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It's been over 6 mo and still hasn't showered. She says "I'm not running marathons so I don't need to. Sponge baths are good enough," then storms off in a tizzy. Her Dementia isn't severe (not typical of mid/late stage but short term memory is getting bad, under 2 hrs) but she does need it since she will NOT allow me to do anything; like washing her legs or hair. She isn't incontinent and doesn't have accidents but there is a slight odor, partly due to hair not being washed I'm assuming. I need to take her shopping for clothes and underwear but I'm afraid that I'm too used to the smell, you know, like a farmer that is used to a barn smell and she won't be allowed to try on the clothes. Actually, what I'm more afraid of is that someone will call Senior Svcs saying I'm not taking care of her and her Neuro (He gave me his POA as long as I'm living with her and that I'm properly taking care of her) or he will send her to a nursing home. Her day nurse has tried and 1 of 2 things happen 1. Mom goes to bed til she leaves OR 2. She berates her and argues with her for the duration that she's here which is for 4 hours so I can get a couple hours of sleep for work. I drive a truck for 12 hrs on the midnight shift. Any ideas would be helpful since my only idea left is taking a garden hose to her when she does decide to go outside for a few min to pull some weeds. Just kidding on that but what other option is there?

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First of all, I never ask my mother to do something. Asking sets up arguments. It sets you up for a yes or no answer. There's no reasoning with her, I will lose everytime. In this case, I simply run the bath then in a cheerful tone I say, "mom, your bath water is ready for you. You need to get right in before it gets cold." When I speak I'm not looking for permission. I'm communiacting that this is what we're doing. I was pleasantly surprised how well it works.
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Does she have any physical problems that are barriers to showering?

Would she be using a shower stall or need to step over the bathtub side? I have a bad knee and even though I'm 25 years younger than your mother, stepping over the side of the bathtub is sometimes difficult because the knee is too stiff or swollen to bend well. I have a grab bar installed at shoulder height just outside the tub surround so I can maintain balance while getting that stiff knee over the side of my soaker tub.

Does she dislike getting "hit" in the face with the shower spray or needing to turn in the shower to rinse all sides of her body? My mother didn't like showers much until she experienced hand held shower heads in the rehab hospital. Once we installed one for her at home, she loved showers.

Is your mother concerned about maintaining her balance in the wet tub? Rehab hospitals recommend grab bars, shower stools or transfer chairs, and/or a towel placed in the bottom of the tub/shower. An added benefit of the shower stool is that it's easier for an aid to assist in washing your mother's hair.

By the 80s (and sometimes sooner) most adults become much more sensitive to cool temperatures. Is the bath a few degrees warmer so she doesn't feel a chill? I heat the bathroom to about 80 degrees for my mom.

Hope some of this stuff is helpful.
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This is one of the hardest parts of caring for a loved one at home. Here are the ways I solved the problem from the time she first came to live with me until the end. Firstly, let me say that mother had only one kidney and was incontinent. She would also get angry and put her fists up if I dared suggest bathing (dementia).
(1) I washed her hair in the kitchen sink and got her arms and back 'accidentally' wet. Then I just proceeded to wash whatever part of the top I could (ensuring that the room was warm, towels were ready, etc.) I had the radio playing and would talk about the song, rather that what I was doing.
(2) I tried putting her in the shower, but it was tough, so I got us a membership in a health club and took care of her in the handicapped shower. The membership was far less than $25/hour with a 4-hour minimum for an assistant or nurse.
(3) As time went on, I played a game with her whereby I pretended to be someone else whenever I helped her with anything personal. Seriously, I'd leave the room and say I'd send Mary in to help her dress, in the bathroom, etc. I'd come back in with my hair pinned up and a different sweater on. Either she played along, or she really didn't know it was me. It allowed her some dignity.
(4) I got a plastic storage box - about 4" high and about 3 feet x 2 feet (the kind with the lid), had her hold onto the towel bar, step into the box and soap her down and rinse her off with lots of small, clean towels. (I got a dozen white, absorbent cloths at Costco for about $12.)
(5) I got waterless shampoo and soap from Walgreens.
(6) I used extra-large (8x12) adult washcloths 240ct for about $10 by Simply Right that have aloe, vitamin-E and chamomile to keep skin nice.
(7) I had NorthShore.com deliver underwear (they will send you samples) that are infinitely better than what you can buy in the store!

