Apr 9, 2010

Alzheimer's Repetitive Behavior -- The Problem -- Shaving

By Bob DeMarco
Alzheimer's Reading Room
Jocelyn asks:

...if you can get Dotty to have a haircut can you tell me how I can stop Paul shaving 4 times a day. Once in the morning, then when we arrived home at 3.30 this afternoon he had another shave, then approximately another one an hour late then again 10 minutes later, each time he said he hadn't had a shave before. Not only are we going through heaps of shaving cream & blades (he won't use an electric one) but his face is just about raw. It is a different story if I want him to shower, then he says he had one this morning but of course he didn't. I can usually talk him into the shower but the shaving I can't seem to stop. Any ideas?

The Best Way to Find Solutions to the Problems that Caregivers Face Each Day

Jocelyn, you are actually describing two problems with Paul: excessive shaving and the dreaded shower for a person suffering from Alzheimer's disease. There are probably additional problems like you being stressed or filled with anxiety when this happens.

Let's focus on shaving this time around.

Right now, I am going to suggest the easier of two potential solutions to the "shaving problem." Next time, I am going to explain a more difficult, more time consuming solution that would be designed to solve both problems simultaneously.

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I think it helps to understand that you are dealing with a pattern of behavior. Alzheimer's or not, we all have patterns of behavior.

For many years during your life, when you heard a bell ring, what did you do? You got up out of your desk and went to your next class at school. You never questioned this pattern and you did it as if you were on auto-pilot.

Do you get up at the same time each work day? Eat the same food most Friday's or Sunday's. Eat chocolate every day (this is me)?

Having well defined patterns of behavior brings comfort, organization, and homeostasis to your life. The fact that we live a life of patterns also helps explain why most of us don't like change. And, why we resist change.

Before I get into a long description of what I would do to change this pattern, and what I believe will work to change the undesired pattern of behavior, I'll offer a simple solution which you are welcome to try.

Have you considered washing Paul's face several times a day (every two hours to start), and then telling him how nice, clean, and well shaved his face feels? You could also rub some lotion on his face and say some very positive words about his face and facial skin -- and how well shaven he is that day. Add in lots of smiles while washing and rubbing.

This simple solution is based on good communication. Kind, loving words. Touch, actually tactile communication.

Smiles, a calm caring voice, and touch fill Alzheimer's patients with a sense of security. Also calms them. Often brings them into the present, or thinking positive thoughts.

Let me put it this way. You come over here, wash my face a few times a day, rub in some lotion, give me a smile, and say nice things and I am going to like you -- a lot. I am also going to start listening to you more carefully. If only to insure I get my face touched and washed.

You are going to substitute a new pattern of behavior for a bad pattern of behavior. A pattern that is designed to make both of you feel good instead of pattern that makes you feel bad and at the minimum is hurting Paul's face.

On the surface, you could be thinking this is a lot of work and that you might not be getting anything (personally) out of the situation. Try it. If it works you can let us know how it makes you feel compared to how you might be feeling right now.

I'll add in a second suggestion here.

When it is time for Paul to shave how about you put on the shaving cream? There are a few benefits here. First, you establish a pattern that you are going to shave together. Second, you establish when the shave is going to occur -- Paul time to shave. Third, you get to use all the communication techniques. Fourth, if you take the time to rub the shaving cream into his face, slowly but surely, Paul gets a better shave. Most men overlook this or are in a hurry. So they put the shaving cream on and start shaving immediately.

Jocelyn, if you are real brave you could shave Paul. If you can establish that pattern you are good to go. Tip. When you shave use short, slow strokes. Clean the blade under the water after every two or three strokes.

By the way ladies, rubbing the shaving cream in, short strokes, clean the blade under the water every few strokes, also works for the parts that women shave.

Jocelyn, shortly I'll come back with what I would do if I found myself in your situation. It will take more time and lots of patience. If you can accomplish what I am going to suggest, next time, it could very well change your life as an Alzheimer's caregiver.

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Bob DeMarco is the Founder of the Alzheimer's Reading Room and an Alzheimer's caregiver.

Original content Bob DeMarco, the Alzheimer's Reading Room