How can I address hygiene with my mother-in-law?

62 year old man here. Long story but I had to help my 86 year old mother bathe a few times before I could get home care set up after a surgery. I do not recommend this. I just didn't have a choice at the time.

You should call an in home care service who can have a bath aid visit. It will be $20 per hour or so probably with a 2 to 3 hour minimum.

Her dementia might be a problem. Might take some trickery and fibbing.

And search this sight for a bunch of info on elders and hygiene. Your not the Lone Ranger on this issue by a long shot.

Sometimes odors come from the skin because of things that Mother-in-law is eating, such as lot of onions and garlic. Could be other food items, too.

This is a tough conversation to get started with someone. It's like telling someone they have bad breath. One thing I could think of is to buy some prepackage cleaning cloths for Mom-in-law to try. You can tell her these are easy to use if she needs to freshen up quickly, and here are a variety to try out.

Just go down the grocery aisles, in the baby section are baby wipes [get scented ones as the unscented have a blah smell, scented might make Mom-in-law want to try them]. In the toilet paper aisle are bathroom wipes, but they aren't flushable. And in the personal health sections are feminine hygiene wipes she can use.

Back when my own mom was still independent I felt the same as your wife, how could I possibly tell mom that? After morphing into her full time caregiver that little concern seems silly now!
I think Windy's suggestion of hiring in help is a good one, hopefully you can spin it as a desire to help her feel more comfortable and alleviate any worry that she may fall. Is her bathroom set up with a bath chair, hand held shower and grab bars? Extra heat is nice too.
As for the incontinence, many women who are much younger have stress incontinence, there are some pads she can use that are especially designed for this and the smallest are very discrete.

Oh, I just thought of something else. Maybe Mom-in-law needs to drink more water as that can help to limit some of the odor.... but then again, there are pills that could create a sulfurous odor. AZO also puts out over-the-counter pills that can help with odor, but Mom-in-law would need to check with her doctor.

I just told my Mom she stunk. I would tell the aide she needed a change. Mom would refuse to go and I would bend over and whisper in her ear "you stink". She would go.

Maybe it is time for pull ups. Or if that doesn't work, sanitary pads. I never asked Mom if she wanted a bath, I just told her it was time for one. Again, I would tell her she stinks. A handheld shower head is great for getting to those areas. I agree that what they eat may be a problem but I also read it has something to do with the skin cells as u age. Using deoderant soap helps. I use Loves baby wipes. They are thick and big. You can use these for a quick wash. For some reason with Dementia, one of the first things is not wanting to bathe. They worry about bowel movements but don't want to bathe.

I know by law aides/nurses have to say "would u like to take a bath". This didn't work with my Mom. You said "time to get a bath". If you "Ask" it would be "no" or "later". I would tell her she needed to do it when tha aide had time. Actually, I told the aides to tell her "your daughter said....". It worked.

My FIL was the same. We got him in home care and they sent 18 yo's, who'd say "time for a shower" and then they'd sit on the couch and he'd go run the shower for minute and come out IN THE SAME CLOTHES and say "OK, take me to the coffee shop".

I witnessed this ONCE and let the poor aide have it. I said "You are here to HELP HIM BATHE , so do your dang job!!" We still had issues, but FIL had bowel incontinence and wow--he got really smelly. I'd just gave up trying to be discreet and nice, since I was also the one scrubbing his fouled clothes and underwear (when I could find it, he'd hide it around the house!)

Never a really "clean" type man, he didn't like to shower, it was hard for him, but he had to have his behind cleaned every single day, whether he liked it or not. Sometimes I'd threaten to strip him down and scrub him myself (while hubby cowered on the couch)...that alone would terrify him into washing. (sigh)

As wonderful as it would be to be kind and gentle, sometimes the whispered "you stink" makes the difference. You wouldn't let a baby sit in a soiled diaper, why would you let an 80 yo? Some people can be cajoled and babied along, some require tough love and tough talk.

Best thing for us was dad's frequent hospital stays. The nurses made him shower everyday, no questions.

