Bathing mid + Alzheimer's patient?

Are you sure she is still at mid-stage Alzheirmer's? Perhaps it is time for her family to have her evaluated by a competent neurologist to see if her disease has progressed beyond moderate Alzheimer's. She is exhibiting many signs of a more advanced stage-IMP.
This sounds like a dangerous situation for you on at least two fronts. First your client is becoming more aggressive. This puts you at risk of being hurt physically. Then there is the risk of you being blamed for her lack of cooperation. In all likelihood, she will become more aggressive, placing you in greater physical danger.
The second risk is the possibility of the family terminating you without paying and with a good recommendation. In the age of online message boards and rating systems, such as yelp., the family could leave a negative message about you and the firm you work for. If they are truly unhappy, then they might stop paying your agency for your time spent.
If you are not keeping a paper trail of the client's behaviors and the family's feedback, then you should starting a notebook with the date and time of the behaviors, such as the ones described. You need to CYA with this family
If your agency has an attorney on retainer, then the owner should consult with the law firm as a way of protecting itself.
I would also make sure that you are being paid in a timely manner. If the family is not paying promptly, then that could be a warning sign of their displeasure with your care.
If I were you, I would start looking for a new assignment/client ASAP. IMO, you might be in a no win situation.
If you want to revisit, the bathing situation, then the best advice on bathing is found in "Surving Alzheimer's, practical tips and soul-saving wisedom for caregivers." The author is Paula Scott Spenser. The book offers the best advice on bathing that I have seen. If you don't have access to the book, then reply with your email address and I will reply with a pdf on bathing.
Perhaps your agency should buy a copy of this book for the family. It sounds like they need help in order to grasp the stage of her illness.
You can't change the client's behavior. But you can change your own by finding a new client or assignment.
You are in a difficult position, where the possibility of the situation getting worse is highly likely. Do be careful and take care of yourself first. I am concerned for you, as I have been in the same spot as you are in now.

WOW poor you. and having the 'family' say you are scared? What the bleep?
They should be supporting you and listening to your concerns.
Have THEY ever tried to bathe her? let them comment when THEY do. sheeesh.

So in my experience. my mother-in-law was the same way.
So, instead. I would say 'listen. you want to smell like a lost cat?"
Sounds harsh but she listened. then I would say ''you know. being bitter wont get us anywhere. you need to clean-up. we need to work together here. you can fight me for an hour OR have a fresh shower for 10 minutes and feel, smell a lot better"

If this bathing is being done at home, you may want to consider suggesting to the family to take a notch and place this person into a home where they can be around trained professionals who actually specialize in Alzheimer's patients and their tendencies. Other posters are right about you being in physical danger since this person is physically aggressive. That's why nursing homes are so full of these kinds of patients. In fact, there are special wings with in the nursing home just for these patients along with specific types of professionals who know how to handle all stages of Alzheimer's. You really don't want to face serious physical harm should this person decide to go all out on you because this can actually happen. I don't think that every attack is the last because it's not, and it will only worsen if you don't place this person into a proper facility where they can get the help they need by specific types of professionals who can actually handle this in a manner for which they are specifically trained. Remember that these professionals must undergo constant updates to their training so that they stay abreast on everything regarding memory care patients.

This does not sound like a person with mid-stage dementia. Leave her alone. Don't fight with her. Give her a wash cloth and let her sponge bath. Why are family members so intent on their loved one being clean? I know urine (the ammonia) smells, so just spray the area or let her do it. She has a terminal illness. What matters if she dies clean or smells? Come on people...Leave her alone.

I've read enough to know that resistance to baths/showers is standard. Mom has always resisted, but the first time she really got nasty about it kinda freaked me out until I was reassured of this commonality - and that the bathing frequency doesn't need to be what it once was, or is for most healthy folks. I only fight that battle with her once a week now.

Granted, I am able to change her Depends regularly (though she also thinks they're always fine and don't need changing) and stay fairly vigilant with toileting clean up in between. There are always wash cloths for intermittent clean ups, too.

Others have given good broader advice here, but maybe at the very least, the shower frequency could be reconsidered.

Hang in there, and bless you for all you do!

You can always try at another time. When she has settled down when she is not so upset.. Just talk to her to try an calm her down. It is not a easy road, they can get pretty mean. Good Luck..................

Sorry, I'm very sensitive to smells. I could not stand the smell of body oder, urine and all else. Mom gets bathed 3x a week sponge on off day. I can't imagine not bathing at all. The family has to realize the laws. You as a caregiver cannot force a person to do what they don't want to. If she is combative maybe time for a nursing facility.

This sounds so much like my Mom. She won't let anyone help her clean herself. She hasn't taken a shower now, in over two years. She simply uses a washcloth every morning. I have often wondered, if the powers that be, would say I'm abusing her because she is not keeping clean. She also insists on wearing her depends for more than one day. " They're fine, I don't need to change them", is her usual reply. When she does, they are usually soaked. I would never criticize a caregiver who was trying to help. I know how difficult it is, as I am the only caregiver around here!

