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My young adult daughters and I live with and help to support my sister. Between the 3 of us, we are her main caregivers and juggle our schedules to make sure she is always covered. Hygiene is becoming an issue, and my main concern right now is to protect ourselves from her very dirty hands touching things, especially in the kitchen. She is older than me by 12 years and a retired nurse, so (in her mind) she knows way more than me and her hands are always just washed. The truth is that she smokes, she masturbates in her room at night (we can hear her) and she has toileting issues - and I know she never washes her hands except when she does manage a shower. She refuses all help. But I'm only asking about the handwashing right now. I've tried everything except force, and I know that won't work. Even if I'm washing my hands and I suggest she do the same before she eats, she is very put out and the most she will do is run her hands under the water and wipe them on the towel I leave out for her coffee spills. We use paper towels in the kitchen and bath to cut down on spreading germs. I am afraid her lack of hygiene will make us sick. Any ideas?

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How about appealing to her nurses training? Mention that you've just read an article that most people don't wash their hands thoroughly enough (and you can certainly find such articles easily enough) and ask her to demonstrate to you and your daughters how it should really be done? Maybe that would nudge her into at least thinking about the hygiene facts she certainly knows.
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Yikes! What a difficult situation.

Could you have some new rules that apply to everyone? Maybe something you "read on the Internet" or "heard on the news" about a new approach to reduce the spread of germs? For example, everyone has to clean their hands before entering the kitchen, even if they have just washed them in the bathroom or just finished a shower, etc. No exceptions. And you put a big pump bottle of hand sanitizer just outside the kitchen door. Explain privately to your daughters why you are doing this and I'll bet they'll cooperate. This isn't as good as thorough washing with soap and water, but I hope it is better than nothing.

Could you buy some "lovely, expensive, imported hand soap" that is just for her use, and a nice coordinating lotion to use after she's washed her hands? This would be because she has always had such a lovely complexion and you want her to keep her nice hands the rest of her life (not, of course, that she needs to work on her hygiene.)

Could you just have been diagnosed with an auto-immune problem and a low resistance to germs, so you all have to go on a crazy super-hygiene routine right now? Would she perhaps be more willing to cooperate with such an effort for someone else's sake, and if it were presented as generally excessive but needed in this case?

I really don't know. I know that hand-washing is almost always an issue in dementia, so maybe other caregivers have come up with better approaches. I hope they'll share!
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