E lives at an assisted living. I’m her guardian and conservator. She has Alzheimer’s with moderate dementia.
E still does much of her own personal care, but a home health aid is supposed to help her with showers and shampoo twice weekly. Lately E has refused to wash her hair. The home health aid has not been reporting this properly; she’s not recorded the refusal to wash hair. She’s young and doesn’t seem to understand how to deal with dementia, nor does she understand how important proper reporting is.
I came home from a trip two days ago and it was clear E’s hair had not been washed in at least two weeks. When I asked E about going to a salon to get it washed, she replied, “I don’t give a sh** about my hair!” Well then! I quickly dropped that topic!
After my visit with E, I spoke with the nursing staff at the assisted living. They are amazing!! They understand dementia and how those affected by this horrible disease can stop caring about hygiene. They understood that this is about staying healthy and that I want to preserve E’s dignity by having her look nice when we go out and about town.
They’d also noticed E had stopped going to daily exercise class and was sleeping later. She’s almost missed breakfast more than once! E told me yesterday she’s had trouble sleeping. I think this is all related.
After discussing the issues, the nursing staff and I devised a plan: we are going to try schedule changes and escorts. If this doesn’t help in two to three weeks, we will then look at adjusting her meds. But we are trying this first.
Beginning today the nursing staff have changed E’s med schedule from “between 8-9:30 am” to 7:00 am. (Her morning meds can be taken before or after breakfast.) They are now escorting E to breakfast and exercise, meaning a staff member will wake her up and encourage her to go eat. After breakfast they will encourage her to go exercise. She always has the option to say no. Let’s hope the earlier wake time and exercise help her sleep. Maybe she’ll be more cooperative with hair washing as well.
Meagan (a delightful and experienced nurse) woke E this morning and gave E her meds at seven. She encouraged E to get up and get dressed. Meagan waited for her to do so. (E has a lovely two-room apartment, so Meagan could stay in the living room and give E privacy to dress.) Then Meagan used the dry shampoo on E’s hair while saying, “Now your hair looks better. But after exercise you’ll be all sweaty, so we’ll come wash it!”
When E balked, Meagan replied, “Well, Kathleen was planning to take you to lunch today. You need to look nice when you go out with her!” E perked right up and agreed to the plan.
Meagan followed through and shampooed E’s hair right after exercise.
She then called me to tell me about the morning’s progress and that E’s hair was being dried and styled by one of the assisted living aids. Meagan also informed me of my new plans to take E out to lunch!! 😊
I live three minutes away so could normally be there quickly. When I got the call I was in the middle of loading my tractor onto our trailer to take for repairs. As soon as it was loaded I went to pick up E. I knocked on her door and said in a cheerful voice, “Howdy! Want to go with me to the tractor store?” She laughed when she saw me in my baseball cap and dirty, baggy work jeans and boots. She happily responded, “You bet!” and grabbed her purse.
E went with me to the tractor repair place (which is about thirty minutes out in the country) then we got tacos “at a gas station!” She had a delightful time!! Watching me unload the tractor made her smile and laugh! She loves that I know how to do such things. Plus it’s beautiful outside today! We were outside for almost an hour while waiting our turn, unloading, and chatting with the tractor tech. After lunch we drove around town to look at beautiful homes.
Meagan is calling the home health agency this afternoon to speak to the aid’s supervisor. The aid needs additional training or they need to find a new aid for E. Things are definitely not going to continue as they have been.
I’m so grateful the assisted living staff understands I can’t always be the bad guy with E nor can I be the only one to complain to home health. A complaint from the nursing staff carries more weight, especially when procedures aren’t being followed. I’m glad they support me with E and go to bat for me with home health.
I’m also grateful they know how to help motivate a person with dementia while preserving their independence and dignity.
(This picture is not E. It is a stock photo.)