The occupational therapist at the Alz center left me a message today saying that she is going to start working with Mom on dressing, grooming and bathing. She said Mom had become more resistant to these things. She also said she had already gotten authorization through Mom’s insurance for this work. That was a relief. She told me to call her back if I had any problems with the plan.
I didn’t have problems, but I called her back. I had questions. A little over a year ago, I was picking out Mom’s clothes and encouraging her to change outfits about twice a week when she was still in assisted living. She had already started to dislike showers there, but she would take one with my help, and was cooperative with one staff member who helped her once a week. More than a month ago, an Alz center nurse told me Mom wasn’t showering at all anymore – she was getting sponge baths in her room, and all the important parts were getting clean, she assured me. So with that history, how is it that Mom can benefit from therapy now? That was my primary question.
The occupational therapist told me she would evaluate Mom tomorrow so she didn’t really know the details of Mom’s behaviors yet. But the nursing staff had told her that Mom has become more resistant to verbal cues or physical help with the tasks of getting dressed, getting groomed and getting clean. So the therapist will try different strategies and approaches and see what works with Mom. She’ll try to determine what Mom can do with strictly verbal instruction, and what she needs physical help with. And then she’ll try to figure out what words and actions work best to make Mom comfortable with the help. I guess I also wondered, but didn’t say out loud, why they were bothering with this. Inevitably, all Alz patients need help with this stuff. My impression is that Mom has needed help with most elements of dressing, grooming and bathing for a good year and a half or so. The therapist said, though, that once she figures out what works best with Mom, she will train nursing staff in those techniques. So instead of the staff having to take the time to figure out each patient’s individual needs on their own, a therapist takes some of that burden from them. It makes sense to me, but I have never given any thought to the details of successfully working with Alzheimer’s patients. It’s not just a skill, but also an art.