Bathing the Elderly

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!

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!

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.

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.

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!!!!

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.

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

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?

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.

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.

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...

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

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.

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 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..

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.

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

My Mom receives physical therapy also. She started a new program which is called "Balance for Life". Medicare allows 8 weeks of this type therapy, 6 weeks at 3/wk and then 2 wks at 2/wk. (A Home Health Aid was also approved by the therapist for this time span). The therapist said she is showing improvement so he expanded it for another 8 weeks at 2/wk. I understand that there must be at least a 30 day break in between treatments (16 weeks) and then you can ask your parents physician for another prescription. If your parent has had any falls, a hospitalization or even have displayed deterioration in their gait, the doctor can request a home health company therapist to evaluate and treat. Some doctors and home health companies are more cooperative than others since they all have concerns about being audited by Medicare.

Wait the 30 days and then ask the physician for another prescription for physical therapy evaluation. I'm in the same boat as my mothers home health care is almost at an end and her physician who was very cooperative has moved and I need to find another physician for her. I hope I can find a good geriatric doctor who will not be afraid to prescribe home health care.

Best of luck.

Ann

Trying again: Do it! Do it! You've got to take care of yourself, or you won't be able to stand up to this job. Take yourself a long bubblebath; light mood candles; do deep breathing exercises, or whatever puts your mind in a happier place.

Good luck -
Lira

Do it! Do it! You've got to take care of yourself, or you won't be able to stand up to this job. Take yourself a long bubblebath

I'm dreading the loss of our home health aide. Since my mom is not in acute situation anymore, the 5 weeks of home health is about to run out. That means no physical therapist to encourage mom to do her exercises, no nurse to check her 02 saturation, and no aide to make her take a bath. Since she completely ignores my suggestions that she needs a bath (she won't even wash her hands regularly, with lots of soap and warm water. Just rubs them a little under the faucet maybe once a day), I refuse to be pulled into feeling angry and frustrated (obviously I am angry and frustrated but trying to keep it at a workable level). We have the safety bars, the safety stool, I volunteer to fill the tub, I keep the tub sparkling clean, make sure she has multiple big fluffy clean towels, whatever she needs. But I will not follow her around and bug her about taking a bath. I have enough resentment going without adding that to it. So I'm taking deep breaths as I think about this week or next week being the end of home health. Not my problem. Not my problem. Not my problem.
I'm SO close to calling my doctor and asking for a Xanax prescription.

& doing very well except he has had recurring bladder infections, which I believe could be caused by not keeping himself clean enough. He acknowledges every I say to him, but his body odor tells me a different story. So, now I am trying to be sure he has all the tools he needs to shower. What I am looking for right now is a taller shower STOOL, where he is not seated all the way down. His legs are very weak and if he sits down on one of the lower benches I don't think he would be able to get up on his own. If anyone has seen a taller shower stool, I would appreciate knowing where I can get one. I have found that being sypathtic with his situation instead of fighting and arguing has better results. The older someone gets, the world revolves around them and their problems, they become very selfish, me, me, me. If you are able to understand it is part of their aging, you can let go anger and frustration. Good luck to all.

I have just found this site, nice to know others are having simlar problems. My Dad is just outright lying to me about showers, or we are in the early stages of dementia, and he believes what he is telling me. We have a senior helper come in 5 days @wk for 4 hrs a day, and everything is working very nicely, except about showering. His aid tells me she can find no evidence of him showering (shower or towels do not appear to be used). He tells her and I both he does not need help. He is 93

I so understand your being upset, I too go through the same thing with my mom. I went to see her doctor and we had a 1 on 1. I told him the things that were going on , pretty much the same as your parents and he thought we might need to get a physc. evualation, which I have set the appt. Phycosis (sp) is pretty close and related to depression, which your parents might be having. I have also set a meeting to get my mom in a senior day care setting for at least 2 - 3 days a week. Now, I am her POA so it does make it alittle easier.
The last issue we had was 5 days with no bath or washing and I finally said that was it and I called Dept of Aging and they will be out to get me some help with this issue. As we can not understand the not wanting to shower issue, there is more to it then just that im afraid. Hopefully when we age we will not be like that!
All I can say is, Take a Deep Slow Breath..... If you can call the Dept of Aging, they are worth a million bucks.... They have lots of places that might be able to help you and your parents. Good Luck

I am so glad I have found this site. I am taking care of both of my parents. They are not THAT old in age but act like they are dead. Dad is 73, mom is 70. They refuse to take a bath not due to dementia but just refuse. They are very lazy and do not clean themselves or thier house AT ALL. I now clean their house 3x week and when they ask how they can repay me(they dont have money) I tell them all I ask is that they bathe once a week. It worked for a couple of weeks but It has now been 11 days since they have bathed and they still refuse, I have tried, over several months, to use sensitivity, patience, calm talking, firmness, and now temper tantrums. They change the subject or even hang up on me on the phone. I even clean out the tub, bought nice candles, soaps and lotions,a heater for the bathroom, chair for shower, installed safety bars throughout......offered to help in any way. just so they do this once a week. I just dont get it. They do nto get around very well and they do NOTHING all day. Sit in the chair and watch TV. They have some excuse every time I mention it. They had to go to grocery. Or they went to go eat lunch, They cant do 2 things in 1 day. My mom is also a chain smoker and betweent hat and the body odor it is unbeleivable. I just mentioned calling home health to ge them some help and that its ok if they can use help and I woudl pay for it and they went OFF on me. Said they would not open the door and etetc. What can I do. I cant just let them live liek this it would be totaL NEGLECT. It is embarrassing too. They act like they are done living and are ready to just sit and die and I am disrupting that. Please help. My dad has Doctors appt constantly for 1 thing or another, his health isnt great. But his teeth are falling,rottingo ut of his mouth and wont go to dentist and my mom wont get a check up at all for years now. I cannot get thru to them..............i have honestly tried all i know to try...............