ADCaregivers. I would like the article on bathing.

Both of the people I dealt with also had hygiene issues. The one on the passport program was very grateful for the help he got from our local passport program. He was taken to the bath 1-3 times weekly when the eggs aides were able to do it. The other person didn't have that kind of help and he never never bathed. There was an upstairs neighbor who told me she could smell him all the way upstairs. I told her there's nothing I can do about it because I can't force him to bathe if he doesn't want to. I can't just physically force someone into the shower no matter how bad they smell. I'm just glad the person was eventually put into a nursing home and cleaned up. I think that being dirty probably has a negative bearing on a person's mood. Think of how bad and cranky when he fail on a hot summer day after sweating, especially after that sweat dries. Things get a little sticky after a while if you don't take a bath to wash it off, and you can actually become pretty cranky. Isn't it funny how we always feel better after cleaning up? One good way to encourage someone to clean up is to remind them of how much better they'll feel afterward.

Goodness gracious, the things we have to put up with; some live forever in a demented state and others depart young when their lives are just getting settled...the unfairness of it all makes me sick! Please Higher Power take me in my sleep before I get to this poinT!

It amazed me that suddenly the frail elder gets the strength of Sampson! My mother almost broke her own eye glasses when I gently tried to take them from her.

Blesson, it seems you really have no choice here, let her sponge-bath as others have suggested or ask the 'family' to help, after all they are the ones badgering you. Let them try to bath her when she is resistant and they will fail....again this is not your fault. People with dementia can be very strong and physical when they want to be...and for some reason they do not want to bath or shower; but sometimes you can convince them to take a sponge bath. If you were to 'force' her to bathe she may be injured and then all h*ll would break loose...how you injured their mom, you're incompetent etc...definitely not worth the risk...Maybe her family should do so in-depth reading on Alzheimer's and the stages that most go through. Just a thought, my blessings to you! Lindaz

Mom has dementia & was on hospice two years ago. Hospice used a great No Rinse wash that I use on the days she doesn't shower. Works really well and neutralizes odor.
God bless you all.

My Mom has a caregiver for 4 hours every morning, Monday through Friday, and Mom will not take a bath for her. We make sure the bath is ready and then I have to lead her by the hand and convince her of how good that warm water is going to feel and how great she will smell and how beautiful she will be. Then I say "lets take off your shoes and socks cuz there's nothing worse than stinky feet. Now turn your back to me and put your arms up...lets get that shirt off you (undo the bra). Now wrap this towel around you to stay warm (really for modesty while I take off her pants and diaper). She says "I have to take off that too" and I say "yes, you don't want your clothes to get wet, right?" Then I say "ok lets get you in that warm water...It's going to feel sooo good". Once she's actually in the tub, she will let the caretaker bathe her. If I'm not around and Mom doesn't mind the caretaker then I just say "OK". I would never fault the caretaker because she can't MAKE Mom do something she doesn't want to do. I would definitely talk to the family and let them know whats going on and ask for their help or suggestions so they understand that you are doing your best.

When Mom fights me on taking off her depends, I always remind her of how important it is so she doesn't get a UTI. I say " you don't want to get a Urinary tract infection, right? Then we have to go to the Doctor and we hate going to the Doctor and then we gotta take antibiotics and we hate doing that too, right?" Once she's agreed with everything I say then I say " ok then, lets get these off of you and make sure you're clean cuz that's what all responsible adults do", Everyone is different and the fact that you're not a family member makes it harder to know what psychology works for your patient. This works for me for it is tedious to go through all day everyday.

Sorry, this is the third time I've answered this but I keep thinking of new things. One day my caretaker actually got in in the tub without my help. She told me that she bribed my mom with Ice Cream. Mom loves ice cream so caretaker asked her if she wanted Ice cream and Mom eagerly said yes, then the caretaker said ok lets get this bath over with so we can go get your ice cream and Mom complied. I had to laugh. Its like dealing with a little kid.

Of course they're going to fight! Who wants to wear a d#mn diaper? None of us, but we may all get to that point!

I must agree that no one wants to wear a diaper, and I hope that not everyone gets to that point. I know that some probably will but hopefully not everyone will. I've known people well up in years who did not wear them, and they were doing rather well for their ages. In fact, one person who was like a grandpa to me actually ran his own farm and even drove well into his old age until he said his kids would no longer let him drive. Some point, someone got him a hospital bed. It seems like after he started slowing down that he probably declined because I hadn't seen him in quite a while. At some point looked him up on the internet only to find that he died years prior. He was one of the very few World War II veterans left. Last time I ever saw him, he was not wearing diapers.

Blesson, this is well past mid-dementia. The patient needs better medication and you deserve some protection from harm. .