My Parent Won’t Shower or Change Clothes. What Should I Do?
The issue of elders who were once reasonably clean adults refusing to take showers and wear fresh clothes is one that is far more common than most people think.
Sometimes the issue is depression. If we have a parent who no longer takes an interest in staying clean or wearing clean clothes, it's wise to look at depression first. A checkup with a doctor is a good idea, especially if low energy is also part of it, or if they just don't care about anything at all. Depression isn't always obvious to an observer.
Another factor is control. As people age, they lose more and more control over their lives. But one thing they generally can control is dressing and showers. The more they are nagged, the more they resist. "This younger generation is trying to take over everything. Well, they aren't telling me when to shower, that's for sure. Besides, I'm just fine!"
A third issue is a decreased sense of sight and smell. What your nose picks up as old sweat, they don't even notice. Not on themselves. Not on their mate. Their senses are not as acute as yours, or as theirs once were.
A fourth cause is memory. The days go by. They aren't marked with tons of activities as they were when they were young. If there isn't something special about Wednesday, well – it could be Tuesday or Thursday. They simply lose track of time and don't realize how long it's been since they showered.
Also, working in with memory is the fact that many of our elders didn't bathe or shower every day when they grew up. We now take daily bathing for granted in this country, but when our parents were young, a weekly bath was likely more the norm. They may have gotten into a more frequent bathing habit in their last decades, but their brain is taking them into the past. Once a week, it's bath time. Then, they forget what day it is, or even forget when they last took a bath or changed clothes. Time just slides by.
Another big issue can be fear or discomfort. Fear of slipping in the tub. Discomfort trying to get in and out. More serious is when a person with Alzheimer's or dementia is in the bathroom and doesn't understand why there is water running on them, or believes the drain that may suck them down. They just don't understand what you are trying to "do to them."
Okay. So what do you do about it?
This is a case where compromise is essential. Third parties can also help. While my mother-in-law was still in her apartment, she didn't remember to bathe and didn't change her clothes, though she'd look me in the eye and say she had. And she believed she had.
Some of this was memory. She thought she must have taken a bath somewhere along the line, so she said she did. However, I feel much of it was fear. She was afraid of the shower. She was afraid of getting in the tub. She was confused by it all. Denial was easier.
Also, she was an exceptionally modest woman, even for her generation. I knew that she didn't want a family member helping her take a bath. Far too intimate. Our "solution" was to get an in-home care agency to come in for the sole purpose of a bath. That effort was better than nothing, but only moderately successful. She grudgingly let "the girl" give her a shower the first time. I stayed in the apartment, but in the other room. Then, a different woman showed up the second time. My mother-in-law refused to let the home health worker in the house. She slammed the door and that was that. No luck. We tried again. She gave in that time, but it was touch and go. So it went.
This behavior came from a woman who was typically very mild-mannered. She was sweet and gentle and not one to "act out," as they say. The fourth time the agency sent someone, a woman of another race came to the door and my mother-in-law, who had never shown anything but love for others, suddenly became a bigot. She grew up in an area where everyone was rather generic in looks. I think her mind was back there, and she didn't understand a woman from another country coming to her door and wanting to give her a bath.
Actually, it's all understandable. I wouldn't want a stranger coming to the door and telling me he or she is going to give me a bath. But caregivers need to do something, and often an in-home agency can be a good choice. Some agencies are more careful than others about the consistency of caregivers. That helps immensely, as then that person arriving means "bath time," and if the person's memory isn't too bad, they may even remember the caregiver who arrives. But we weren't so fortunate.
Thankfully, a room at the nursing home we were waiting for opened up, and when my mother-in-law settled in there, she grew more comfortable, and baths were no longer a problem. It was part of the routine.
There are different approaches to take, once you've figured out why bathing is such a big deal. If a doctor finds the elder is depressed and antidepressants work, the problem may solve itself. A renewed interest in life may make the person more aware of needing (or wanting) a shower or bath and clean clothes. Energy may increase and that, too, helps.
If you find you are in a power struggle with the elder refusing to be "bossed around," a little trickery can come in handy. If the elder has a good friend, it sometimes works to get the friend to give a call and say, "Hey, Mable. Shower up and put on your newest outfit. We need to go out and have lunch." A reason to get cleaned up for someone besides family, coupled by an "I don't care what you smell or look like if you don't" attitude by the son or daughter, can sometimes do the trick.
If you can still get them in the shower, but they are afraid of the water (or sitting in the tub), there are many types of shower chairs available. These are wise for anyone who is getting older or who may have arthritis or balance problems, as it decreases the risk of falls. A hand-held shower head helps a lot with the fear factor if the person doesn't have water pouring down from overhead.
However, if the person is in a demented state and afraid in the bath, then you or another person must move gently. Don't insist on a shower or bath. Begin with just asking to wipe off the person's face. Gradually move to under arms and other parts of the body, talking and telling them what you are doing, as you go. Be soothing. If they fight it or say stop, then stop. Try again later. You may at least get to a stage where there is an occasional sponge bath.
The thing to remember about cleanliness is that you may have to lower your standards. It's hard. You know that at one time Mom would have been humiliated if she didn't smell good, or had stains on her clothes. That part of you, due to kindness, wants to take over and have her look like she'd have wanted to look.
The other part, though, is that she is now in a different mode. Too much nagging is counterproductive. If Mom isn't as sweet smelling as you'd like, or if Dad has stains on his shirt because he spills – well you all may have to live with it. Constant arguing about cleanliness and clothes can make the person feel belittled, and that won't help at all. They will not take it as love. They will take it a criticism. So, compromise may be in order.
The main message? Outsiders understand better than you think they do. Do your best to help your elders look nice and stay clean. But don't expect a pristine appearance. It's often not realistic, and the issue may be more about your own ego than about the elder. Think it through, be honest with yourself, and find a way to live with what you must. It's once again attitude adjustment time.