I have a client who has a severe intellectual disability ,is elderly, is obese (Lymphedema, cellulitis, lipodema) and has bad arthritis. she can put on clothes on, walk around (with difficulty but fine around the flat), make basic sandwiches, make tea, operate the shower, she needs support with putting cream on legs, stockings, and putting a pad on (although sometimes she does this herself). Amongst the more obvious: cooking, cleaning, medication , personal safety etc.
The problem I am having is supporting her with washing, she can have a shower herself, but she finds washing her bottom difficult, so I support her with this…
she is obese so a lot of poo gets deeply lodged in the bottom and it’s quite difficult to get in there to clean
It’s apparent she doesn’t wipe her bottom at all (I am not sure if it’s because she doesn’t know to do it, can’t physically do it, or doesn’t care).
She only wants me to use her special flannel she uses for the rest of her body (she’s very stubborn, won’t even let me launder it) and afterwards it’s covered in poo and she then takes it off me, rinses it and then proceeds to use it to clean the rest of her, I try to tell her not to, it’s dirty etc, but she shouts and gets mad, even violent.
I have minimised this by only supporting her after she’s done most of the cleaning she can do… but sometimes she’ll still use it again (even on her face).
I’m not really sure what the best thing to clean her with is… even if I she agreed to me using something else. I do try sort of ‘jet washing’ her with the shower down there first, but because it’s so deep, it doesnt work unless you pull apart her buttcheeks and spray , and often the water bounces back and sometimes has hits me in the eyes, I already wear so much PPE (gloves, sleeves, apron, shoe covers).
It’s a pretty unpleasant job for me and for her, and I would like to make it easier and safer, for us both.
I wonder if there is equipment available that could help …maybe a special wiping contraption for her to use after toiletting or maybe a special cleaning contraption for me that would make it easier… maybe a portable bday or something.
Anyone got any tips or advice?