One of the things that carers have to get used to is providing what is tactfully described as ‘personal care’. Jill Eckersley explains.
That can mean anything from helping with dressing and bathing, reminding Mum or Dad to keep their dentures clean or change their clothes, to mopping up after an accident.
Personal hygiene is something that adults are used to managing alone, without help. We may feel horrified or embarrassed at the idea of sharing those intimate, personal tasks with anyone, even our nearest and dearest. When someone has dementia, the time comes when they just can’t take care of themselves any longer. They may forget to keep clean or mistakenly pop used incontinence pads under the pillow with their nightclothes. Carers have to take over – and it isn’t easy.
Couples and families vary a lot on their attitudes to privacy, nudity and bodily functions. I didn’t feel embarrassed when I had to help Mum have a shower but if I’d never seen her without her clothes before, I might have done. My sister-in-law said she would have felt uncomfortable showering Mum (but not her own mother) though my brother was fine with it. Luckily, Mum was happy for him to help, which isn’t always the case with an opposite-sex parent.
Getting Mum dressed was painfully slow. She had worn ‘corselettes’ (one-piece, heavily elasticated bra-and-girdle foundation garments) for years. She refused to change to a simple vest-and- knickers combination which would have been easier than the daily struggle to get her into, or out of, her corselette. It wasn’t worth a battle, though, so a corselette it was.
Sounding matter-of-fact and practical about it all made life easier for both of us. “How about a shower today? I’ve got some lovely rose-scented shower gel/soap/talc”, seemed to encourage her. Getting Mum into the bathroom, out of her nightie and slippers and into the shower took forever. We put a plastic chair in the cubicle, and there was a handle fitted, so she felt secure. I controlled the shower spray so that Mum neither froze or risked a nasty scald. Plenty of warmed towels and non-slip flooring were also vital.
Mum always knew when she needed the loo – and always set off – but sadly under-estimated the time it would take to get there, pull down her trousers and pants, and sit down. We made sure that her trousers and skirts were elasticated with no fiddly buttons or zips. With help from a Continence Adviser at the GP surgery we persuaded her to wear ‘special night-time pants’ – which included pads – and there was a rubber sheet under her cotton one.
There were still accidents, though. When the inevitable happened, Mum was terribly distressed. She cried and said she was sorry and felt “so ashamed”. What could I say? Except: “It’s all right Mum, don’t worry, anyone can have an accident”. The one blessing was that Mum was so forgetful that by the time I had cleaned her up and got her back to her room, she had forgotten it had ever happened. I left her listening to the radio with a cuppa while I got down on my hands and knees with a bucket of diluted Dettol and my heavy-duty Marigolds.
Incontinence pads helped, but we found they were neither close-fitting nor heavy-duty enough. We bought a steam-cleaner for use on the carpets – and soon realised why care homes and day centres have easy-care vinyl on their floors, and no cosy rugs for residents to trip over as they rush for the loo.