you know her best.
I strongly doubt you will 'be allowed to use the facilities like the employees to shower mum.' You are placing her into a Memory Care facility precisely so her care team can do these things FOR you!!! Just relay your concerns and needs to the staff when she goes into the MC at first, being sure to write down her skin sensitivities and what products will be needed for her care. Normally, you will be expected to provide those products that the staff will need to use on her; that's how it is in my mother's MC.
Good luck.
Looking forward to MC, you could discuss these and other conditions before you settle on the right place for your mom.