Additional information to keep in mind: My mother's urine never smelled. I had her drink water during the day, sometimes mixed with a little cranberry juice, or a squirt of lemon. Her diet was 'clean.' When she first came to live with me, she acted really 'weird' and I suspected a UTI (dark, pungent urine), so I gave her D-Mannose and lots of water to clear it out. I also restricted sugar/bread. What a difference!! Urine should be pale yellow with little or no odor.
Secondly, people with dementia have fluctuating moods. Treat them as if they are like the weather - don't push what you have to do if they are in a cloudy or rainy mood. If all you get is 1/3 of the way though, it's ok. Do another 1/3 the next day, and the next - which is how I had to bathe my mother at the end.
Taking care of my mother was a blessing and a privilege. I did it for over five years; I wish we had had even more time living together. Once I recognized the ebb and flow of the disease, our time was infinitely more pleasant than when I barked orders like a child taking over the parental role.
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My husband is bedridden an isn’t able to get into our non-accessible shower. I wash him down every day, sometimes twice. I use baby wash because his skin is sensitive. I pay particular attention to “down there” because he is incontinent.

Poor hygiene is the #1 cause of bladder infections. And in Seniors, those can be really rough. But, I understand why Mom doesn’t want to shower. With bad shoulders and back, showering and dressing for me is a real effort. But when I don’t, even for a day, I feel dirty and itchy.

Have you told her she has an odor? Have you told her that her hair is dirty and it smells (and probably itches as well)? Have you said you’d like to go on a nice day trip and buy her clothes, maybe go to a hair salon and go out to lunch but you can’t because of her poor hygiene? If she truly doesn’t have dementia, maybe a little tough love is called for?
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First you have to know this is so common, there are lots of reasons why they don't shower. My dad forgets and thinks just washing his face and brushing teeth is enough. He can't smell himself and sometimes the odor is awful. He was showering, for a while if I said I'm not taking you out if you don't shower. But last time he "showered" he smelled just as bad so I think he just sat in the bathroom to fake me out. I have a chair and a hand held hose - I have heard having water on the head can be very disorientating for them. I make sure soap and wash cloth are readily available and set the water temp and leave it on for him. I have also heard sometimes you just have to let it go. NO ONE will think badly of you (and if they do it's ignorance) I don't think there are answers just know you are doing your best - and it's enough, do not feel guilty or bad - your Mom is lucky to have you. Be good to yourself and good luck, we are with you 100%.
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I have a great deal of sympathy for you--it's hard enough to keep a job and then have to worry about this sort of thing. Have you tried speaking to her doctor about it? During the early stages of dementia with behavior problems such as refusing hygiene care, they can prescribe some medications that may help. Since she is able to self-care bowel and bladder, you may want to consider another option: Assisted living facility. Since she wants things "her way" but only needs minor supervision. If she is on Medicaid and she deteriorates, loses the ability to self care bowel and bladder--it is very easy to put her in a nursing home. If she is not on Medicaid, start considering that option and be very careful about how her assets are spent because there is a five-year look-back law. You will need to see an eldercare attorney to get her Medicaid ready. Believe me they do deteriorate and unless you are willing to quit your job and end up cleaning her feces and urine, change her diapers, deal with the frequent butt wounds from thin skin and considerable amount of sitting-- and basically pick up dead weight -- start planning on a nursing home route. Being a home caregiver is nothing admirable, but you sacrifice your own life and live in constant misery every waking moment for years and years..all because you love your parent. I tell people don't do it. Put them in a nursing home. You get no help from the government as a caregiver. NONE. Hiring sitters (who just sit and do nothing else) costs about $20 an hour. Certified Nurses Assistants, who help with bathing and hands-on care, is about $35 to $40 an hour. And if you hire people off the street which can do it as little as $10 an hour, you don't know what you are getting and if they CLAIM to get injured in your home they can sue you. So that's why it's better to use an agency because the workers are insured and if they get injured they cannot sue your estate, but they go on workman's compensation. Welcome to the world of elder care. And if you pay the same person over a certain amount you have to do their taxes..all kinds of garbage because the government is dirty. I do everything myself and it's back breaking and full of enormous stress..but I still love my mom and I know one day she won't be around so that puts me in great deal of turmoil I don't want to ever lose her. So yes being a caregiver left me an emotional wreck and I have nightmares of her dying. I'm just being honest--do you want to end up like me? I have two brothers and get no help from them. That's the way it is.
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JoyB1618 Sep 2018
First of all, it sounds like you have tried very hard to do a good job. Being a caregiver is hard (usually) thankless work. So great job!
In some states (Iowa for sure), if you qualify for Medicaid, you then qualify for the Elderly Waiver. The EW will pay for in home caregivers, including a bath aid. And respite services in addition for you! Not 24/7help mind you, but some help (and insured through agencies). The doctor should be able to make a referral to a home health nurse for meds, skin care, etc. And a bath aid, or the nurse could do it.
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Those Hair Wash Caps are the Nuts! Our Hospice provided them for my FIL who was bedbound, and you just put them on their head (they have a no-rinse cleansing solution inside), and just rub and massage them around on their scalp, and Presto, Clean scalp and hair, and my FIL Loved the Special Attention! They definitely do in a pinch, and their hair smells clean afterwards!