Thanks to all for the multiple replies. One by one here are my responses: "(Use) in home care service(s)" we've considered this and it may be the best option. "Dementia might be a problem" she is very easy going for the most part and her dementia is not severe at this time. "Odors come from the skin because of things that Mother-in-law is eating" I'm confident it is feminine hygiene just can't or don't want to explain why here in this forum. "Buy some prepackage cleaning cloths" trouble is she forgets, short term memory is very very bad. "Morphing into her full time caregiver that little concern (telling her she stinks) seems silly" we've been her 24/7 caregivers for three years now and neither of us can work up the gumption to say this to her. "(Set up the) bathroom with a bath chair, hand held shower and grab bars" did this long ago but she won't use it. "(There are) pads she can use" again she probably won't remember them. Thanks again. I will search the site for more information and will post when we reach a resolve.

There is a difference between caring for someone in need of total support with all ADLs and the level of caregiving you are at Best, I was where you are now about 7 years ago and the learning curve seemed very steep. My comment about addressing odour as silly is measured against my need to physically bath, toilet, change diapers, and more for my mother. I've been peed on and pooped on, so yes, the issue of odour seems trivial now.
My mom also relied on sponge baths, when she finally allowed herself to be showered by someone she commented that she "tingled all over", and that was a good thing! Until I began to look I did not know there are so many helpful incontinence supplies, waterproof bed and chair pads etc. There comes a time when the caregiver child has to step in and take the leading roll in the relationship that was once dominated by the parent, even though it is uncomfortable and feels disrespectful and unnatural.

Best, one of the first behaviors one hears about related to Alzheimer's/demensia is that the person stops wanting to shower. When the demensia becomes "severe" she will be double incontinent and probably be taking bed baths. So this is a demensia related issue, unless you are saying your mother in law has always not bathed and smelled bad. The suggestions made here are sound. These are shared out of experience, not off the cuff. We have been where you are.... are more. 

When my mom was at that stage, I would start the water running, get her shower chair in place, use a space heater to warm the room, get her towels ready, put soap on the wash cloth and says, "time for a shower momma." Then I was there to help her out and put her robe on.

Your MIL's demensia is far enough along that you are saying she won't remember to use a "poise" type pad...so that means someone needs to help her put the pad in her panties, or open it and get it ready and hand it to her to put in her panties. Caregiving quickly gets much more hands on with demensia. Sorry, it is just what happens. One thing not mentioned yet, or at least I didn't see it, is having her checked for a UTI. That can create odor too.

Another thing I did in the early stages was to get a couple of Peri bottles. I would put a mild soap with warm water in one and then one with clear warm water. On mornings mom didn't shower, while she was on the toilet, I would spray her Peri area with the soapy water and then with the clear water. It helped clean her down under a bit.

They make flushable most wipes... Adult disposable wash cloths... No rinse soaps... All can help in these situations. With some demensia patients, it is the running water that they don't like so they do better with a bath. Again, some assistance may be needed.

One thing is for sure when dealing with demensia/Alzheimer's.... This too shall pass...it is progressive and this stage will pass and you will have a whole other set of issues and behaviors.

Thanks again to everyone for the helpful suggestions and ideas.

I really like cwillie's answer who commended windyridge's comment:

I think Windy's suggestion of hiring in help is a good one, hopefully you can spin it as a desire to help her feel more comfortable and alleviate any worry that she may fall. Is her bathroom set up with a bath chair, hand held shower and grab bars? Extra heat is nice too.
As an elderly carer I usually walk in and straight away I am talking, " Okay...shower time..." and if they say: "No, later..." I say..."Thats fine... ..but phew, what"s that smell? Is that pooh in your hair?"  OR: " You have been told that you NEED to have a shower and you are to have on today then you don't have to have one this afternoon." It's difficult though , you must speak empathetically and it can take a couple of days of constantly talking and maybe even getting another carer in who speaks the same as the first carer.

