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gingersmomma Asked September 2013

What can the assisted living facility do to my mom if she refuses to shower for weeks on end?

We increased my mother's aricept and I think now she is more argumentative and harder to get along with. The taking of a shower is still a big issue and today she said she wanted to bathe at night before bed. So we are going to give this a go. I asked the Care Director what would happen if she refused for weeks and she said if it became a health issue it would be a problem. Can they move her?

EXPERT Carol Bradley Bursack, CDSGF Sep 2013
It's not likely to be a health issue for quite awhile, but I'd say bathe here whenever she's cooperative. Make it as pleasant as possible (temperature, relaxed atmosphere). Also, there are good wipes and dry shampoos that spray on so she can be freshened up.

As far as can they move her because of that, I suppose they can, but it may depend on where you live. You can check with the long-term care ombudsman for that area at ltcombudsman.org. Type in the AL Zip code. These people are experts on such topics.

Take care,
Carol

NotHisFault Sep 2013
In my opinion, I think a bath once a week is unacceptable. I think it's the assisted living or nursing home facility's job to figure out what is the best trigger or method to get a resident bathed. Recently, my husband, with Stage 6 dementia, was an inpatient in a pretty good nursing home/rehab center for two weeks. He refused to let them bathe him so I did it. I didn't press the issue because I was going there every day for several hours anyway - and I knew he would be coming home soon. But the nurses and aides in the facility really didn't try very hard. They have a one size fits all mentality and if the patient doesn't respond to their initial efforts, they give up. It's really unacceptable. My husband resists mightily every other day during bath time, but cleanliness is not an area where I'm willing to compromise. It took some time, but I figured out how and when he would respond the best, so why can't the facility do the same. I think a bath twice a week in a facility should be the absolute minimum. Everyone is different and as dementia progresses, the facility just needs to figure each resident out as to the best way to get them bathed. If they can't, they may be in the wrong business because this is a common issue with dementia/Alzheimer's and elderly patients.

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butterflykisses Sep 2013
My husband with ALZ. did not want to be wet - he did not like having his head washed. So...we did a chair bath 3x's a week with the help of our Hospice CNA. It worked, sometimes easier than others, but I prepared him for the time. There is something about dementia/Alz. patients they fear being wet. It also makes them feel cold which is another thing that makes them uncomfortable. It is a puzzlement, but we were able to make it work because we were careful, loving and respectful of their dignity, most important of all. Bless you for caring.

jinjelle Sep 2013
Just wondering, has anyone ASKED her why she doesn't want to shower? Falling water on aging skin can be painful. Baths are healing, but are (lately) too hard to come by. It's like a joke, go in shower, get "Beat on" by slamming water from shower, or sprayed in face by too highly-mounted jets, or hurt wrist trying to control handheld with a mind of its own, or even claustrophobic in some tiny little closet shower hole with no room to wash without slamming arms into the wall. When will all these "Senior" places wise up. Step-in baths are now readily available, but . . . ..

I was once in a hospital where I begged for a bath and they looked at me like I was nuts. This was a teaching hospital, for God's sake and they thought I was nuts for wanting a bath over a shower.

stressedmom Oct 2013
As a retired hairdresser, I often had clients from assisted Living Facilities or Nursing Homes, who came in periodically to get their hair done. And yes, I saw it all....! From heads that had layers of sebum buildup ( oil secreted from your pores), to open sores!! All of the clients were mostly in their late 80's & 90's. I tried many things so they did not get water in their ears, when I finally came up with a solution! I used 2 small foam coffee cups...cut them down to a little less than half and placed them over the ears while I shampooed! I would then ask my clients to help hold them in place. The clients were so thankful...they kept their ears dry and felt good that they were able to help me in the process. There is not enough empathy these days, especially in the " Care Giver " field, at least from what I have observed. What little effort you can put forth is all our elders get, 90% of the time, in most of this countries care facilities. What a shame we are so intolerant of our aged....just remember, everyone will be there one day.....! Maybe this will offer a hint on what can be done for the ' water in the ears" comment. God Bless

pamstegma Sep 2013
Nursing homes schedule a bath once a week. Going longer will result in nasty skin fungus. Assisted Living will, for the good health of others, suggest a "higher level of care" which means nursing home. Discuss her changing moods with her Neurologist and he may rotate to another medication or add one on.

anonymous182580 Sep 2013
sharynmarie-- you are absolutely right! Once a week is all that is necessary for an inactive elderly person. Their skin is dry and paper thin and as you say they rarely perspire unless they are morbidly obese. As my mum's live-in caregiver, I give her a hot soapy chair bath once a week as that is all she will agree to, I wash her hair on a separate day because doing it all on the same day is too much for her. I soak her feet on yet another day and I have the foot care LPN come to the house every 8 weeks to cut her toenails, deal with any callouses and give her a foot massage.

sharynmarie Sep 2013
For the elderly, their skin can be very frail. Because they are not actively sweating, a bath once a week is what is recommended. In between a bath, use the pre-moisten disposable bath clothes. Most elderly will have thin, dry and frail skin. Bathing daily can damage their skin setting them up for skins sores.

mongomay Sep 2013
Believe it or not I had okay success when getting up first thing early in morning and using getting ready for work to take a shower while Mom was a bit disoriented. It was part of her everyday routine before the disease progressed. Some how latent memories helped. As it further progresses, this will not work. It was alot more difficult being male and her son to do this. Usually someone will have to take the lead for this activity. They will not do it on their own as the progression goes longer. Did not see benefits of extra pills, had issues with reactions and "new" issues during medication changes/increases.

Lizann Sep 2013
If the refusal is part of being disoriented that is one problem. However, bathing/showering the fragile elderly takes time, planning, proper equipment in the bathroom and lots of preplanning to eliminate all barriers to a safe trip in and out of the bathroom and shower. Perhaps she has a fear of falling or being dropped in the bathroom or shower? I would observe the process on who they attempt to administer the shower. Also hospitals are known for rushing the process which does work after age 85.

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