Bathing the Elderly

Yalady,

My mother also has urinary tract infections. At first I also thought it was from not bathing but what we found is that she has trouble moving her bowels and the pressure keeps her from urinating completely thereby causing the urinary tract infections. After a hospital stint her physician prescribed Miralax ever other day. I know this sounds gross but I have the handle of the toilet disconnected so she cannot flush her stool. I have a small chain connected to the toilet tank that I can pull and flush but she doesn't know where it is. This way I can keep track of her movements and know if I need to increase the dosage or frequency of the Miralax. Urinary tract infections are very common with seniors. You might want to ask your fathers physician if this could possibly be the cause of the urinary tract infections. It is so hard when they get a urinary tract infection because besides being ill and not wanting to do anything, they become much more disoriented and confused increasing the difficulty with bathing.

Good luck

Ann

I am so glad I found this site. I thought I was the only one wirh this problem with my mom. We finally had such a big argument about it and I warned her that social workers could remove her from our home if they found out she wasn't bathing. I let her sit with that overnight and she finally agreed the next morning. It actually worked for a couple months, but now we are sort of back where we started......guess it is time to restate the threat. It is very helpful. though, just knowing there are others out there dealing with the same issues. Thanks for the support.

I have found that with Mom - we schedule her shower for Sunday (hey - at least it is once a WEEK!) then on Saturday I just mention it "tomorrow is shower day" and on SUnday "after breakfast you are going to have a shower" It seems to have worked pretty well to work up to itl, even though she doesn't like it - I tell her that we don't want her getting "stinky" and how much better she's gonna feel afterward...pretty much working up to it without any requests..just statements - If I gave her any options it would be a battle. I also go with her to the shwer & help her in & out and stand outside telling her "what" to wash next so she doesn't miss anything..

so how do you deal with a 96 year old grandmother that your father won't even deal with? I am at wits end getting her to shower and the ALF will kick her out if she will not take showers! The passive aggressive crap is getting old!

I know. I dont know what to say. except pray! 96 is a lot older than my parents and they are just as bad. I am at a loss for an answer. but I am here for you to vent anytime, that seems to help too.

Why not try a bathing garment? It removes the embarrassment, so there's no excuses. The book Alzheimer's for Dummys says that AD patients get resistant because of someone wanting to remove their clothes (who wouldn't?) They recommend a modesty garment. Dignity Resource Council has them on their dignityrc.org and they even give them away if you can't afford one. My mom used one and it really made a big difference.
Robin

Hi, I just want to know what is normal, really normal fo a 90 to take a shower. I take her or have someone take her to salon to get her hair shampooed and styled, and getting in the shower wasnt an issue until she started with some vertigo and was afraid. whe washes very thoughly with huggies, esp. right on the chair right by the toilet and also has a transfer bench with the handicapp bars. but now I believe she does need help getting in and out of tub because the verdigo issue. I helped her yesterday whle out of town, bought all the transferable items that are portable... but wondering (again) how many showers a week are appropriate? Thanks...

Am having trouble knowing how dirty is ok for old folks with dementia. My grandmother does not have any health issues related to lack of cleanliness (like rashes I have read about) but the incontinence is a pretty sad and unbearable. Any thoughts or shared stories would be great. Thanks and best wishes to all.

Experiment with different times of day. Sometimes upon awakening it's a bit much to push someone who is still sleepy to take a shower, but early afternoon, or early evening, or right before bed works. I don't push any regular schedule for bathing. I go with my loved one's mood and each day bath time varies, but there is never a problem if I simply pay attention to when might be the most convenient time to ask, "Would you like me to help you take a bath?" If the answer is no, I respect that, too.

Copperhead, I shoot for daily assistive shower support, but it probably depends on multiple medical and physical considerations. For example, is her skin intact, or does the person have any sores, among other considerations?

Thanks for the good thoughts. Any opinions on what is acceptably dirty for a person with dementia and extreme resistance to showering? Don't want to force her but it can be bad. Not sure what is ok... I know it is a tough question to answer

May be a great question to pose to her doctor in a private call; even the doctor's nurse, actually, will be able to offer very specific guidance tailored to the patient. It's a topic they know very well.

