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Personal Finances Taking Care of Parents
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I was called by the Medicare-affiliated home health agency yesterday afternoon, and less than an hour later the intake PT examined DH. Of course, that meant that DH was especially sure-footed compared to recent months, climbing up and down the front stoop at a reasonable pace and without holding onto the railing or getting two feet on each step before proceeding as he has been for the past few weeks. The 3 of us took a short walk, where he was slow but had no need to hold onto anyone or anything.

DH was unable to follow or imitate instructions for standing up & down on tiptoes while holding the kitchen counter, making arm circles, a seated leg exercise). I was able to do arm circles with him by grasping his hands and both of us doing them. I did everything so I felt like I got a little PT :wink:

Best of all he took the hubster’s BP–120/60. Alrighty! I tried taking it with our wrist cuff shortly after–way lower coz when I do it he fidgets, wants to hold my hand, grips the lap blanket I roll up to raise him arm, etc.

Anyhow, even though we think it won’t be terribly useful, Medicare allows for PT twice a week for 3 weeks to see if it can help. Can’t wait! At least we can walk outside again (no rainy days please on PT day!) and get his BP twice a week. At least once or twice I’d like our aide to be present so she can learn his exercises and maybe get him to do them when we lose the professional. When I get very close to him, he gives me a hug or assumes I want to take his hand to lead him somewhere, so it’s confusing.

The PT has worked with other advanced dementia patients over the years and says DH is a lot more functional physically, particularly his balance–and of course way less verbally and no ability to comprehend. He was cooperative, but confused. Didn’t help that I had to wake him from a nap for the session. PT is impressed that the hubster walks so well. He even seemed less stooped than usual. And din;t show off his tremor.

BTW, this was the same guy who was my at-home PT after breaking my leg almost 2 years ago. I jumped and ran a few steps to show him my improved functionality–he was impressed :smiley:

ASIDE
I’m becoming more forgetful to the point I’m considering requesting a cognition test for myself. After 72 years of never forgetting why I went into a room, I’ve forgotten twice in the past week. or was it 3 or 4 times… I also forgot I hid his belt and couldn’t find it. Then I found it, and now it’s missing again and I have no idea why or where. And I forgot what I planned to make for breakfast several times (so the chopped ham hangs out waiting for that Denver omelet…I hope it’s still good…maybe for lunch today–if I remember…). And I spelled fidgets figit, which was marked wrong, so I tried fidgit, still wrong, and it took me a few secs to think of fidget. I’m having similar trouble spelling more often than ever before. Yikes =8-0

AND IN TOILET NOOZ
Yesterday while I was opening an Amazon box on the dining table, he peed on the dining room floor while walking towards me, ending up with the final drops on the rug (this is a pricey Indian rug). At least my back is stronger so my main objection is the waste of paper towels and cleaning stuff. And feeling like I have to tail him around the house.

Last night he slept from about 8pm to 3am, then got up to pee. From about 3:45-4:15am he stayed out of bed but not to fidget with the blankets or wander the house as usual. He kept zipping and unzipping his pants (yeah, he slept in jeans again). I brought him to the toilet 4 times to no avail. Finally the 5th time I got him to sit. And he pooped. Went right back to sleep. Me, I was up 3-5:30. He didn’t wake me again till 7.

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Aide couldn’t come yesterday but is here today. While I went out to run errands, she washed my breakfast dishes and made the bed while the hubster slept, gave him snack of fruit salad w2.walnuts that I made this morning, then tried several times to shower him, but failed and got slapped :frowning: When I got back I helped manhandle his clothes off, then started washing his hair, which makes getting him to step into the shower easier. But much harder than last Thursday, yikes. Then I left the 2 of them to it. Ah, they’re out and she’s dressing him. It’s nice to have a break from that :slight_smile:

I tried to score some gummy supplements at at Target for him–omega-3, CoQ10, K2, D3. Just bought D3. Just not got a combo k2-d3 from amazon. Omega-3 gummies are all too weak. Maybe I’m spoiled by my twice-day, heavy duty Garden of Life fish oil. Without which my joints would hurt, and my skin wouldn’t get compliments.

