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Since you posted this under ALZ & Dementia, I'm assuming he has it, but how advanced is it?

First and foremost, make sure he isn't having a health problem (like some sort of pain) which may explain why he's reluctant to get out.

Here are some strategies for the hygiene:

https://www.agingcare.com/articles/how-to-help-with-bathing-and-personal-hygiene-top-tips-from-caregivers-212010.htm

https://www.agingcare.com/articles/elderly-parents-who-wont-shower-or-change-clothes-133877.htm

We ended up hiring a neighbor who was already a PT caregiver to come in twice a week to shower my Aunt with advanced dementia. It took a while for her to trust the neighbor, and was never "happy" to have a shower, but she cooperated. It helps to have a 3rd party do it, someone experienced, so maybe consider hiring an aid for this.

As for refusing to get out of bed... maybe try not bringing his food to himi and see if he will get out of bed to eat. My MIL, who had short-term memory impairment in AL, eventually stopped getting out of bed. We eventually figured out she had chronic pain from a prior back break injury and surgery that didn't rehab well. She could get out, but wouldn't and no amount of incentives and cajoling worked. She eventually became bedbound and was moved to LTC.

Is your husband on any meds for depression or mood? If not, maybe it's time to consider this. Or, just that his dementia has moved to another phase. I wish you success in getting him to participate in his care. Most of all, make sure you are taking care of your own self, first and foremost. Never feel guilty about this.
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