But the most empathetic and goodest response in my mind is Grammyteacher. Check it out.....it's a dialogue with someone who suffers demensia/Alzheimer's...wow, what a caring person.

Dear BestMotherInLaw:

I am exactly where you are now. I am the daughter in law of a bright elegant 96 year old with short term memory issues. She used to take daily baths on her own and get dressed in a nice outfit everyday. Now she only gets dressed when there is somewhere to go and needs to be reminded to bathe. In addition, she has become incapable of wiping herself well after using the bathroom. If she has an accident, she tries to wash out her clothes in our sink and does a poor job.

Since we all use the same bathrooms, this is not acceptable.

We do set up the bath at least once a week and tell her it is a good time to do so now.

We also have taken away her panties and replaced them with disposable pull-ups, the nice ones that fit like underwear. We have those and some wipes in a basket by the toilet, along with a smaller covered trash can. The basket and the trash can are "labeled" with instructions such as "underwear and wipes." I have a brief instruction sheet in the basket to change underwear daily and when necessary.

Whenever she takes a bath, we grab all of the used clothing and do a laundry load. We also have a cover over the sofa wher she sits. This is washed on a regular basis. I also have jars of odor absorbing gel in her room and sitting area.

Occasionally, she does state that she is offended that we think she is "dirty ". We tell her that she is getting forgetful about baths and that we are helping her to remain elegant and pleasant to be around. We also tell her that it is necessary to be clean when living with others. This conversation takes place 1-3 times a month.

The other writers are correct. This lack of awareness of her own hygiene is due to memory (dementia) issues and aging. She does not remember and she does not smell herself. She cannot fully take care of herself.

If we get to the point of too much care and no cooperation, we are considering more in home help or assisted living.

I hope that this is helpful. It sounds like you truly want to be respectful of your MIL.

You have to help her keep her bottom clean! The dementia she has been experienced actually could be caused by urinary tract infections. Older ladies have a real problem keeping that area clean because of all the folds of skin. You should try to help her carefully wash the bottom at least once a day, twice is better. If she sits or lies a lot ultimately she can get bed sores and uncleaned fecal matter can infect the sores causing sepsis which in 97 years old is terminal. Baby wipes can help, but take care to make sure they don't get flushed in the toilet (even if they say flushable on the box) or they may stop up your plumbing! Also make sure she changes her pull ups or diaper at least twice daily. If she is wearing underwear alone, get some of the Tena pads. If you keep her in synthetics (fleece, not cotton), you can wash and then air dry the under-ware or pajama bottoms and they won't smell as badly. We used Tide with Febreze to keep my mother in law smelling fresh. The home health and hospice assistants always commented on how nice she and her clothing smelled.

My mom lost her sense of smell and insists she cleans herself, she doesn't. Also showers on older skin is more sensitive. Her care center is very kind and wants her to feel safe. The hygiene is a tough one, she has excuses after excuses not to bath. We are kind still must be firm for her and others around. Not winning but must kind trying. We love our moms !

My mom lost her sense of smell and insists she cleans herself, she doesn't. Also showers on older skin is more sensitive. Her care center is very kind and wants her to feel safe. The hygiene is a tough one, she has excuses after excuses not to bath. We are kind still must be firm for her and others around. Not winning but must kind trying. We love our moms ( some days - grrr!) Love you Mom : )

Hi Bestmotherinlaw,

One "tactic" I didn't see mentioned was bringing in an authority figure to broach the topic with your mother-in-law. Set up an appointment with her primary care physician ('just a routine check-up") and ask the doctor to be the bad guy. Generally speaking, older generations respect authority figures and will listen to them when given instructions. Perhaps you could arrange to have one of her doctors tell her that her hygiene is problematic and needs to be addressed? She might be less likely to push back and more likely to follow orders. Even if she receives it poorly, you can continue to blame the doctor when you make efforts to help her stay clean ("I know you're not wild about this, but the doctor said we have to do it."). Your mother-in-law's dementia may thwart the efficacy of this strategy, but it could still be worth a shot.