Maybe I should let our aide fix a denver omelet for all 3 of us :slight_smile:

=alstro, Queen for a Day :wink:

PS–He peed once in his Depends each of the past 2 nights. Good. I’m afraid if he peed twice, though, he’d overflow them like Mom did.

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Progress! Hoping the PT is approved for a longer period!

=sheila

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With all due respect to a person’s right to autonomy and refusing medical or other care, there are limits, and anyone living in my house will shower.

That said, manhandling wouldn’t be my first choice. Any pills available that would improve compliance?

Alstro, I realize you balk at the prospect of your DH’s being “drugged up,” but to me that’s looking pretty good about now.

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I plan to discuss options at next neuro appt, in a few weeks. He can’t take ativan or presumably anything similar (makes him violently crazy–I mean call the security guards in the hospital crazy). Also wondering about sleeping meds, but not too much–I like getting a solid 6 hrs myself.

It’s typical for advanced dementia folks to balk at showers. I don;t know why he does, though–he enjoys the hot water once he gets in. And is always in a good mood once he’s showered, shaved, and dressed.

Many dementia folks hate being in the shower as well as getting in. Perhaps it’s simply a confused person insisting on status quo --which is why, despite him enjoying outings once he’s on them, he sometimes balks at leaving the house/getting in the car.

Aide had ordered groceries from Whole FOods for my brother and they texted it was ready so she needed to pick up. So I made us a denver omelet. He loved it. For me, just OK. I don’t seem to be as fond of ham as I used to be. I’m lucky he’s not so fussy :wink:

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It’s typical for advanced dementia folks to balk at showers.

What’s the usual solution?

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The advice I’ve found online I already follow…speak in a soothing and reassuring voice, bathe when you aren’t rushed and the patient’s in a good mood, make the bathroom warm (I keep a cube heater in there now and turn it on 5 minutes before I try to shower him–of course, I usually have several failed tries before I succeed so the bathroom’s positively hot by then!), use a hand-held shower head to reduce fear. I also encourage him to reach his hand in to test the water temp to be sure he likes it. Thank goodness I have a grab bar to help him step in–he uses it every time. But will not use the shower chair or even put a fgoot on it for easier washing.

This advice video is sweet but almost totally inapplicable to the hubster who doesn’t speak or understand English any more (and doesn’t seem shy about being naked in front of people these days and doesn’t appear to be afraid of the water as he eventually willingly steps into it and seems to enjoy himself–he mostly washed himself today):

https://www.youtube.com/watch?v=sl3Dc1kERto

Here’s another website:

In my experience, I have seen the following as common difficult behaviors exhibited during the bath or shower experience:

Physical resistance including hitting, pushing, kicking, and biting

At least he doesn’t kick or bite!

Verbal agitation such as “leave me alone,” crying out, yelling, or cursing

He doesn’t do any of this. Just physically balks by trying to prevent his clothing from being removed. I think he isn’t capable of raising his voice any more.

Withdrawal and fear in which the person may shake, cry, or hold themselves tightly and rock

Never happened (yet?).

The role of the therapist is to discover, with the help of the CNA or family member, the cause of a behavior problem as named above. Some likely causes/triggers include:

Unmanaged pain

The facrt that he enhoys the shower once in makes this very unlikely.

Being cold

I warm the bathroom to the point that I start to sweat. I try to be naked as well as I get wet when I shower him.

Feeling frightened, vulnerable, and exposed
Feeling embarrassed
Feeling a loss of control
Not understanding what is happening, misperceptions, and poor communication

I cannot say. Fear of loss of control seems most likely.

Speaking of which…earlier this afternoon he acted like he needed to pee so I took him to both bathrooms and the commode numerous times to no avail. Then I went outside to pick up an Amazon package and to bring in the trash barrel. While I was gone, he peed in the bathroom corner by the shower, wwetting tthe painted molding and mat outside the shower. sigh.

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Hmmm, since undressing is the point of contention, how about undressing him during the shower, instead of before?

Just a thought. Might help, might not.