Im so happy to have found this site..... Every post has something to offer. My mother has come to live with us and she has many health issues ans none are fixable, enjoy her for as long as you have left, but some "DAYS" that is very hard to do. She is 73, does not want to shower and every other day is a fight or an excuse. She has been at my sisters for the last 4 days to give me a break and I had to step in because it is now 5 days with no shower, she is wearing a diaper and she will not use toilet paper to wipe and so you can imagine the smell from her, so this 5 days with the same diaper, no hand washing either. I told her if she did not get into the shower that I was going to get some stranger into the house to shower her, It worked.... But the next time will be the same thing. I am so tired as is my husband. I have been taking care of my mother since I was 15, in some way or another and now she is with us. My sister has a hard time dealing with the dementia and my brother took mom in, only after 3 weeks to move her out..... This can be very exhausting... Any suggestions would be greatly appreciated, we all seem to be in the same boat....

I would like to add some suggestions regarding hiring a home health agency. I had the experience of hiring one and even though they promised someone in their early 40's with experience instead they sent a very young girl who had little experience other than helping her grandmother. I asked for someone else for the next time and again they sent another young girl (18 or 19 yrs) who had very little experience. I had to get my mother into the tub both times as she would not respond to either girl that was sent. As everyone know, getting them into the tub is the hardest part.

My suggestion is to talk to the Home Health Agency and be very specific that you need someone with experience and patience that is familiar with dementia. Make sure that it will be the same person each time that comes out. BE VERY SPECIFIC AND MAKE IT CLEAR THAT ANY DEVIATION WILL BE REFUSED. Otherwise they will send whoever is available and that person very well may not suit your needs and you will still be charged.

My neighbor gave me a good referral as did my doctors office. Ask at your doctors office as many of the middle aged nurses are going through the same thing and know of good qualified people who are retired nurses and do this as a sideline. Please note that they are not licensed and insured when they do it as a sideline but at least you know that they are qualified with experience.

I suggest hiring a home health agency. Another person has made this suggestion as well. The elderly tend to respond better to those dressed as and have the deamnor of health care professionals. These aides have dealt with this type of situation on numerous occasions. They know all the tricks of the trade.

Well I went through with this with my mother. Maybe its the embarrassment of you being around? For my mother it was control and I think someone else watching her (for her safety).

But regardless, if she gets like that with the dirty clothes, stuff them in bed with her and just say "I thought since you didn't mind them, you might like to sleep with them. If you don't there are baskets... otherwise..."

I think too its about choices. I always gave my mom choices. Sometimes they worked sometimes they didn't but I had to be prepared with the consequences I issued with my "threats".

Don't worry about having sympathy. I look at my mom now and how miserable she is, but its all her own doing. I could sit and cry just thinking how she didn't have to have this life (although in exquisite facility), but just the always being so miserable.

But do what you can while trying to keep yourself sane. Be passive-aggressive with her and turn the tables. That will knock your mother right off her keester... :)

My husband has learned more sympathy for me while in this whole thing, because any kind of emotional push, demand, etc... just throws me either into tears or a fit of anger. He knows what the cause is, and I think this whole thing may have STARTED to help us heal in other ways. Just take a breath.... step back and re-evaluate boundaries, and keep in touch here on these boards! They are a great source of encouragement and knowing we are so not alone.

My mother has never been a daily bather (she grew up on a homestead with no running water) but she used to bathe at least once a week. Not anymore. I noticed her baths getting to be more like 10 days apart a while back. I would remind her occasionally but it made no difference. Now she uses the "no energy" excuse constantly, and I refuse to fight with her about this as I already have too many anger issues with her. When I left town for a month in December, just as she was going through a COPD flare-up case of bronchitis, the doctor got her back onto homehealth visits, with a physical therapist, nurse, and an aide to help her with baths and change her sheets. Since the aide came once a week, my mom was forced to take a bath once a week. Well, the home health aide was cancelled a few weeks ago because my mom said I could help her now that I was back home again. She then promptly refused to take a bath. I would tell her I just scrubbed the bathtub extra clean so that she could have a nice bath (the bathtub is always really clean but I tried to make it even nicer). She put me off. Two days ago, the visiting nurse asked me how it was going with mom's baths. I was so angry I just threw up my hands and walked out of the room without answering her. I heard my mom admit to her that she hadn't had a bath in almost 3 weeks. The nurse promptly reassigned her a home aide, who showed up yesterday morning to help my mom get a bath. I heard my mom bitching at the poor woman through the whole thing (I guess they are used to that), but at least when I asked her if she felt better for having a bath she said yes. So now we are back to the aide coming once a week for her bath. Mom says that they "force" her to take a bath. I have zero sympathy for her attitude. It's bad enough that she doesn't wash her hands (she rubs her fingers together under the faucet) and has no immune system. I have turned OCD about cleaning every surface and changing all hand towels in the house once a day to offset her dirty behavior.
She also won't put her clothes in the laundry (she has TWO laundry baskets in her room and all she has to do is tell me to get them or just shove them out her door for me to take to the garage to wash) and wears the same clothes over and over even though she has enough clothes to open a used clothing store. I am a tidy person and already deal with a husband who throws his clothes on the floor and leaves his boots in the middle of the living room for me to trip over. Living with a passive-aggressive slob like my mother is making me insane.