I had to go out to Bickford today because I suddenly remembered that I was supposed to bring exam gloves and diaper ointment. I had both in the house, and went out. The aide, R., looked down-hearted; Mom was refusing to cooperate after her early-afternoon nap, and wouldn’t allow R in the bathroom with her. I asked Mom to come in, which she readily did, and suggested she use the toilet. I also told her R. would be coming in to help. In went R. (“she won’t let me in there, R told me hopelessly). Soon I heard her tell Mom she was going to remove the wet pants. “Take your own pants off, dammit! I mean it!” I entered and found that Mom had grabbed R’s wrist and had an ugly look on her face.
“Mom!” I exclaimed. “Let go of her. You are hurting R. That is NOT OK!” Mom announced she didn’t NEED her briefs changed–they were not wet. “Let me see, Mom.” Of course the brief was soaked AND dirty, and this is what is causing the sores on her bottom. I said then that I understood it was probably embarrassing to have someone help in the bathroom, but that she (Mom) needed help. Mom calmed down and let R remove the soiled briefs, and then showed me a trick that meant Mom didn’t have to take off both shoes and slacks to get the fresh briefs on. I pointed out to Mom how easy that made a change, and that I thought it was a benefit to have R. helping. Mom submitted, washed her hands (she squeezes the brief to see if it’s wet–she can’t see) THOROUGHLY, and we headed outside to enjoy the warm weather. There Mom and I tried to talk things over, but it’s almost impossible. I told her that she cussed R., and Mom was surprised to hear it. “Sorry,” she said.
R. tells me that she’s fine in the morning, but the nap after lunch leads to this ugliness in the afternoon. Her other caregiver agreed. I looked up something about mean or aggressive behavior in Alzheimer’s patients, and there was a good article which pointed out that the acting out is a form of communication when those with dementia otherwise can’t. Often it’s humiliation at being intruded on for intimate care that they resent and resist–no surprise. I did soften toward Mom once R. was working to get her into clean briefs, saying I understood it was humiliating and annoying to have [essentially] a stranger helping in the bathroom, but that she needed extra help and my sister and I thought this was the best way (really the only way) we could think to handle the problem.
I will print up the advice for Mom’s aides, and hope it’s helpful. Perhaps I can meet with the Bickford nurse and get some other suggestions. I hope, anyway. I do hate this condition with all the attendant problems SO MUCH.