How can I get my husband with dementia to let me help him when he has "accidents"?

1 answer | Last updated: Sep 21, 2016
A fellow caregiver asked...

My 83 yr. old husband is both bladder and bowel incontinent. Lately he is fighting me on changing him or getting him in the shower. He is not afraid...he just doesn't want me to change him. He thinks he is just fine. His dementia is severe and on top of that he is almost deaf. Just a short while ago he almost hit me because I wanted to help get him changed. I don't know if there are any answers to this question but I was wondering if anyone has any helpful suggestions. I am so discouraged and almost in tears. All I want to do is help him.

Expert Answers

Joanne Koenig Coste is a nationally recognized expert on Alzheimer's care and an outspoken advocate for patient and family care. She is the author of Learning to Speak Alzheimer's. Also, she currently is in private practice as an Alzheimer's family therapist. Ms. Koenig Coste also serves as President of Alzheimer Consulting Associates, implementing state-of-the-art Alzheimer care throughout the United States.

My heart goes out to you as I read of your frustration that so obviously stems from your love for him. More important than his incontinence, is the need to take care of yourself. If something were to happen to you, who then would be the caregiver for your husband? It is these stressful caregiver situations that lead to acute illness and burnout in the family member doing the care. Now, with that said, it must have been quite scary when he 'almost hit' you because he was feeling threatened. This occurs when the person with dementia can not comprehend what is expected of him. Most folks like your husband do not want their loved ones to be involved with their bathing or hygiene; it increases their vulnerability and feelings of having lost control over the most simple activities of daily living (ADL) such as bathing, dressing, eating, etc which in turn leads to feelings of being threatened. It is not rational thinking but it is quite real to the person with dementia. It continues to amaze and delight me when I hear daily success stories of how a trained Home Health Aide can come into the home and do the ADL that the person with dementia will not allow us to do. I heartily recommend you have a trained aide come in for helping with ADL. Present it to your husband as "I don't feel so well today and I need some help". This is telling him that he is not the person who needs help. These little 'fiblets' work really well! It may take a few tries to get the right trained person but to keep trying is well worth it. A male aide may work better for you. My husband was a very large athletic fellow who towered over me when uprght. He too, in the mid-stages of dementia would become extremely agitated at bath time. My solution was to wait until he fell asleep at night and I would gently and quietly bathe a small part of took many nights but by week's end, he was usually relatively clean! I used dry shampoo and he grew to love having it brushed out. You might want to try some incontinent men's briefs; they look just like regular briefs, have a fly front, and are washable. They can easily be found online (Health Dri and WearEver are two reliable brands). Many carepartners dealing with dementia aggression and incontinence say "Let me have your briefs, I am doing a white wash now"....another great fiblet when you know your loved one has been incontinent and yet you want to not draw attention to his 'accident'...the fiblet makes the need to change his clothes be about you and once again, not about his failure. Please take care of YOU!