I used to wrap my grandson in a towel, and lower him into the warm bathwater while he was still wrapped up.
Now that my DIL’s bathing him, she wears a bathing suit and gets into the tub with him. Not sure when in the process his clothes come off.

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I still like my distraction idea (i.e. appealing to his reptilian brain). But taking him into the shower and turning on the water might work. I suspect he won’t like wet clothes, and will then be willing to take them off.

Of course, that may only work once. He then may not be willing to get into the shower at all. Dunno.

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But taking him into the shower and turning on the water might work.

Uh, nope. The master bath has the most distant pipe from the hot water heater. It takes a few minutes to heat up shower water. It’s gotta be runnoing and steamy before he’ll step in. Or me(!).

I suspect he won’t like wet clothes, and will then be willing to take them off.

It’s very difficult for a single person to get wet clothing off a strong, retarded adult standing in a shower. A glass shower… Don’t confuse him with those weaklings lolling in their wheelchairs around the lobby tv or nurse’s station in a nursing home or dementia ward.

He’s actually entered the shower with a single item of clothing twice before. Last thursday he still had one sock on. Impossible to get it off while he’s in the shower as he ignores/won’t sit in or put a foot on the shower chair (which was a new addition to the shower when I broke my leg) and needs both feet to balance. He had underpants on another time, which I was able to pull down in the shower. But he wears Depends all the time now. If I can get him undressed to that point, it’s pretty easy to get his Depends off as they have rippable seams on both sides. That’s how I always get them off (sometimes the pants/pj;s over them stay on a long while after-).

What he doesn’t like is soapy hair and loves to get it rinsed. It;s how I get him into the shower, but first I have to get his clothes off–that’s the hard part.

This problem is not uncommon among the elderly in general, not just dementia patients.

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Summer clothing–loose t-shirt and loose shorts, maybe bare feet in sandals–not so bad to get off wet. But jeans, long-sleeved tee, flannel shirt, a sweater or fleece, thick socks this time of year–nuh-uh.

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As for pills to make him more cooperative (or at least weaker in his fight against removing clothing)…have to be careful there. Don’t want him losing balance and falling. Also…glass shower–dangerous. Trippable threshold, too.

I note that the shower isn’t really the issue–he usually rebels against having night clothing removed in the morning and daytime clothing removed in favor of pj’s.

ASIDE
Last night after I got everything ready for the night (did the dinner dishes and cleaned the kitchen, turned on the mattress pad warmer and turned down the bedding and put his pj’s on his side of the bed, turned off unneeded lights, tuned in a movie he used to like (Dave) on the bedroom tv since it was too early for Olympic figure skating (I’ve had sufficient bobsled, biathlon, and skiing-), turned down the thermostat for the night, he refused to leave his den recliner and fell asleep. Not unusual. After a while I heard the chair creak and waited for him to arrive in the bedroom. Took too long so I began to wonder if he was peeing somewhere en route and got up. He was sitting on the commode (which now lives in the living room) with his pants pulled down! As I praised him on approach, I had to stop short. He wasn’t peeing–in fact his Depends were still on. He was using the commode as a chair and taking off his jeans. I helped him finish, then quickly brought his pj bottoms, which he happily donned :slight_smile: Then he pulled out a dining room chair, sat in it, and crossed his legs. And his arms(!). No soothing voice, proimise of a fun movie, or caresses moved him. SO I went to bed and periodically checked back. He eventually took my hand and came to bed, I tried to interest him in the toilet first, but nope. He was asleep in a few minutes. Just woke up around 3:30 to pee and back to sleep. Me, I’m wide awake and online as you see…

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For my dad’s bathroom shower, I removed the glass wall & door, and replaced them with a shower curtain, for accessibility and safety.

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On the surface a good idea, but hmmm…the opening isn’t that wide–it’s a one-person shower. I or his aide stand in the open doorway while he’s showering anyhow to wash his hair–and his body if he doesn’t (she also washes his feet, which I have trouble doing). I’ll ask her opinion. She has 30 years of experience washing disabled clients. I also think he might be freaked out by such a change and have yet another reason to avoid showers.