I am so glad to hear I am not the only one out there that is dealing with this, and I honestly have begun to think maybe I'm maybe too big a deal out of it. My mother recently moved to my home town so I could care for her, at the time of her move we had no idea that she may have Alzheimer's. I discovered this during our 12 hr drive while moving. Doctor has now referred her to a neurologist as well to confirm diagnosis. It's very confusing to me b/c she is physically capable of showering, dressing herself, and all other needs, yet, she is not doing them. She is down to 88 lbs, swears that she is eating, & inhome nurse has her noting everything she eats, but she is putting on that list things I know are not in her fridge. Then there's the showering issue, she has been here nearly 4.5 weeks, she tells me that she is showering, but I see no used towels, or wash cloths in her laundry & I'm the one doing the laundry. An aide tried to come by today to help her get in & out of shower and mom refused to let her help. She was nice to the aide, but furious w/ me. I told the inhome nurse and aide that we need to convince her the doctor has ordered this. I am just beside myself not knowing what to do. Does this mean she needs to go to assisted living, or what? That would devastate her. On one hand I think she's fine, then when I see her try to take her meds two times in a row, or say she's eaten when she hasn't, or ask over & over again where she lives, I think -yes, she needs to be closely monitored. But on the other hand, when she seemingly is getting along as she is, I think I will hurt her if that choice is made for her to be assited. I know this is why the doctor has ordered the nurses to come in and now the aide, but I cannot even sleep at night worrying about this. Oh, the shower, yes, it has a chair and we've installed the hand held head, so there are those comfort and safety issues. I think she honestly believes she has showered, just like she thinks she has eaten. I know that I have to grow thick skin and be ready for her to be angry w/ me when I am only trying to help her, but then I worry that all this help will only hurt! HELP!!!!

I am still having similar issues with my mother wrt bathing. She had started suddenly to get worse with losing things and getting lost in her own house. The doctor said it was dehydration not worsening of dementia. Yay. But just try getting her to drink something other than coffee (which he has said she must cut waaaay down. As close to none at all as possible).

At least she does wash, so maybe I am ahead of the game.

Thank you so much for this post. I am caring for my 91 year old aunt who now lives with me. She refuses to bathe and will cry and throw tantrums if the subject of bathing is brought up. She has a caregiver who comes 3 mornings a week to assist my aunt, but my aunt has outsmarted her. My aunt will make sure that she is up and fully dressed before the caregiver gets there, and then will refuse to remove any of her clothing. I am at my wit's end!! She's got my whole house smelling like "dirty old people". I can't deal with it anymore. I'm ready to put her in a nursing facility.

What about the old fashioned sponge bath?

Maybe one day just work with your loved one to have them wash their upper half - maybe just their arms - thoroughly. That's it. Let them do it - by the side of the bed, in bed, in the bathroom, whatever is safest and works best for each person.

Then, the next day, work on just the legs.

The third day, maybe soak the feet in a nice warm feet massage unit.

The fourth day, maybe the face, neck, ears.

While it's not a long hot shower every day (or once a week) it's not so overwhelming for the person getting completely naked and all wet at one time.

While the whole shower issue may be a control thing, perhaps it is just exhausting and frightening as well. Maybe the person is afraid of falling. Or is wiped out after a shower.

Some nursing homes have wonderful SPA baths that they rarely use or recommend because 98% of the staff doesn't want to be bothered on how to use them correctly. Before my loved one came home, I personally made it a point to learn how to run the spa at the facility (with the help of ONE aid who knew how) and then as time went on - I showed/trained others there!!! It was awesome to have my loved one in a big warm BUBBLE BATH - seated in a chair - in the big bath with jets!

Also, be sure to change the sheets EVERY SINGLE DAY!

