One of the features of living with dementia is the constant battle over what the mind can help the body to do. As the disease progresses ability to do simple personal tasks, or even awareness that they need doing, can gradually decline, making assistance with things that were previously taken for granted much more important.
We all like to look and feel our best, and that certainly doesn’t alter when someone has dementia, even if they cannot articulate it. Their tolerance of having assistance may fluctuate however, as witnessed on the many occasions I battled to file my dad’s nails whilst he valiantly tried to prevent the emery board from doing its work.
Throughout every stage of my father’s dementia we strived to keep him looking smart and feeling as comfortable as possible. He was always a proud man, long before dementia ever came into his life, and it is almost as if his pride was transferred to us when he could no longer maintain the standards he had set himself.
Whilst it may sound quite simple, paying attention to the little touches that make life more pleasant is surprisingly time consuming. Apart from the shopping for clothes and bed-linen (dad had his own pure cotton sheets, since all three of his care homes used the cheapest, nastiest poly-cotton bed-linen that resulted in him sweating at night), I became an expert in keeping him clean shaven (if the carers had not had time), maintaining short nails (essential to limit his scratching) and regularly set up in the hairdressing room to perform my duties as a barber.
When someone is living with dementia, their perceptions of their appearance can alter quite dramatically. Mirrors are renowned to cause problems, usually because what the person is seeing does not reflect what they are thinking or expecting, and in my dad’s case when he caught his reflection in a bathroom mirror shortly after I had cut his hair one day, he exclaimed that he was, in fact, now bald! (He wasn’t).
Outside specialists came in to all three of dad’s care homes to offer chiropody and eye tests, but when dad developed severe problems with his teeth (long-standing issues existed anyway, but with his dementia keeping them clean was a massive problem), we had to run the gauntlet of dental services. Suffice to say that if doctors do not receive adequate training in dementia, many dentists receive even less, and the few that we saw clearly struggled to cope with a patient who could not understand instructions. However, numerous appointments later and dad’s rotting teeth had all been removed, which may sound very drastic, but poor dental health is known to cause problems throughout the body and is a massive infection risk.
Introducing a full set of dentures to someone without the ability to comprehend what on earth is being put into their mouth, and therefore being completely unable to co-operate with this alien invasion, proved very unsuccessful. Spending many years without a tooth in his head did not bother dad one bit though. His gums toughened up, his oral health was greatly improved, and his appetite remained one of the best, if not THE best, in the whole of the nursing home.
For dad, another major problem was his skin. Keeping him cool, particularly when he had no ability whatsoever to move himself, was a constant round of opening and closing windows, using fans, adding and removing layers of clothing, and hoping that the care home could finally get their antiquated heating system to offer gentle, constant warmth rather than blasts of hot and cold. Sweating meant itching, and with no ability to tell us when he felt warm or cold, everyone needed to be very mindful of his body temperature.
Bloodied scratches became a regular feature on dad’s skin, despite those short nails and us trying glove treatment, and indeed at one point a GP even declared that dad had scabies (he didn’t, but the hassle this diagnosis caused not just to the home but to us as his family in our homes – which effectively had to be pulled apart and everything washed – is the stuff of legend). Initially we trusted in the products prescribed by doctors to treat dad’s skin, but when it got worse, it was plainly obvious that all the chemicals and synthetic ingredients were making his skin, and his mood as a result, ten-times worse.
Investment in natural skincare products made a huge difference to dad’s life, and when the carers had the time to shower him regularly and apply body creams and lotions, his skin was calm and moisturised and his agitation disappeared immediately. To anyone else watching his distress, you would have been tempted just to pop a pill into him to calm him down, but a little thinking around the problem and a perfectly logical solution was found.
Our experience was always that such small, yet common sense steps had an amazing effect on dad’s quality of life. He was always the smartest resident in the home, but more than that, his personal care also brought him calmness and comfort that he could not possibly ask for but that he really needed. The things that many of us do regularly for ourselves can easily slip when someone has dementia, but just like the ladies in the home having their nails done or make-up applied, a little bit of pampering can become a fantastic therapy, as well as giving people with dementia dignity and pleasure, and there can be nothing more worthwhile than that.
Until next time…