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If you are your mom's PoA, that's great and you are in a good position to help her when she can no longer make good decisions for herself. Please read the PoA paperwork to understand the conditions under which that authority can become active (some require 2 diagnosis of cognitive incapacity).
If you (or no one) is her PoA, please make every attempt to encourage her to get this taken care of. Without a designated, documented PoA it will become increasing difficult to legally act on her behalf. And, if she gets a medical diagnosis of cognitive decline, this can prevent her from creating the PoA in the future (as well as cause issues of control among siblings).
If you manage to get her to the doctor (use a fib like, Medicare requires it) then go with her with a pre-written note explaining who you are and your concerns about your mom's behaviors and to request a check for UTI, medication, and memory and discretely give it to the staff or doc. They will do it for you. They did it for me. Also while there try to get her to assign you as her Medical Representative (a separate thing from medical PoA) this way the docs can legally disclose her private (HIPAA) info to you and you can supply them with info about her. I wish you much success in working to help your mom!
Lots of people with dementia are reluctant to shower for some reason. Maybe she needs an aide to help her or give her a sponge bath regardless of whether she thinks she needs it or not.
Tell her there's no shame in not remembering everything and that it happens to a lot of people.
And yes dealing with someone being negative and argumentative and difficult is VERY exhausting.
And a hoarder too. Wow lots of things going on there.
Definitely contact the doctor's office before the visit so they can be aware of what is going on so they can discreetly asses her.
Good luck.
I would bring up issues with my mother's doctors, but being that she couldn't remember what the doctor said, she would just angrily dismiss the doc's wisdom when ever I reminded her. "THE DOCTOR IS NOT LIVING IN MY BODY!", she would say. Okay, then. So much for that.
The arguing and snappiness and general unwillingness of my mother to live according to my simple rules, along with the other effects of dementia, stressed me out so much that I was soon incapable of functioning, myself. I live with health concerns of my own, and it was all TOO MUCH.
She now resides in a LOVELY Memory Care Assisted Living Facility.
I even bought my mother a planner, like you did! She now carries it around with her in the Memory Care, and it feeds into her OCD. She eats a bite of food, comments out loud, writes something down in the planner, and REPEAT!
As they say in some programs, "Keep Coming Back!" You will learn a lot here! :-)
Best wishes.
Quite honestly, I was able to determine my mother had dementia, and most likely it was vascular. She had been on BP meds for MANY years and the progression was much as described for vascular. The doctors didn't do any testing. The aide company we tried to use to keep mom in her condo longer DID send a nurse first, for an evaluation, which included a much better test than the doctor offices use (our latest one did try the test with mom, but she was already in MC 2 years at that point, had lost her hearing aid, so that test was a bust!) The nice part about that evaluation is having it done in mom's place, sitting at the kitchen table, with 2 of us present. It was a lot less "dr" like, and less threatening. Medicare paid for this. We were also given some pointers, like using a timed/locked dispenser for her meds.
Write a letter to dr prior to visit and ask him if he would ask mom some questions during the visit. How often do you take a bath? Brush teeth? Walk around house or outside? See what her answers are with you standing in the room listening to her answers - correct her as needed. Ask dr to tell her she needs to bathe X times a week, walk so far each day, etc. And if she needs help to do those things, he will order it. Home health can send a person to help, as needed, with a bath, phys therapy if she needs some exercise, etc.
If mom understands your conversation, then let her know these are the rules of the house regarding hygiene. If she wants rules set down by someone else, she can move to some kind of facility care that fits her needs. Ask her what she prefers so you can help her live where she wants to live
Doc should also write the instructions in addition to recommending what she needs to do. She likely won't remember. Maybe, just maybe, coming from a doctor she might read it and do it. Have copies so if she loses or tosses her copy, you have another to post on the wall or include in her "planner."
In the meantime. try to have a series of discussions with your mom about what life could look like with her living in your home. Explain your values: cleanliness of home and person, respectful conversations... Ask your mom what she values and expects. I have a feeling mom values her privacy and her freedom of choice. Try to find ways to incorporate both. For example, she agrees to bathe more often and you both put the dates and times on her planner. Another example, she agrees to allow you to clean her "place" and throw out garbage, and that 1 thing kept = 1 thing let go of.
With the not wanting to take a shower of which my husband is a real challenge for I have found that I tell him it is change the bedsheet day and only clean bodies get into clean bed. I call it “strip the sheets and shower day”. Another idea might be to make it a spa day, with special products, towels, etc and see if that will draw her to basking in the treat. Don’t know if this will help you, but I hope it does.
Best of luck to you - being a caregiver -as you know- is not easy or simple. It is very demanding and you may want to talk with a counselor yourself or spiritual advisor.
I do encourage you to get the documents noted above a s soon as possible before you reach the point that without them doctors cannot talk with you and you don't have the authority to pay her bills or keep track of her monies.
Be firm with her and inform her straight out that she stinks and you will not go anywhere with her until she has a bath. And, if she wants to stay with you she will be expected to have a bath twice a week. If she needs assistance just say so. It could be that she is too proud for her own good
No, you are not her mom, you are her caregiver. If she does not like the arrangement find someplace else to go.