You could also try to get her doctor to instruct her to use the bathroom modifications you said you've made.

I worked for a Senior Move Manager and was trained as an Aging in Place Specialist (for those who planned to live safely at home as long as possible), and we found the "authority figure" method to be particularly effective. The adult children would come to us months after trying to convince their parents to either move into a Senior community or make modifications to their home for aging in place. Even though we might be saying basically the same things the adult children were telling their parents, we could get their parents on board because we were seen as authorities rather than their "overreacting children."

You sound like you've been doing a great job, and you're way ahead of where many caregivers are in this kind of situation.

You may have covered all your bases for the bathroom, but I wanted to share a pretty extensive guide I wrote that you may consider sifting through just to double check everything. Just putting down all the things I learned while working in this world - hoping it can be helpful to others: https://thehelpinghome.com/aging-in-place-at-home-definitive-guide-part6/

Part 6, 7, 8, and 9 all have to do with hygiene. Maybe you'll find something in there to be useful.

Best wishes!

Jason

These are all great tips.
I wanted to mention that my mother in law developed 4 tract infections within one month involving an entire month of hospital stays and rehab.
We finally started washing her bottom and she has not had one tract infection since.
She does not wipe properly.
It is the unthinkable and we try to be matter of fact as to allow her to keep her dignity.
It is necessary.
We even had a home health aide come to the beach house where she was vacationing with my husbands family.
Good luck!
Good luck!

Perhaps it's time for a Dr appt to address the feminine
odor issue. I think as caregivers your wife and yourself
need to be much firmer, it isn't going to get any easier.

A woman of 97 probably doesn't have a lot going on "down under"---we tend to kind of dry up, sorry if I'm being gross or impolite.

If you can get her to bathe well, and the "intimate odor" continues, you should see a Dr. She could have a yeast infection or some other kind of Ph balance issue. She could have an overgrowth of pubic hair and it needs to be trimmed. (Yes, this happens) That would certainly trap more odor and be pretty rank. I guess I don't really understand what you mean by has "feminine hygiene" smells. I'm a little befuddled by that.

Just getting the old urine smell gone is usually the hardest, as it clings to everything. So potent. Not bathing is simply not an option, so good luck with this. Or rather, to your wife, b/c I cannot see a SIL stepping up to bathe his MIL.

I think re-training mom to use different 'cleansing' methods. The big wipes, the prepackaged washcloths that hospitals use that foam up and then are used to wipe the person down. No rinsing needed. Those can take the place of a bath for a while.
Also, check her hair. My grandmother had very thick hair and when she got very old and could not keep her weekly hair appts, she developed something like cradle cap--the oil in her head built up something fierce--and it smelled awful.

I really feel for you--I went to mother's one day and she was standing stark naked in the bathroom while my brother bathed her. You'd have thought she was Cleopatra--she was positively reveling in the attention. I said "Oops, I'll come back" and she said "Oh, no stay and chat. We're having a lovely time." (Brother looked at me and mouthed the words "ONE of us is having a lovely time". Bless his heart.

Yes, there comes a time that you just have to DO IT instead of coerce them to do it themselves. Tell her "doctor said one to two showers a week". Pick a day, have a schedule, hire an aid. Heater and shower bench. If it's "shower day" don't "get dressed" til shower is done; just PJs or robe. Tell her she'll feel better and smell better. Don't make it too big of deal, try to be fast; "after we are done with shower we are going to do _______". Mom didn't resist but was unable to do it herself. I used the type of Body Wash / Shampoo product that they use in Hospitals and Nursing Homes. They are pH balanced and don't require rinsing (we did rinse, but any residual product will not cause any problems). I started with the hair, face, neck and ears; very fast. The aid started with the feet. We worked fast, we worked together, met in "the middle." We did this until she could no longer walk and get to the bathroom. Then it was sponge bath in the bed before getting her up to the wheelchair. Then to Nursing Home was next. Good Luck.

