Alzheimer`s Disease/Husband with demetia, messes his pants
Hello, my husband is only 66 yrs old - lost his job in october/12, and down hill - doctors state he has demetia - today he messed his pants (lives at home) - he won't let me change him, or shower him, pushes me away - any suggestions? he just states he will remain like this as he doesn't care - how can I shower or change him, when he won't let me-
Hi JoAnne - did the doctors offer more information? They should have given you info about his specific diagnosis (i.e. what is the cause and type of his dementia). The type of dementia gives you some idea of what to expect in terms of behaviors and progress. There are medications that can help with depression, anxiety,agitation and delusions - and even hallucinations - which are common with many dementias. However, the doctor does need to know what type of dementia he has, since some of the medications can actually make people with certain dementias like Lewy Body worse. Depending on the kind of dementia he has, there may be medications that can slow down the progress, which will give him better quality of life longer, and make caregiving a bit easier.
As you probably know, all the progressive dementias basically end up at the same place, although they can progress in different ways initially - each has it's own pattern of brain damage causing distinctive behavior patterns. As brain damage progresses, the person is not only impaired in terms of memory, but in terms of ability to use and understand language, emotional control, depth perception, sense of smell and taste, ability to reason and use logic, to recognize people, objects and locations. They also lose physical control - often starting with fine coordination and progressing to gross coordination - so initially, they might start fumbling with buttons and utensils, and ultimately lose their ability to walk, chew, swallow and control their bowels.
One of the reasons for incontinence can be that they get confused about what the sensation of needing to use the bathroom means - much less what to do about it. They have to know what the feeling means, where the bathroom is, how to get their clothing off, and what to do next. It can be very hard for them to coordinate everything that needs to be done.
I would get into the doctor and tell him or her what is going on. If your husband is getting agitated and uncooperative, not only is that a problem in terms of his hygiene but I would think it might be a problem of physical safety for you. As a caregiver, if he is not cooperative, even if he means no harm, he might hurt you. He also sounds pretty upset and depressed, and that is miserable for both of you.You need some help from the doctor to deal with your husband's emotional distress and agitation. There are likely medication that can be tried. Don't give up if it takes a few tries to hit on the right medications either - what works for one person doesn't work for another, and sometimes it takes some adjusting of doses as well to hit the right spot. You want him calmer and happier but not zombified or floppy.
You might also want to look into what community supports are available where you live. You might qualify for in-home assistance. My mother in law, for example, qualified for several hours a week of assistance, which was great. She was much more cooperative about having a bath and getting cleaned up with a home care aide than she was with us. Not sure why that was, but maybe she just obeyed the stranger better!!
My best advice to you is also to start looking into other resources as well. You need some back up plans for looking after him, so you don't end up stressed out and overwhelmed. This is going to get harder and harder physically and emotionally, and more and more relentless. Look after yourself. Might there be adult daycare programs near your home that he could attend - these can be great in terms of giving you a break, and giving him a chance for an outing and to be kept busy and active during the day. You may not be ready to consider it, but you should also look into longer term care options for him. What is close to you and what can they offer? If you got sick, do they have temporary respite spots (i.e. so you wouldn't end up in a crisis if you were laid up temporarily and couldn't look after him). What places specialize in dementia? Will they take people as they decline and need wheelchairs?
You need a plan ready to go just in case circumstances change suddenly and you need options! Do some homework so you are ready.
I'd recommend a book called "The 36 Hour Day" by Mace and Rabin, published by Warner. It's in paperback, and it will give you some good insights into what he is going through, and how to respond to him. It's full of helpful ideas and approaches.
Hope this helps. Just remember, he's not doing this on purpose. He really has no insight into how his behavior appears to other people, or affects others. See the doctor and ask about resources as well as medications.
Here are some Alberta links that might offer some leads
I'd call Community Care Access to find out who to talk to where you live - they can help unlock assistance for you.
You are not alone!! Hope this helps.