If she wants to stay with you, she will behave with respect towards you and your family or get out.
If her doctor is any good they will be more concerned about what you have to say rather than her hurt feelings.
Moms doctor expects me to behave in such a manner as to be attentive to what is happening and report it to her.
I was horribly abused for six years. Now, I have had enough and put my foot down. She does not like it but she dislikes the alternative even worse ( the alternative is off to the old folks home she goes. See how long they tolerate that behavior, hint. It will not be too long. And, she knows it too )
You have to be strong but respectful towards narcissist's or they will treat you like crap.
I speak from a lot of experience both in my family and in society.
As for her wanting to die, it is just to get attention.
My mom does the same thing but there have been a few times she actually though she was going to die. She was terrified because she knew she was going to Hell where narcissist's belong. I do not say that in anger but from a Biblical perspective.
Next would be getting her to the doctor. Fibs are your friends. Medicare requires yearly (or more frequent) checkups. Document all your concerns and observations and provide those before the appt, so doc has time to review first (letter or through the portal.) If doc is also good, he won't mention your letter or documentation. He can use what you provide to explore what's going on with her. I would stay out of the exam room, since you already gave information. She might be more willing to be open or accept what the doctor says if you are not there. S/he might also be able to convince her to sign a health care proxy, same reasoning. Even if you have POA, this would be on file in the office, no need to find your copy of the POA.
I also wouldn't worry about her showering before the office visit. Let the doc see her in all her glory! All the more reason for the doc to believe you over her.
As for compliance at home... Arguments will only get you and her upset. Yes, we would prefer they, occasionally at least, can bathe and be clean, but arguing will get you nowhere fast! In MC they can't force any resident to do things they are refusing to do, such as bathing, taking medications, getting wound care or go for medical treatment. Even those with dementia have "rights." So, the staff has to coax the person, trying somehow to make it THEIR idea to do whatever needs to be done. Ask instead of tell. Does it always work? No, but it's worth a try! Wouldn't you like to get cleaned up mom, so we can go to _______ (that being something she likes to do.) Lay out fresh towels and clothes, perhaps some nice smelling soap, etc. Let it be HER idea. Don't try to correct her either, even when you know she's wrong. Acknowledge and move on to something else.
"...I’ve tried to help her to focus on the positives. She just glares at me and goes down a rabbit hole of negative." Keep your "chatter" light and breezy. If she still goes negative, tune it out and continue with chatting about happy things. It's hard to tune it out, but it does get easier with practice. You can always just drift away if she continues. Don't acknowledge her negatives. Let her ramble on.
Hoarding - what kind of things is she hoarding? Do you clean her "space"? When cleaning, perhaps sneak obvious small trash out, or get someone to take her out for a bit and get rid of some of the trash - don't go overboard, you don't want her to notice stuff is missing. A little each time gets the job done.
When clearing/cleaning out mom's condo, she was keeping the oddest things, but clearly it wasn't just hoarding. Cover of microwave mac n' cheese has the instructions - have to save those in case the next one is missing! The stuff she had multiples of is because she'd put them away and forget she had them and ask for more (TP, paper towels, trash bags, etc.) She lived 1.5 hr away, so I couldn't check before buying/delivering.
Try to make the bath and shower spa-like and fun. Nice music and comforting products may help.
It may make her feel humiliated to hear she stinks. It may make her feel demeaned to see “take a shower” on the calendar. She is losing control over herself and that is scary. Be gentle with the words you choose.
What do you remember about her bathing habits? Did she like hot baths? Reading in the tub? Long showers? Try to recreate what made her happy as long as it’s safe. (Watch out for bubble baths which can cause UTIs).
Some luxury hotels offer “bath packages.” Take a look for inspiration.
Add grab bars and absorbent safety mats. If she takes a long hot bath, stay close to help her stand and exit the tub if needed.
I don't know why this is such a common thread, but everyone complains about their family member with dementia not wanting to bathe. I think they avoid bathing for many reasons....vulnerability, confusion on what to do and how to do it, a fear of falling, not remembering when they bathed last and I think they have lost their sense of self awareness. They don't know how they look or how they smell, etc... but they still have that ingrained response of "it's none of your business and they don't want to talk about it". LOL
Also, on a separate sheet of paper, ask her doctor/nurse team to write an order of sorts advising her to bathe every Monday or whatever day is best for you, on the doctor’s office letterhead. Keep this bathing order out where she can see it. Repetitious reading helps. Remind her when it’s bath day and produce the letter if she’s forgotten, and she will.
If your mom is receptive to her doctor’s advice then this might help and if she isn’t, it didn’t hurt to try.
Good luck!
My dad’s doctor did this for us and even wrote about the importance of bathing to shield against infections and bacteria. He also gave him a bedtime because my dad has more energy than is good for him. Doesn’t always work but oh how wonderful when it does.
She is not just resistant about showering, if she isn't given an incentive, she is downright explosive and vicious, as in "I hate you, get out of here." About 6 weeks ago she even told my sister she was taking Judo classes and would take her out. She lives alone, does not drive, goes nowhere without one of us, but is taking Judo. This is how much she hates showering.
Dangle a "carrot" in front of her face.