My mother in law had the same problem. We were living with them to help out. The entire house would smell when we got up because she wandered at night. I finally just told her I was going to give her a shower and do her hair so she would feel fresher. I didn't take no for an answer. She loved it and felt so good. They refused to let anyone come in to help. Sometimes you just have to bite the bullet and do it. I did have to tell her she smelled but I tried to be kind about it.

Our adult parents 80 and over are mostly old school modesty. Sometimes they prefer an outsider to help. Sometimes the kids have to build up their parents trust in themselves to allow you to "HELP". I was concerned about my mom not bathing everyday until someone wrote on this site that they probably didn't bathe everyday growing up and it's OK. The smell situation maybe you could get them to use the wipes instead of soap and water. Someone mentioned the parent being in the same clothes. Unless the are wet everybody where's their clothes more than once. My mom had taken her clothes out of her drawers and put them on a shelf. It turned out to be a brilliant idea for both of us. I could pick out an outfit or if she wanted she could. I made sure I got the old clothes in a pile and moved back and had her new outfit on her bed. I am a BIG proponent of helping " the help" they are grossly underpaid and it's just a "job". It's your responsibility to see that your parent is getting what YOU consider the BEST for your parent and that usually means helping. It's funny how we expect someone else to lovingly do what a lot of children won't do for their own parent. I was sole care giver for my mom. My siblings lived out of town. I never complained and I can now look back and know my mom had the best and I was FREE of charge. Love you MOM.

Try enrolling her in a swim class for arthritis or stretching - then she will shower before & after plus being in water for over 1/2 hour - I go to the nearby pool regularly - advantage is you don't need to clean te shower afterwards

Getting in & out of tub & cleaning it can be a worry for even active seniors so this may contribute to problem - use this as an activity with a family member[s] to start with so that she goes as an 'outing' not a clean up issue -

If someone could do a liberal spraying of a deoderizer while she's out will help also - otherwise take old socks filled with kitty litter & stuff them down sofa etc. - replace every few weeks

Well, I am the mother in this situation. Only difference is I have no issues with incontinence or bathing. I have a huge walk in shower. 1st...Can you put a walk in shower for her. 2nd. DO NOT BE afraid to speak the truth to your mother. I would rather my kids speak the truth then not. I am 75 and live in a house behind my kids home. That is as close as I will get. My mother was independent until the end. Even tho we cannot predict what our end will be, I would surely appreciate my kids being honest.

Female lack of hygiene is among some of the most disgusting smells in the world, (in all fairness male-unclean " uncirmcized" ordor is just as disgusting) .. next to decaying animals etc. the odors are violently putrid. god, just hire someone and force her get clean..use the reasoning is she doesn't she could contract such a bacterial infection it could kill her. Then I would ignore any and all back lash from her .. get that funk taken care of. If she's over weight the yeast build up between rolls of skin alone is disgusting by itself . .. then the female "private areas if not controlled can make one vomit. Hire someone once a week. Otherwise it won't stop. Have the bath aid (after drying) place an anti yeast cream under any folds of skin and have the aid use a strong deodorizing body wash. It will take a couple baths  to kill all the bacteria. And I suggest showers .. the bacteria needs to wash away from the skin rather than sit in it as a bath would do. 

A large shower cabin or walk in shower where you can put a plastic stool or small plastic chair to sit on is a must. Also plenty of bars and handles to clutch onto to keep one's balance - and a properly anti-slip floor. Some old people are just simply frightened of falling and not being able to get up. Getting out of a bath can be murder for someone in their late 70s or 80s. Perfect excuses not to shower or take baths.