I wrote a while ago about my mother not bathing after a little more than a month. She has nurses that come twice a week, and aides coming twice a week. She finally found one aide that she connected with. This is the only one who can get her to get in the shower. She talks to mom, makes her feel comfortable, and then suggest that she take her shower. The others, myself included had worded everything wrong by saying we were going to assist her with her shower. This aide told her that she would sit in the bathroom just to insure her safety & that she would not touch her unless she needed assistance. I guess by the rest of us saying we were going to assist her she felt threatened & loss of control. I cannot imagine how scary that must be for elderly people. As I had mentioned before my mother is deathly afraid of the water, always has been. So, she is still not washing her hair, so I take her weekly to get her hair washed & set. I hope she keeps us with the showering and wish all the rest of you the luck you need in dealing with this issue. Just remember to be patiient and loving, one day that could be you in their situation. I know it's frustrating and we just don't understand it, but some times things like this are out of our control. Take time to sit back, relax, and think of how you want to be treated when you are old too. Some times I have to count to 10, take a deep breath, and then speak b/c I get so frustrated w/ her and her lack of hygene. Having someone to vent to certainly helps me too!

I have told my dad he's getting "stinky." He goes, "Okay." But it doesn't mean he's running over to take a shower.

I find I have to have extreme patience, and wait till it's a warm day, and he's both not too tired, but also a little bored. When I see this window of opportunity, I prep the bathroom, hot water in a bucket, stools ready, shampoo within reach, towel within reach, clothes hamper open, change of clothes all set out.

Then I non-nonchalantly go over and say, "Hey, come over here. You have an assignment." He responds, "Oh oh." But usually then he will follow me over and when he sees it's shower time, he'll start taking off his watch, clothes and will go take a shower. He has Alzehiemer's so I stand outside and call out steps, "Pour water over your feet, now soap." He keeps calling out, "What next?" I figure at least it's still better than someone bathing him.

I have it on my Yahoo calendar as a regular-recurring activity about once-a-week.

Hi Ann L.

I think we are too used to giving adults "a choice." I won't say it to my dad directly, and I don't like it when people make the comment, "He's like a five-year-old." But the truth is, I do have to treat him in a similar manner. He has Alzheimer's and the parts of his brain that aren't working are just like those of a little toddler that haven't yet developed.

Try phrases like this instead:

"The shower's ready, you can put your clothes in this basket here," to prompt her to action.

"Your bath is ready, the water's hot, so don't dilly-dally undressing."

If the day is warm, she's not too tired, etc., I bet it works. The key is to just put her "into the moment." All manner of giving reminders, suggestions, rewards, etc., just don't work.

If she really for whatever reason doesn't want to, she'll still protest. When I tried once with my dad on a day that was too cold, he really landed up protesting and I accommodated, to try another day. But boy was I frustrated and upset and biting my lip.

Maybe my idea is too simplistic, but it seems to work. Would be interested to hear about other's experiences. I do dread the day my approach doesn't work anymore.

I think it's wonderful that your dad can still take orders, and be good natured about it too. I guess it's when he looks at the water and doesn't know what water is used for, that you'll have a whole new set of problems. Until then, I think you've got it figured out.

Keep in mind your parent doesn't like being adependent,it doesn't feel natural. They feel angry, ashamed,embarress,and sometimes down right hostile. The kid feels pretty much the same way. I was lucky I had late in life baby experience.My dad was totally bed ridden. He had numerous problems,but his mind was good most of the time.Once you realize this is just part of the process and your quality time is getting limited you approach the situation differently.I've decided that if you can't pee,poop or throw up on the ones who love the most ,who can you do these things around.I Kept in mind that this could be me someday and I TRIED TO deal with my dad as I WOULD Want someone elese to treat me. No one at anursing home loves your mom or dad as much as you no matter how good they are.Sick people generally want there family around them especially in embarrassing and scary times. No grown person wants to be dependant on another. No matter how hard a care giver has it,the sick one has it harder. I would let my dad know if he was sticky. I played down his lack of dependance,I Could see his frustration,sometimes I got the fury of his frustration. I'M very thinkful for being able to go to the toliet myself.Isn't weird how we take the simplest of tasks for granted sometimes;pooping and bathing on our own.It's like air and water, we don't miss it until it's gone. I would get the softest preemies cloth baby diapers I could find, cut them up to a good size,turn up the heat,get a nice smelling skin softening soap start at the face and ears and go down. I gave the bath like they do giving massages,uncovering only what is being washed.That way when you get to the private parts,its not toocold or embarressing to either of you.Remember only warm water and use a light touch.My dad had a caregiver that rubbed too hard he said, "she rubbed so hard, she could take the hide off of a mule."Music helps relax the tension as does laughter and talking about good times. My dad liked telling me war stories. I was sleep deprived and tired,but I sure enjoyed our quality time.You don.t have to be fit as afiddle and have avacation to Disney World to have quality time. Bath time with your newborn is quality bonding time and so it end of life responsibilites with your parant. Once they are gone they are gone and you don't want to sit around wishing you have done things differently.

