My mother has always had a difficult personality, and as time goes on, her personality has become even more difficult. We have been through many aides, but I now have a team in place that she can tolerate and that can tolerate her.
Recently, she has begun to have screaming tantrums when she needs to have her diaper changed. One aide handles the situation like a pro: She advises my mother it is time to change her diaper and proceeds to change the diaper -- even if my mother is screaming at her. My other aides are frightened of my mother's tantrums and have left her sitting in the dirty diaper until my mother is receptive to being changed (and this can be hours later).
My mother has suffered multiple UTI's which can be caused by a dirty diaper, so this situation is of great concern. Has anyone had any experience with this issue? I would hate to have to let some of the more emotionally fragile aides go because they have been with us a long time and my mother is comfortable with them. On the other hand, I feel I cannot allow this situation to continue. I have tried to reason with my mother to allow her diaper to be changed when needed, to no avail: "I'll change it when I'm good and ready!" I've explained the UTI danger, to no avail: "I don't care!"
Any suggestions or advice would be very much appreciated!
While it may be "okay" to struggle through it, screaming and all, it would be better if there was a way to calm her down. I don't know how staff handles this issue, as clearly sitting in soiled briefs isn't good - generally, so they tell me, they can't force someone to do what they refuse to do. They usually have to coax them, promise something good, get them to think it's their idea, etc. Hospice nurse said mom seems to be "shy" now about being changed. It may be that her dementia has progressed further, esp with the stroke. But, much as I dislike medications, I would try that before trying to change a whirling dervish! The nice thing about the one she took, worked first time, every time, usually in about 15 m or so, and no need to wean her off of it if it doesn't work out. If you can find one that she can take a little before the usual changing time and it goes smoothly, go for it!
Otherwise, they'll just have to suck it up and continue bulling through the process. If those aides can't do it, find others. You can't reason with dementia, so trying to explain why the change is needed really won't help.
You need to hire people who can do just that: push past your mother's tantrums and change her soiled briefs. Otherwise, you're going to have a lot bigger problems to deal with than screaming fits!
Good luck!
If it is anxiety again medication might help.
OR
this is just her having a tantrum like you say. If this is the case then the caregivers that back off need to be TOLD, INSTRUCTED that they are to carry on with the change no matter the screaming that is done.
If they are from an agency you could request other caregivers that will do what needs to be done.
BUT if you mom is doing more than screaming, if she is hitting, biting, scratching then she needs to be either medicated or since this is in your home you can put mitts on her to somewhat restrain her hands. Sometimes giving someone a towel or a soft toy will keep the hands occupied.
I probably would not give her anything to eat during one of these tantrums as she could easily aspirate whatever is in her mouth. But a child's teething toy might work.
"Screaming tantrums" - what exactly is your mother's objection, though?
Oh, and save your energy on explaining UTI to her. You're wasting your breath. My Alz. mother sometimes refuses to do things, and I tell her when she's done changing into a new clean diaper, or taking a shower, I'll take her out to go shopping. That usually gets her to cooperate.
What does you mother like? What incentive will work with her?