At 97 years old you should probably be accompanying your Mother to the bathroom if she smells bad. Put on latex or vinyl single use gloves, blow into them first so they slide on easily. Say, "here let me help you, you have poo hanging on from your butt." Let her wipe first then you can check out from the back with baby wipes until they wipe clean. Use disposable paper panties and you can use something like panty liners - extra long is good if leaks are pee or poo in the paper panties. When Mother was in a rogue Personal Care facility, residents had to line up for lunch and then wait, one wheel chair behind another until the doors open. There was a terrible stench in the hallways. When daughters were there, many of them complained and helped their moms out even if it was just the days they were there with their Mom that their Mom's didn't smell. Mother is at a different facility now, with most of her friends in Assisted Living or Independent Living. No one stinks. It was a step up. I stay with Mother as full time Caregiver here and make sure she has clean panties, clean butt and we clean her fingernails with a pick and use peroxide on a fingernail brush before meals. Also as far as personal hygiene, Mom gets a shower once or twice a week. I assist her and help her wash her hair. I wear a long raincoat, it makes her laugh and we heat up the shower by getting the shower all steamy and warm before she steps in. We brush our teeth together in the bathroom in the mornings and I use a toothbrush on the inside of her bottom teeth for her. The dentist just suggested a water pick. If your Mother is doing a good job regarding personal hygiene, you wouldn't be asking for advice. My advice is to encourage Mother to do as much as possible by herself but if she is not doing a good job that is where you need to step in. Mom and I dress in coordinated outfits most days, and she wears her pearls and a big smile. We were always a very correct and polite family. It is correct and polite to keep your Mom clean and smelling good.

Stop the crap about kids need to care for their parents. I'm so sick of that. First of all can't you people read?? he's a son-in-law and I imagine one in his 60's or 70's himself based on she's 97. She's a female mother-in-law, does that not switch your advices appropriately?? It should. No son, let alone a son-in-law should EVER "have to, nor should Ever be made to feel guilty into "maintaining the hygiene of a mother-in-law, my god. 

Stop telling people, who ever it may be, that they should feel responsibility of anyone regarding aging individuals, if the feeling is there, then they already own that to the degree they do, so let them work out their own situations regarding "feelings!!!!!!! 
Good God the man (if in fact the poster is in fact a man) .. a man should never have to clean the a**, breasts, nor vaginal areas of a female. (Unless it's his wife or child) and even then, out-side help would be easily found to do such a task of thorough bathing. (one thorough shower per week is sufficient for a 97 year old. Any more will dry the skin causing chances of skin issues that include itching and skin tears and abrasions to be more frequent.) 

Unbelievable .... someone Telling this guy to put a glove on and make sure poop isn't dangling?????? Then you have someone Telling him to spray a sh** ton of air freshener???( good way to throw a 97 year old into a respitory attack) .... I swear to god I think some who respond are not of their full-facilities, actually based on some of the comments psychological assessment red flags are popping up all over the d*mn place. 
 This is 2017 not 1900... this man has resources that he can draw assistance from within his community, and if her insurance is governmental or private both will have bath aids integrated within assistance. She's 97 years old for so stop telling him to start talking with her, and start telling him to bring someone in once a week and get it done. It's not time for a hygienic intervention to reteach a 97 year old what's acceptable social hygiene. (I'm cracking up out of pure disbelief and blown away what many of you've written...) 

You folks need to direct him in the way that will both alleviate his concern and minimize the event all together.... , but for god sakes knock the guilt crap off """ yes I said 'crap Off" and stop the weirdness many of you seem to love to publicize  ..... (some of you have clearly lost it... wow. "One flew over the coo coos nest, and "mommy dearest are flashing through my mind reading these from some of you.) 

The husband of the daughter seemed to write the question. He said my "Mother-in-law." He said his wife was uncomfortable talking about it. It seemed the writer and his wife lived with the Mother and took her to visit a brother who called them up after their visit to tell them the Mother had a bad odor. I did not say the son-in-law should be taking care of the Mother's hygiene. Our generation is old fashioned about that. However who knows what the future will hold. There are male and female Doctors / gynecologists, urologists, etc., male and female nurses, sons and daughters. Who knows where the future will take us. Female nurses and nurses aids have long been giving personal hygiene care to female and male patients and residents at long term care facilities. Men have to make a living too. Society is changing. Now a person can change their sex if they want to. It is nice to hear old fashioned values. We read the information differently.