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My mom has dementia and is in the nursing home after living with me and my husband in our home for 7 years. We always had to argue with her to get her to bathe and were only successful with getting her in the tub twice a week after a lot of arguing with her. In her mind, each time she changed clothes, she thought she had already bathed (or so she argued). Now in the nursing home, they have her scheduled to bathe 3 times a week and the staff tries really hard to get her to comply and shower. They have no other problem with her--just the bath. I don't know what to do. I've gone up a few times and insisted that she shower and have taken her clothes off and put her in the shower by lifting her in myself and showering her. What can we do to change this battle and get her to shower?

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I'm honestly a little surprised that the staff is having trouble getting her to do this. They should be pretty experienced with this. Hopefully it's not because they are short of help or not trained well enough. I'd talk to the admins and ask their help to "brainstorm" a solution -- this is a diplomatic way of moving the complaint up the ladder. Ask then how they've solved this type of issue in the past with other residents.
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I agree the staff should know how to handle this.

First thing...ask them if they ask her if she wants a shower and the answer is no. If so ask that they don't ask, they tell her "Mrs Jones, time to get a shower" maybe not even that, just walk her to the shower and guide her in.

Second...my daughter, RN, worked in NHs for 20 yrs. She says you allow them to think they made the decision. "Mrs Jones would you feel so much better all clean and fresh clothes on?" She says they may agree and allow u to shower them.

In NHs by law they cannot force a resident to do anything they don't want to. With the shortage of CNAs, I would say when they get no for an answer, they move onto the next resident.
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Missymiss Jan 2023
Yes, I was told at my mom's MC that the patient has right of refusal. Three "no" replies and they move on. I'm having this same issue.
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I was a son taking of his mom. No showers.

Every morning, I gave her a warm soapy wash cloth so she could wash her face and arms. Every other day, I helped her change her bra, and washed her back, neck and assisted in washing her breasts. She was incontinent, so at least three times a day, I cleaned her rear end, put Calmoseptine cream on to prevent pressure ulcers, and made sure she had new pull ups. Once a week I soaked her feet and powdered them, cleaned her legs, and put lotion on. Clean pads and sheets on her bed daily. Once a month we went to her hairdresser for some special pampering. Our routine worked and she was clean. She died in January 2022 at age 93.

Drop the shower mandate and discuss with staff a different approach to keeping her clean. If you can, make unannounced visits to monitor the situation. Believe me, staff will pay attention if they know you are on top of things. My mom got a pressure ulcer when she was in nursing home rehab for hip surgery, and boy, did I explode. I vowed she would never get one under my watch. She never did. I wish you all the best.
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My mom rarely got a shower and no one could reason with her because there is NO reasoning. I bought adult size wipes with no rinse soap and she washed up each morning while sitting on the toilet. Believe it or not her skin stayed healthy and she was always prone before to rashes and yeast. She permitted her hair to be washed in the sink & we used dry shampoo often. Use powder on skin flaps and do the best you can.
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I think that forcing someone to shower is unnecessary. Yes, a nice warm shower or bath is ideal but there are other ways to stay clean. My husband had ALS which totally paralyzed him and we did not have a bathroom large enough to accommodate a shower chair or a walk in shower to put it in. So you improvise. I would first make sure the bathroom was nice and warm, he would sit on his commode chair, I would soap up a wash cloth with warm water and wash down his body. Then use a separate wet wash cloth to get the soap off. When it was impossible for him to sit up for that long I would use the pre-moistened cloths and just hit the important areas.
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KathleenQ Jan 2023
God bless you,
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What are the regulations in the State where she lives?
I was surprised that in Illinois the regulation is 2 times a week. So if they are trying 3 times a week but succeeding 2 times that is great.
A Bed Bath can be just as effective as a full shower or bath.
As long as she is cleaned properly after toileting I see no need to worry or insist about showering 3 times a week.
Showering or bath can make the skin drier. It removes oils that are necessary. This can make skin itchy and if she begins to scratch that can be a never ending cycle itself.
I am surprised though that they have a problem. Typically the CNA's or CNA assists are real good at getting people that are non compliant to shower. That said they can not "force" and to do so could be more traumatic and make showering again later more of a problem.
My suggestion...
Let the staff do their job, let them handle the situation.
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Hi there,

Does she really need to have a bath? The poor soul doesn't like to bathed. Why not give her a good overall wash if this is more acceptable to her?

My husband has dementia and he won't go near water but he has a really good wash every day.
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Hello Solace,

Sorry to hear you're facing this problem.

I agree with Greton777, I would have expected the nursing home to have experience with such matters.

Maybe they've tried various things and nothing has worked?

Some video's talk about pretending the experience to be a spa treatment and encouragement by suggesting a nice lunch or dinner afterwards or a hair styling.

They also suggest to be flexible in the time, i.e. if loved one say no in the morning, suggest bathing in the afternoon.

Maybe a sponge bath and then slowly progress to the shower. I don't know if this will work, but it might be small steps for encouragement.

Solace, I really do hope your issue with your mom showering/bathing is resolved soon, with the help of the nursing home.

Love & Peace.
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It's not strictly necessary for a person to shower or take a tub bath. Ideally they should, but it's not always possible. A daily bed bath can be just as effective.
I've worked for care clients who were bedbound or whose homes were not equipped for them to be able to use the shower or take a bath. So we did daily bed baths. Maybe your mother would be more responsive to getting 'washed-up' in the bathroom instead of showering.
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The facility should have skilled caregivers adept at this. Speak with the administration. It is not unusual for this to occur. With some dementia the depth of vision changes as well as body sensitivity to touch such as water....it can actually hurt.... and, hence the anxiety about bathing increases...
Perhaps a compromise could be reached 2 showers / baths a week and then sponge/ bed baths. Or even one shower a week and maybe two bed baths.
Check with her PCP for recommendations.
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