Setting boundaries around physical care

Sneezy · October 18, 2022, 10:35:06 AM

I am struggling with where and how to set boundaries regarding physical care. Both my mom (covert NPD with extreme anxiety) and my MIL (HPD with dementia) are having issues. MIL is in memory care and often refuses to shower. So DH will bring her to our house to shower (where she has more privacy). I am fine with getting the bathroom all set up for her and with cleaning up afterwards. But she is starting to need more help. So far, I've assisted with minor things - helping her get her shoes on, etc. But I just don't want to get too intimate when it comes to her care. DH has been a saint with his mother, and I understand that he, as a male, is uncomfortable helping his mom get dressed. But isn't that one of the reasons she is in memory care? Isn't that what his dad is paying for? I have helped out in a pinch - for example, MIL had her bra completely twisted up one day. But I don't want to help with showering and dressing. And yet, I think DH would like me to help. How do I gently set this boundary? DH is in a fragile place with his mom right now. I know it's hard for him and I want to help. But I can't do the hands-on stuff.

With my mom, it's not as extreme. But she keeps asking me to brush her hair or help her put her makeup on. Again, I just don't want to do this. With my mom, I feel like it's more of a control issue. A "good daughter" would help her mom to look nice, right? That's the implication, anyway. And I just don't want to do it.

I guess I'm not a real hands-on person. Any suggestions for ways to gently and kindly say "nope, I'm not doing that."

Fiasco · October 18, 2022, 01:02:38 PM

My best suggestion would be to draw a line and hold it based on safety. What's going to happen if MIL falls in the shower? Is DH willing to run in there with undressed mom on the ground and try to pick up a wet, uncooperative adult? Is he expecting you to perform this feat? It's a great way for one, two, or all three of you to end up with torn back muscles or concussions.

And yes, memory care is being paid for this, knows the tricks of their trade, and frankly bringing her to your place to shower may be messing with her (limited) ability to adapt to her caregivers and the routine there. You wouldn't expect your kindergartener to ever get used to eating lunch at school if you ran over there every day and took them to the drive through instead, and I see this situation as similar.

I went through similar things with my mom as you describe with yours. I don't want to touch her at all and I'm surely not fancying her up. Just find a line you like and stick with it I guess. "Sorry, never went to beauty school" and leave it at that.

Cat of the Canals · October 18, 2022, 02:20:32 PM

Quote from: Sneezy on October 18, 2022, 10:35:06 AM
But isn't that one of the reasons she is in memory care? Isn't that what his dad is paying for?

That's a big honkin' YES. Having done a stint on a memory care ward in nursing school, I'm a little surprised the staff hasn't made more of an effort to find some way for her to shower there, even if it means extra time. If I had told one of my instructors, "Oh, I didn't do her shower because she didn't want to" I would have been reamed out, let me tell you. But I suppose this is beside the point since you have no control over the facility. Perhaps as she eases into the facility being her new "home," she will grow more comfortable with showering there.

QuoteI know it's hard for him and I want to help. But I can't do the hands-on stuff.

I would tell him exactly this. Aside from what you are/are not personally comfortable with (which is the main thing that matters here), I would also consider this an issue of safety -- both hers and yours. (I see Fiasco beat me to this point.

) What happens if she falls? Is your bathroom equipped with grab bars? Somewhere for her to sit? What happens if you hurt yourself trying to lift her? It might sound melodramatic, but professional nursing staff gets injured this way all the time. And the more severe her dementia gets, the more risk for both of you. There are a lot of reasons that this is an unfair ask.

QuoteWith my mom, it's not as extreme. But she keeps asking me to brush her hair or help her put her makeup on.

I think you're smart to say no, because my first instinct is that this is a trap. Once she gets you on the hook for these grooming tasks, it will become expected. And why do I suspect your mother is the type who won't step out the door without her hair and makeup done? Meaning this will be something she wants you to do every day.

It won't take long for that to become, "Well, I can't go do XYZ unless you come do my hair and makeup!" And now it's "your fault" she can't go do anything (which already seems to be a tune she whistles often).