We still have a shower “curb,” for which he recently started using the grab bar (installed when I broke my leg) for security while stepping over it into the shower (I no longer use it except to hold his shampoo and soap within my reach while he’s in the shower.) I like containing the water as we have no drain in the bathroom floor–I’d feel like we need a drain as the shower and bathroom floors aren’t tilted toward the shower drain (I squeegee the shower walls and floor after showers to prevent puddles/mildew/mold).

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I made a fancier lunch than usual (Thai pork salad), but he wouldn’t eat it. So I opened a can of lentil soup, and he won’t eat that either. Finally I tried a bowl of fruit salad w/walnuts. Yup. Ate it up. Hope this isn’t a harbinger of future fussy eating Especially since he can’t tell me what he wants. He usually eats anything. High protein smoothie this afternoon fer sher.

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…but he wouldn’t eat it.

So? You’re not a short-order cook. When he’s hungry, he’ll eat.

Yeah, I got that attitude from 1poordad. He used to say that when I didn’t like something. “This is what is being served; if you don’t like it don’t eat.”

1poorlady would get me anything I wanted, but I’m trained (after growing up with that) to eat whatever is prepared. She’s not my maid-servant. She’s my wife. I realize he probably doesn’t have sufficient cognition to appreciate that. But, if he’s hungry he’ll eat. If he doesn’t eat, well there is the next meal.

P.S. Interested in what “Thai pork salad” is…sounds like something 1poorlady especially would like.

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For my dad’s bathroom shower, I removed the glass wall & door, and replaced them with a shower curtain, for accessibility and safety.

I did the same in the bathroom my son uses.

I’m considering replacing the bathtub/shower combo in the master bath with a curbless shower. My wife was the bath lover, so the tub is no longer needed. A curbless shower would be safer for me as I get older, and would be much simpler for my son as we could easily roll his shower chair in rather than having to use the complicated bit of rolling base and transfer rails and stationary base to get him into the shower.

–Peter

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We have a walk-in “snail” shower. But it has a step when you first get into the snail. If I had it to do over again, I would make that a ramp. It’s only about 3" of a step. Over the ~5’ that it would be a ramp, it would be very gradual. There’s about a 1" step down into the shower basin. I’d probably ramp that as well. Though it is tight for a wheelchair, when 1poorlady had her cancer surgery, we verified (by experience) that a wheelchair can fit into the snail entrance. The person pushing it needs to plan ahead, though, as there isn’t room for them to get around the wheelchair once it has entered the snail.

Little things I would have done differently had I known… At least there is no glass door or partition. And it is spacious once you enter the shower basin proper.

Can’t do anything about the tub. I never wanted it anyway. But apparently if we ever go to sell this house, a jet tub would be an added attraction (or so they told us). It separates our vanities, and is in no way connected to the shower.

The MIL suite has a large walk in shower with glass, and a generous bench. And there’s a step-over lip. Again, if I had it to do again I’d tweak that a bit. It is wide enough for a wheelchair, though. If MIL becomes sufficiently disabled, we probably would have to have the glass removed. As of now, her only real problem is blindness.

None of the facilities we toured for 1poormom had glass. All the showers were roll-in, with a curtail rod (you have to provide the curtain), and most had built-in benches that fold up when not in use. Apparently that is pretty standard now.

1poorguy

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What is a snail shower?

I feel so old-fashioned. We have a bathtub with a showerhead, and we climb in and then climb out! And we’re both pushing 80.

=sheila

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=sheila ~

What is a snail shower?

I feel so old-fashioned. We have a bathtub with a showerhead, and we climb in and then climb out!

Thank you for asking. I, too, have never heard that terminology before. Maybe it is a very small shower that you cannot turn around in. ???

Robyn

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What is a snail shower?

https://www.google.com/search?q=snail+shower&client=fire…

Here’s mostly classic snail showers. You can accomplish the same idea with square walls rather than the fancy curves.

The main idea is that the spray from the shower can’t get out, you don’t need a shower curtain, and the floor is flat or only slightly sloped. With beefier walls (and more room) you can accommodate hand rails or a wheelchair or a fold out seat.

–Peter

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