There are a wealth of questions on how to get aging parents to bathe – especially when the elder has Alzheimer's or severe dementia.

One consideration is how often do elderly parents need to bathe? Since the U.S. is a melting pot of people from around the world, we have different cultures with different views on what staying clean means. In my high plains area, many of the generation now in their 80s and 90s grew up with weekly baths – sometimes because they lived out on farms and water was too precious to waste. For others, that routine was just normal behavior. We bratty "kids" would mutter under our breath they would bathe when they were "ripe enough."

All of this is to say that if your elder won't shower every single day, he or she is not going to die of some dreadful disease caused by "lack of bath" syndrome. For some elders, some fairly clean clothes and a weekly bath is what they consider enough. However, there are other issues to consider.

Watch for change in attitude. A change in attitude is a key component with bathing, as it is with many aging issues.

If your elder has dementia, then you may have a more difficult situation on your hands. People can think they have just showered, but in reality that was last week. Or, they can become confused when they begin the process, and rather than tell someone they are confused, they just avoid it. Or they can become afraid of the shower or bath because they don't know what it's all about or they think they will get hurt.

Think about how frightening it would be to have water pouring down on your head when you can't figure out the reason. Confusion and lack of understanding are bound to lead to fear.

  • If you feel that the reason your mom isn't bathing is that she thinks she has already taken a bath, or that she just doesn't see the point, try tying her bath to something fun. Say something like, "Let's both get cleaned up and pretty and we'll go for lunch." This could nudge her into thinking it's worth her while, and even fun, to spruce up.
  • Make sure the shower and/or bath are safe and comfortable. If the bathroom tends to be cool, see if there is a way it can be warmed up before a bath. If a shower is the best route to go for the person, install a grab bar to for stability while getting in, a comfortable stool to sit on and a hand-held shower head. This type of shower head keeps the water from continually coming down on the person's head, so the elder is forewarned when it's hair washing time.
  • If dementia, such as Alzheimer's, is so advanced that the elder is frightened of water, or scared of the tub or shower, you may want to try a different tactic. A person can get clean with sponge baths.
  • Whether you are using a sponge bath method or helping the person with a shower, talk about what you will do next, taking into consideration the person's dementia and where they are mentally. Don't surprise them. Describe your every move in a low, soothing voice. Say, "I'm going to wipe your face with this nice warm cloth, okay?" "I'm going to lift your arm and wash, but I'm keeping you warm and comfortable under this blanket."
  • Find products like dry shampoos so you don't have to wash hair as often.
  • Take privacy and modesty into consideration. Some people, my mother-in-law being one of them, don't want family or others close to them to bathe them. My mother-in-law was a very modest woman. We were great friends and she let me do anything for her but give her a shower. We found that hiring an in-home agency to come and bathe her worked best. I would be at her condo when the person came, but the woman who arrived for the bath looked like a nurse in a hospital. This made the nudity more bearable for her. Also, agency people are trained, so if you find a good agency, they may be able to cope much better than family members.
  • Remember that a daily bath isn't necessary. Also, please ask yourself if all the fuss is because of your own standards and what people will think of you if your mom isn't pristine all the time, or if it's really about her health and comfort. Try to compromise.
    Yes, cleanliness is important for good health. But a complete bath or shower daily is not next to Godliness. It could be closer to torture for your loved one. Try to find alternatives and a middle ground so that some sort of hygiene is maintained with a minimum of unpleasantness.

Another issue that may contribute to an elderly parent whose bathing and grooming habits take a turn for the worse is depression. My mother was a clean freak, and she loved her daily bath. Her clothes needed to be fresh daily, preferably smelling of springtime.

When she made the decision to move to the nursing home where my dad lived, she went through the expected period of depression. One of the major clues was that she would put on the same clothes every day. Some of this was simply that she saw them laying on a chair and forgot that they'd been worn. However, some of change in her behavior was because she was temporarily depressed.

Depressed people often don't care about personal hygiene. They don't care about their clothes. The just don't care in general. If you see this happening to your elder, then you have a reason to be concerned. My mother's depression lifted as she adjusted to the nursing home. I tried to hurry that along by buying her some new clothes and making good use of the nursing home beauty shop. These steps helped, and she was soon back to being to her clean-freak self.

If her depression hadn't lifted, I would have asked the doctor to consider treating her for depression. If you find your elder has changed from am very clean person to one who doesn't care about appearances at all, you may want to consider a checkup to see if depression is at the bottom of this change. This depression is especially prominent after the death of a spouse.

Carol Bradley Bursack

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Over the span of two decades, author, columnist, consultant and speaker Carol Bradley Bursack cared for a neighbor and six elderly family members. Her experiences inspired her to pen, "Minding Our Elders: Caregivers Share Their Personal Stories," a portable support group book for caregivers.

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