My dad refused to go to a nursing home,said he would go to the funeral home first. I wished he could have experienced a big bubbling spa bath.Soaking in tub can't be beat.

i am havin the same problems here . from then on i started to sponge bath my dad on his toilet . for some reason he doesnt like water sprayin on him , and i fear that he would fall trying to take 6 steps to the shower with me hanging on to him .
i would ask him every morning do u want me to crank the heat up so u can take a shower , oh no he says . so i crank the heat up anyway and give him his sponge bath while he sittin onthe toilet , it works he s clean ...
older you get and you just get scared of fallin , me too im scared of falling with him .

If you would try the cut up baby diapers for sensitive skin instead of a regular wash cloth,you will be surprised how much easier on the skin it is.The older we get the more sensitve our skin gets especially when all there is to chose from is sponge bath or asponge bath or a sponge bath.

I know that this can be a very real and frustrating issue... I think that sometimes it depends on the words we use I know that seems simple, but I do know that it works. I think your tone of voice makes a differance and perhaps even giving them choices. Many ladies would rather take a bath than a shower. Try using lets get cleaned up, rather than you are doing to take a shower. One thing to keep in mind with folks with alzheimers disease or dementia they become child like. I am not saying they are children however they do become somewhat childish. It can become a battle of the wills. With ladies get new bubble bath or something that smells good to them. Another thing can be the time of day. Maybe they always bathed at night and we want to do it in the morning. Make sure the room is warm too... Many things to consider.

i would love to have one of those walk in tub !!! and im sure my dad might would go for it , i can see him slide down and drown . so no not a good idea .
but its a thought . and the prices on one of those makes me say nah .
yes i use the softess wash cloth to wash him down with , cuz he did mention once that rag is rough so i thought ok i ll find the softess one . cloth diapers is a exclent idea . ill go see if walmart has em .

I am trying a new approach. Letting my mom know that I am coming to take her out for lunch. I asked her to be freshly showered. This is my plan...if she is not cleaned up, I will stay for a few moments to visit and then leave. I am planning ahead so that I will be prepared to have a pleasant attitude if things don't go as I hope...praying the serenity prayer has been helping me mentally also.

My parents dont have dementia...yet. Dad, cant get his legs over the side of the tub and feels like hes going to fall. I installed heavy duty safety rails to help. He will take a shower once a week. Mom, just hates it. She likes to take a bath not a shower but has a hard time getting in and out. She wont use a chair, I got one, tried it. She has the idea that she can sponge off and its ok but you can see dead flaky skin on her arms, legs and her feet are horrible!! I have done everything I can think of and Id be happy with once a week. The more I try the more she rebels. we wrote it on the calendar book, on Sundays then it got moved to Wednesday then she was too busy(they go nowhere) so ity moved to another day....etcetc. If I leave it alone, she just doesnt take one at all. If I talk about it as nice as I possibly can, she digs her feet in the ground and gets mad and pouts. What do you do???

The real concern besides odor, is skin breaking down!!! The peri area is tender skin. Her bottom needs washed. Try a sponge bath at the sink... I would also try something that smells good body wash or bubble bath... I do wish you well I know it is tough...

My mom has been in a Nursing Home since December 31st. She has dementia and has not had a bath or shower since she was placed there. The NH said they cannot force her to take a shower or bath and my brother and I have tried everything. Yes, we told her she stinks. She is starting to get a bed sore on her back and has had the same clothes on for 2 weeks. She refuses to change clothes too. We placed her in a Nursing Home because she couldn't do these things anymore and we couldn't do 24 hour care. Whose responsibility is it to get her to bath and change clothes and what should we do?