Is this something she genuinely needs help with or just something she wants you to do?

lkdrymom · October 18, 2022, 03:36:05 PM

My father was in assisted living and one level of care we had for him was that he had someone help him shower twice a week. If your DH insists she shower at your home just tell HIM that you are not comfortable doing hands-on care in that area. He can't fault you if HE feels uncomfortable. Please don't fall for "but you're a woman...". My father got to the point where he needed assistance in the bathroom. Nothing like having to take your father's pants up and down. And my poor son had to assist with holding him up so he wouldn't fall while I did that. I felt awful needing his help. After Christmas 2019 I realized I could not have him over for the holidays anymore. It was just too much. Covid gave me an out for 2020.

Sneezy · October 18, 2022, 03:37:49 PM

Quote from: Fiasco on October 18, 2022, 01:02:38 PM
And yes, memory care is being paid for this, knows the tricks of their trade, and frankly bringing her to your place to shower may be messing with her (limited) ability to adapt to her caregivers and the routine there. You wouldn't expect your kindergartener to ever get used to eating lunch at school if you ran over there every day and took them to the drive through instead, and I see this situation as similar.

Thank you! I felt like I was missing something and this is it. MIL is going to need more and more care as time goes on, and she won't accept care from the aides at memory care if she doesn't get used to it now. If she is able to shower and dress herself, it is probably ok to let her shower at our house now and then. But it is really important that she start to get used to accepting help now, with showering and dressing, before she needs help with feeding and toileting. She is on a downward slope and it is sad, but she is in a very nice facility with kind staff, and she needs to get used to having them helping her.

Sneezy · October 18, 2022, 03:45:19 PM

Quote from: Cat of the Canals on October 18, 2022, 02:20:32 PM
It might sound melodramatic, but professional nursing staff gets injured this way all the time. And the more severe her dementia gets, the more risk for both of you. There are a lot of reasons that this is an unfair ask.

I am still in physical therapy for an injured shoulder and so this is a good point. I don't want to hurt myself, or hurt MIL, by trying to do things that I'm not physically good at doing.

Quote from: Cat of the Canals on October 18, 2022, 02:20:32 PM
Is this something she genuinely needs help with or just something she wants you to do?

Ha, with my mom, it's just another bid for attention. She is perfectly capable of doing her own hair and putting on her own makeup. She just likes to have me cater to her. The other problem I have is that mom and I are polar opposites when it comes to clothes, makeup, hair, etc. I know this sounds really judgemental, but I just can not understand some of her choices. When I was a kid, I was embarrassed at how tight her clothes were. On the one hand, I do firmly believe that every woman gets to make her own choices about what to wear and all that. But on the other hand, a mom should not be embarrassing her kids by wearing pants so tight that they look painted on.

Sneezy · October 19, 2022, 10:01:28 AM

Quote from: lkdrymom on October 18, 2022, 03:36:05 PM
He can't fault you if HE feels uncomfortable. Please don't fall for "but you're a woman...".

Thank you - that is so true. If DH feels uncomfortable, I understand. And he needs to understand if I feel uncomfortable.

Quote from: lkdrymom on October 18, 2022, 03:36:05 PM
My father was in assisted living and one level of care we had for him was that he had someone help him shower twice a week. If your DH insists she shower at your home just tell HIM that you are not comfortable doing hands-on care in that area. He can't fault you if HE feels uncomfortable. Please don't fall for "but you're a woman...". My father got to the point where he needed assistance in the bathroom. Nothing like having to take your father's pants up and down. And my poor son had to assist with holding him up so he wouldn't fall while I did that. I felt awful needing his help. After Christmas 2019 I realized I could not have him over for the holidays anymore. It was just too much. Covid gave me an out for 2020.

Our DS works with special needs kids and he has to assist with feeding and bathroom needs. That is tough work and I don't think I could do what he does. It was very sweet of you and your son to help your father, but it is just not something most of us can do for any length of time.