Once she gets used to the feel and smell of clean hair, she may be more acceptable to washing her hair the traditional way in the future, or even over the kitchen sink! You can purchase them at the Medical Supply store, or possibly at a Beauty Supply Store, or most probably you can order them through Amazon, which has EVERYTHING!

Definitely give it a try, she wouldn't even have to leave the bed or recliner, just have a couple of towels available and one wrapped around her shoulders!
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I understand your situation. I feel your despair. Mom is stubborn and after 6 months yes the body odor is apparent to all. Perhaps her doctor could intervene with an option of personal hygiene? It may be taken care of with the aids who come,- no option available per doctors orders. Parents are perhaps more receptive with the directives being given by others....and not having the personal hygiene a family discussion as anger and resentment sets in...once a week is reasonable from head to toe....
with best wishes,
Emi
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I have had my 89 year old mother in law living with me for the past year.  She moved in on August 30, 2017. 
She, too, refuses to shower.  There is nothing physically wrong with her.  She, however, is incontinent.  She wears Depends 24/7, so you can imagine the odor she gives off. 
Whenever she is sick and needs to see the doctor, the diagnosis is always the same, a urinary infection.  I assume because of her bad hygiene.
Instead of getting in the shower to wash, she does sponge baths by the bathroom sink.  When you wear a diaper, as she does, this is not sufficient.
My oldest granddaughter dreads going near her because Nana often hugs her and poor J's head winds up in her armpit. 
In fact, in addition to refusing to shower, she is very sneaky.  I have witnessed her come out of the bathroom in fresh clothes and then take her shower chair and put it in the tub and turn on the water for about 10 seconds and then come out of the bathroom.  When I confronted her, as I was standing outside the bathroom door, she denied doing it, even though I stood a short distance away and watched it.
Before she moved in, we had a decent relationship.  I thought she was a clean, honest, nice woman.  That isn't the case.  She lies to me constantly and she is very sneaky.  And her avoidance of the shower is the icing on the cake.
I really don't like the person she is.  I don't understand how or why she lies to me all the time.
 I avoid contact with her but I still manage her medication and do her laundry and tend to any errands she needs taken care of.   My husband isn't too happy about the way I feel about her now but he spends a minimum of time with her also.  I always encourage him to spend more time with her since she is HIS mother  and not mine.
(She lives in our home but has her own small space - including her own brand new bathroom/shower in our basement.)
I don't know how to deal with her lack of maintaining her hygiene either.
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Same problems here. Mom is 90 with Alzheimers. She will never go willingly. Here’s what we do. My daughter gets the bath ready with stool, towels, soap, shampoo and warm water. I start talking to mom about the need for a bath. I put out my hands, face up, inviting her to come with me. She gets up saying “where are we going”. I till her to make her feel better and my daughter then slips in behind her. We walk together until she figures it out, then my daughter, (behind her) wraps her arms around her and walks her forward, with me in front, holding her hands and telling her there is no discussion, she will have a bath this morning. She screams, yells for help, tries to bite, and head butt us. We move her toward the bath and remove her clothes under protest. Once she is in and the warm water is flowing over her she totally relaxes and submits to the bath and shampoo. After its all over and she’s clean and smelling good, she takes a nap and doesn’t mention it again. We get this done once or twice a week as needed. She never holds a grudge and in some ways it seems to be getting a little easier. We’ve had to do it this way for about a year.
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