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My uncle has become fecally incontinent, or sometimes just unable to wipe himself without making a mess on his clothes. So now he requires showering or bathing at least 3-4 times per week. He has become uncooperative and beligerent about cleaning up. The health care aides are becoming so frustrated I'm afraid we will lose them and have to put him in a nursing home. Any suggestions would be appreciated.

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Can you figure out what his concerns are concerning taking a shower? I'm my mom's caregiver (age 92, severe dementia) and noticed she's afraid she'll slip and fall and also hates to be cold, so I've done everything I can to address those two issues at shower time -- extra safety bars and a space heater helped a lot. I also toss her towels and robe into the dryer so they're nice and warm when I hand them to her. I also remind her several times how beautiful she's going to be when she's all finished. Should she get ornery, I squat down, look her in the eye and remind her that I'm doing everything I can to keep her happy, warm and safe so she doesn't have to go to the nursing home, but I need her help. It's never posed as a threat. I'm simply asking her to help me do my job. It's working! Here's another thought. I don't know if you ever had children, but they feed off of tension. The more tense mommy gets, the more the baby cries. It could be that your uncle's caregivers are coming in with tension. They have a job to do, they want to get it done quickly, on their schedule and don't want to have to put up with antics. He feels that tension and responds accordingly.
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Showering is always a chore but once my husband is in and the warm water is flowing over him, he relaxes and seems to enjoy. Having two large beach towels to dry him is also a big help as he gets so cold when the water is turned off. I have had a hand-held shower attachment put in so I can lay the attachment down and let the water warm up while I get him into the shower. I also have a shower chair so he can sit down and I soap him up and can clean him from the chair. The chair has holes in it so cleaning the butt is much easier. I also have hand held bars for him to hold onto when he gets in and out of the shower. For now this is working good but he does complain a lot when I get started but finally gives in. I just have to work quickly and stay calm.
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My husband with late Alzheimers was having this problem. I get him up every morning and take him to the toilet immediately. I help him take off his pjs, and tell him I am going to get him dressed while he is sitting on the toilet. After changing the diaper, putting on his clothes for the day and combing his hair, he most of the time has done his morning duty. I then ask him to stand up and I clean him with incontinent wipes and then he is ready to start his day. Sometimes this takes maybe 20-30 minutes and I just stay with him and talk about the day or whatever makes him happy. I'd say this works about 6 days a week and it takes patience but much easier than cleaning them up later.
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Extragarlic : have you mentioned the nursing home to him? It sounds like he is so afraid of losing control. Of course, he already has, but it hasn't caught up to him yet. Is there any psychological technique you might use so he believes everything he complies with is his idea? If I were a manipulation genius I would tell you, but unfortunately I am not. Can you afford to get a bidet? Also, a hand-held shower attachment in the bathroom for easy access rinsing off. I know, none of it is easy:(
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Getting a male bath aide is a good suggestion but might be easier said than done. In caring for my dad when I needed him to do something that he just refused to do I pulled out my Guilt Card: "Dad, you moved here so I could care for you. Please help me care for you." Said softly and lovingly and this worked every time.
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I rue the day when my husband gets this way. Right now I have to be careful how often I mention that he needs to shower/shave/change his clothes because if he thinks I'm "nagging", he just digs in his heels are the more and will find any excuse NOT to do anything. He has always been this way about anything I ask/need him to do so it's not new. It's just worse since he has developed dementia. I like the ideas DebMath has given. Perhaps you should talk to the agency and ask if they have someone else they could send; someone new who might be more patient. Might he respond better to a man than a woman? Who knows what might make a difference. Maybe you could ask him why...is he afraid of something/someone? I'm just throwing out some thoughts that come to mind. Good luck.
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Any suggestions on how to get an Alzheimer's patient to brush his teeth. He won't let me do it for him and fights me every inch of the way. Is there something I can use to wipe his mouth and teeth to keep him from getting infection.
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thanks all for your suggestions. We can only have male home care aides because he is slightly intimidated by them but will roll over most women. He lectures the aides that "this is MY house and you have to listen to ME". They try to explain things to him but for some reason he becomes more agitated and incoherent over this issue than anything else. Once he (finally) leaves the bathroom cleaned up, his mood immediately brightens and he denies that he was screaming, fighting and and carrying on.

My technique is to get him to the bathroom (usually on false pretenses) and then pull the diaper off quickly before he realizes what I'm doing. At that point, if he won't shower at least I can wipe him and put on a clean diaper.

The other alternative, only if I have a lot of time, is to run the bath, sit by the bathroom door calmly, and tell him he can't leave until he takes a bath. He'll come up with 10 reasons why I have to let him out, and after he realizes nothing is working he'll get in the tub.
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Not from personal experience (yet) but I was going to suggest Cetaphil to peeps who are bed bound or hate the bathing experience (though not loving a shower is unimaginable to me). It is a white lotion that you can put on, rub in to clean the skin, and then use a wash cloth and a water container to rinse the cloth in. This would be good for between baths. I use it on my face like that.
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I don't know if this would help but we have a "washlet" toilet seat. Everyone loves it.
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