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Lisa4YHVH Asked July 2018

Bathing for the elderly with dementia?

My mother-in-law hates to bathe. It's always a fight between her and my husband. I'm home with her 24/7 and even when she hasn't bathed for 3 weeks, I never think she smells bad. My husband can be very mean to her about this, telling her that she stinks which, of course, starts the fight. She comes to me and asks me if it's true that she stinks and, honestly, I never think she does. Is there a reason for this? I've learned to stay out of the middle of this repeated fight they have but it bothers me that he can be so mean to her. I've tried explaining what I've learned about bathing and dementia to him but it never helps, so I have 2 questions about all this now. (1) Is there a medical reason why, even after not bathing for a few weeks, that she doesn't actually smell bad? And, (2) is there something I can do to help her with this situation?

OldSailor Jul 2018
My DW does not bathe daily but the smell she has is from gas. I do try to keep her clean "down there" and in the back. sometimes she gets past me on this. I do encourage her or ask if she wants to take a bath. She does at least every two weeks or sooner. She enjoys sitting in the step in tub and pouring warm water over her body( not her head) or using the hand held shower. She does not wash her hair very often and I am no longer adept at washing hair. (haven't had any for decades)But I try.
Brushing her teeth is encouraged more often but I have to watch since she likes to clean the sink with her tooth brush.
Combing her hair is done 2 or 3 times a day. Changing clothes? Maybe one change a week, not counting diapers.
Of course we don't have visitors or go out very often.
Bath talc may help some. Sponge baths as desired.

gdaughter Jul 2018
This has got to be one of the most miserable and perplexing caregiving questions, based on my own research. My answer will not be of much help...but just give you a sense of things...I come at this as a daughter (the evil one if you asked my mother with dementia) where the relationship was not close but still 2 people there for each other. Antagonistic and filled with differences more often than not. So, at least for now, I am not the personal care aide candidate. I am also....a social worker...who has been in the aging field 25+ years...not only with dementia patients...No one has any answers that particularly are good. Helpful little guides with all sorts of hints to make the person comfortable, environment warm, safe, inviting. Bribing, promises etc. But when someone is rejecting of all efforts and claims they do it themselves...what's left? Last YEAR we believe mom took a shower prior to dad's big birthday. No matter who encouraged her, if she was insulted, NOTHING worked. I set a deadline (about 3 months, yes, seriously). And then I called in the pros. A nurse came out from a hospital affilated home care agency. She struck up a conversation with mom. Mom, normally a meddling little you know what, took leave, and went about her business "dusting" downstairs in our split level while the nurse and I chatted. Based on her observations of mom's physical abilities she said, "You know what I'd do?" What? Nothing. "WHAT???!!!" Nothing. They had seen many people go a long time without a bath or shower. How long??? Could be year, years. THe premise is /was, why unnecessarily get them upset and bent out of shape etc. She asked me if I knew how typically old people died. So here I am in the business, and I am sort of clueless...what is she getting at? Falls. I liked this person, but it was still a little weird...I mean, I don't wish for my mom to have a fall and die, or to have a fall and wind up in rehab, or for that to be the way she succumbs to at-home help and bathing assistance. I mean, taken to an extreme as I consider it now, it was almost like, for the best outcome, go push mama down the steps and then we'll get weekly bathing....

But I was oddly relieved, and felt less guilt, at the time, this info coming from a pro. Then we had a follow up with the neurologist, a guy I am very fond of...but his staff had no miracle answers and neither did he. Some redirection to the local Alzheimer's Assn, which I haven't done feeling I know everything that could be said. But the neurologist made an important point. That he felt what that nurse had said was ageist. As he said, come on...if she were in her 50's or 60's do you think they would have said just do nothing?

Now Dad thinks she actually did take a shower in the past couple months...and he's in that bathroom so he would know better than I...

ANd she is not particularly smelly either. We have to wonder if somewhere in the demented mind she is embarrassed about not knowing how to work the shower...or is she sponge bathing herself?

The issue haunts me and I have yet to pursue it...I feel like I need a day to deal with this issue alone, and working and taking care of the other details of their lives seems to take precedent when one knows the hassles and arguments this will create.

I have come close to considering a private hire...the expense is high with minimum hours. I think it is good she gets out once every couple weeks (in addition to meals out with my dad) to get her hair done/washed. Those that seem more reputable for personal care, do not necessarily do housecleaning, which I could use a little help with. And then, knowing how she is, I just see the money going down the drain because she will still reject the person.

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shad250 Jul 2018
Underarms and privates, maybe all she needs

GAinPA Jul 2018
cwillie made an excellent point about keeping the room warm. During the winter months, I make sure the powder room where we do her daily routine is kept extra warm. On the weekend shower run, I turn the heat up in the bathroom, make sure she dries off IN the shower before stepping out, and use dryer warmed towels (stuffed into an insulated bag) to make the process more comfortable for the both of us.

cwillie Jul 2018
I think you should try for a weekly bath/shower. As GAinPA says you can just sponge bath through the week, a good wash and rinse is so good for the skin, especially skin folds and sweaty places. For what it's worth I never thought my mom smelled of BO either and she didn't need deodorant, but she was incontinent and that area needed to be kept clean separate from her shower times.

Some people have better luck getting their loved ones into the bath/shower by hiring a bath aide. You might also look into why she resists getting clean, be sure to provide sturdy grab bars and a shower chair, and keep the room warm.

GAinPA Jul 2018
Have you tried a daily routine (performed while on the toilet) of face, neck, armpits, under the breasts, belly fold (if she has one), and feet? (I include a daily warm sitz bath for the nether regions.)

Caregiverology Jul 2018
Although I don't agree with how your husband is handling the situation, I do agree that your mother in law should bathe more often. Hygiene is important not just for odor, but for overall health and well being. Three weeks without bathing is way too long. I'm not even suggesting every day but certainly more often than every few weeks.

I personally am not aware of a medical condition that causes people to not have an odor. However, some people do have a more pleasant natural scent than others. It may also simply be that you are used to the smell. Either way, that isn't really the point I want to get across.

I hope I'm not sounding too pushy, but I want to stress how important bathing and hygiene in general really are. Not just for the people around your mother in law, but especially for her. Best of luck.

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