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She says she just "washes" up and that is good enough. She is 87 and lives with us. Sometimes she does get confused..has cataracts (legally blind) and is terribly hard of hearing. She refuses to have a cataract operation which would improve her eyesight and does not want a hearing aid. I was able to get her to a doctor only one time since she has been here and she refused all tests. She just continues to say she is fine. Even though she does not smell...I know she needs to get in the shower and scrub up. I told her it would probably make her aching back feel better. Any ideas on how to get her in there? Thank you.

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Mindy, When I started looking out for my mother-in-law after my father-in-law died, my sister-in-law and I were horrified to find out she also NEVER took a shower. She just did the P.T.A. method (pits, tits, a#*) but she also didn't stink, so that was a plus right? Well it turned out the reason she wouldn't get in the tub to shower, was that she was afraid of falling. She has really poor vision due to macular degeneration and she was in the beginning of dementia we found out too. So my husband (her #3 son) and our son removed the shower door, got a shower wand instead of the shower head, and we got a shower bench that would go over the tub. So she could slide from the toilet into the shower easily. She had a hissy fit at first saying she wasn't gonna even try it, but I had her do a couple dry runs while she was fully clothed, and she caught on. After that it was piece of cake. She told me later how much she loved having that warm water all over her body. What a shame she went all those years with only the PTA.
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I'm wondering if your aunt's refusal to take diagnostic tests arises from her disorientation due to the blindness and hearing loss. That may also be the reason she won't shower; without those two primary senses gone, her balance, equilibrium and sense of where she is in relation to her surroundings would be severely compromised.

I think Nancy's idea is excellent, if your aunt would agree.

There also comes a time when caregivers have a right to be insistent that someone for whom they're caring cooperates so that the best care can be administered under the circumstances.

This goes beyond the issue of bathing and extends to medical treatment and tests themselves. Is she someone who grew up in a rural area, or farm, where the family used home treatments and didn't interact much with the professional medical establishment?

I think I would try the "dry run" shower procedure that Nancy suggested, but if your aunt becomes resistant and/or aggressive, let it go. Then wait until some time when she's in a good mood, talk over the situation, explain your concern for the health of her skin (which isn't being helped at all by lack of thorough cleaning), and if you're comfortable with this approach ease into the fact that you want to provide her with the best care possible but can't do so unless she agrees and cooperates. Don't give her the opportunity to say she's fine and doesn't need all that medical stuff, which I suspect would be her response.

Drop the issue, leave the room, and move on to some other activity and let her think about what you said.

Good luck; these situations can be so difficult.
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Mindy2014, by chance could your Aunt have a fear of closed up spaces, like being a shower stall?

I was so surprised when I, myself, developed claustrophobia regarding the shower.... never had such a problem before but in the past couple of years I was dealing with my own serious illnesses which could have triggered it. Thus, I was thinking your Aunt's progressive loss of hearing and eye sight could do the same thing.

If that might be one of the root cause for your Aunt not showering, what I found for myself was to leave the shower door opened a bit, that had really helped me.

If you aren't already using one, buy a Rubber Maid shower mat to put down, that helps giving one's feet a more secure feel. As one gets older, falling in the shower/tub is always a fear.
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Mindy, how would she feel about soaking in a tub to relieve her back pain? Would that be a theoretical possibility (i.e. have you got one, would it be possible to assist her into it, are there grab rails etc. etc.)?

How does she manage washing her hair? Is that done at the hairdressers'?

Tread carefully. She's gone two years without a shower (crikey! - really??), and that does kind of make her point that there is 'need' and there is 'need.' She could say with some justification that clearly showering is not essential.

I think the thing to work on is getting her to remember how pleasurable bathing and showering are, and at the same time try to identify what factors are bothering her. It could be fear of falling, it could be just too much like hard work, it could be anxieties about people - i.e. you - having to be called on for help if she gets stuck… or it could be that she prefers not to think about it too much and has just generally gone off the whole process.

Meanwhile if she's not smelly she must be washing thoroughly, so that's something. No rush, just see what you can do to change her mind. Good luck!
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Thank you all for your suggestions. She is a very stubborn lady. She has been divorced for several years, has no children, was VP of her company in a metropolitan area. She has NEVER gone to doctors, had no friends, no church family ... And played to the beat of her own drum i.e., completely her own way and independent. She spends her days sitting and staring ...sometimes trying to work a crossword puzzle but mostly just sitting. Does not watch tv or read. She does not complain .... Just doesn't say much of snything. She used to be an avid scrabble player and we still play; however, she has difficulty seeing the tiles and can no longer count the score. I know her quality of life would improve so much if she would just get her cataracts taken out. We had her scheduled for the surgery and then she wouldn't go....she assured me it wasn't that she was afraid...just that she didn't want to do it yet....maybe later is what she said. Like you all have said....this is a difficult! Thank you.
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In the meantime, perhaps you could get books on tape for low vision people and at least try to stimulate her mind. Anyone who's been in business for herself must have a certain level of drive and independence and I would think be very frustrated now that she no longer has those qualities.

Do you ever discuss business issues, especially those related to the business she ran? And BTW, what kind of a business was it?

If she can be motivated by her previous business drive and see a life for herself given her limitations, perhaps she'll begin to take a different approach to adapting to her current life.
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Oo Mindy, that doesn't sound good. Maybe research ideas on how to get her to do less giving up, and more 'raging against the dying of the light'? She sounds mega-depressed. For lots of sound quality-of-life related reasons, of course, but all the same...
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Tell her that she can no longer live with you if she is not bathed daily
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Cataract. Surgery would improve your aunt's quality of life. I had my left eye done and it was easy. It didn't hurt at all, and I felt sheepish for dreading it so much. If she could be talked into having the procedure, it only takes a few minutes and it's well worth it.
Years ago, it was much more involved, and it was done as in-patient surgery, with the patient lying flat on their back for two days afterward, their head held immobile with sandbags. Maybe your aunt thinks it's still like that.
If she could see better, the shower might not be so intimidating to her.
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Sodonewithsal1, good to know that cataract surgery is easy.... I am going down that path of getting cataracts, not even close to needing surgery, but I always been scare silly about anything that has to do with my eyes.

Glad to know I am not the only one dreading it when the time comes. Always afraid of the outcome, will everything make me feel dizzy, silly stuff like that.
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Do you have a walk in shower? Try outfitting the shower with hand held sprayer and a shower chair with a towel on it for secure feeling. Buy a Beth sheet so she can be fully covered and get in. Maybe she will allow you to assist her in that you can discreetly hand help her step in, hand her the sprayer, provide a small tote with soap, cloth, or bath gel to help her manage on her own. Then prompt her, by gently taking her hand with cloth (better yet a bath mitt which is easier for them to control) and say, here, let's wash your neck, and let her feel her neck, then move her hand to each arm, thighs, legs, etc, maybe a long brush for her back and feet. Consider putting a towel down for her to rest her feet on in the shower as this provides more secure feeling.

Then have a warm flannel sheet to wrap her up in.

If she still refuses, maybe consult with physical therapist for some suggestions.

It's tough when they won't bath, but most are afraid of slipping or no longer like water splashing in their face.

Good luck.
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