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My mom has not bathed for over a month. She was born during the war and all her life she has been very conservative with her water usage but this is ridiculous. I say "why don't you go and have a bath and you'll feel fresher". We live in South Africa and are in our summer now so it's a bit humid at the moment. She says she'll do it in the morning. She doesn't smell dirty but I'm a bit worried that she'll pick up an infection. Although she has dementia, she still has the ability to look after her hygiene. I don't know if she doesn't realize how long it is since she last bathed but to actually get her to do it causes huge fights. Any suggestions on how I can convince her to bathe without there being an unpleasant exchange?

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Isthisrealyreal gave good suggestions to you.

You stated,

"Although she has dementia, she still has the ability to look after her hygiene. I don't know if she doesn't realize how long it is since she last bathed but to actually get her to do it causes huge fights."

The new, realistic way to think about it is that she no longer has the ability to look after or care about her hygiene. Dementia is a progressive disease, so now she's permanently lost her ability to do this for herself (remember to bath). She may still have the ability to wash herself but now you may need to use "therapeutic fibs" to coax her into bathing, like "We're expecting visitors this afternoon, so we need to freshen up" or whatever you think would work. Appealing to fears about infections and such will probably not work since that's too complex a thought for her to process.

How many times a week bathing was normal for her? Whatever it was, it may need to be fewer now. Also consider giving her sponge baths in between times.

Is her shower senior safe? Is there a shower chair in it? Is it sufficiently lit? Does she remember how to adjust the water temp? These are all things you can no longer assume about her abilities. Sometimes elders develop a fear or dislike of having water pour over their heads or face. Sometimes having a different person to help bath her works better. We hired a neighbor who is a retired NH employee to give my elderly aunt a shower 2x per week. We started with 1x, then moved to 2x and I don't think it'll ever go to 3 because she doesn't need it. For whatever reason she doesn't put up a fight with Shirley.

I wish you success in solving this challenge du jour!
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Try and make the experience a positive one for her. I make shower time a concert and put on her favourite music. This way she associates her favourite music with shower time. I may also talk about it being a pamper session and do her hair after. The other thing is that I know you say it’s humid but when my mum is showering there’s a portable heater and heating lamps on despite that it might be 25 degrees warm that day. For me it’s suffocatingly hot but for her it’s ideal. I’ve figured the water temp and room temp can’t have much variation or she’ll Yelp that it’s icy or boiling! Last thing,.. compromise. If I know there’s no chance of Mum having full shower I convince her to rinse her bottom half with the hand held shower. I bring it up while she’s changing her pants so that she’s already undressed. Mum gets lots of UTI’s as her bladder doesn’t empty properly so I try reason how it’s doctors orders to rinse below and it’ll feel so fresh after!
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The one thing I learned is not to ask her. If I ask she will fight me. I tell her it is time to shower. With Dimensia Mom has no concept of time, hours, days weeks. But for some reason when I say it is time she cooperates a bit more. If she still gives me a hard time I tell her if she doesn’t let me help her wash they will send in the big male aid, so let’s just get it done before that happens. There is no big male Aid, but saying that gives her a sense of urgency and makes her feel I am her helper rather than forcing her to shower. When she is finished I sit her on the toilet and hand her towels to help her dry herself. I hope this helps you.
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GAinPA Nov 2021
I like the approach of not asking. Better a “let’s get this done approach”.
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Your mother no longer has the ability to look after her hygiene; dementia has robbed her of that ability, as it does all the rest of the poor souls who suffer from it. You'll have to bathe her yourself or hire an aide to come in to do it once a week b/c the elders often argue less with a stranger than they do with a daughter! Watch Teepa Snow videos on how best to bathe an elder with dementia:

https://www.google.com/search?q=teepa+snow+hand+over+hand+bathing&rlz=1C1CHBD_enUS896US896&oq=&sourceid=chrome&ie=UTF-8

Up above is a Google link to those videos along with other good articles on the subject. Teepa Snow has invented a 'hand over hand' bathing technique which soothes elders suffering with dementia & seems to help lots with the issue.

Tell mom she'll need to have a bath once a week *or twice a week which is plenty at this stage of life* and that you will help her with it. The X through the calendar is a good idea, but you can still expect push-back b/c elders with dementia don't like to bathe, period. If you can make the experience pleasant for her, that would be great. Figure out if she has fears and address them, first and foremost. My mother was afraid of falling, so water shoes eliminated that worry for her.

Good luck!
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WifeOfMike Nov 2021
This doesn't always work. My MIL hasn't had a proper bath/shower since Dad died last July. She uses a washcloth and feels that's sufficient. We hired a nursing service to attend to her needs and she won't let them either. I've offered to assist her so that it's someone familiar and nope... no go. Thanksgiving week, we're moving her to an assisted living facility. This has been a struggle for the past year and my husband and two of his siblings are doing this, whether she likes it or not. It's going to be hell week for Thanksgiving... :(
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I am not on the the 'leave her be' side.

What jumps out at me is *Dementia & *not bathed for a month.

Even if physically able, other issues sometimes prevent tasks, especially personal care tasks from being done independently.

Some folk forget how to start - if you start them off they can do it. Some forget the steps (sequencing) & need verbal prompts to do it. Many, as suggested, become fearful. Vision & sensory changes mean they can't see the water, or it hurts etc.

CarylorJean, I would suggest playing detective & work out the problem if you can.

Could try the Ask-Say-Do approach. ASK her, if no action, SAY how to get started, if nothing, try later with DO. Don't discuss, just take her hand & lead her into the bathroom & start the process. See if she is willing..? but stop if she resists.

Once you know HOW much help she needs, then you can plan. Is this going to be a task you help her with, say 3x week? Or is getting a local care assistant affordable?

There is no need to explain to Mom she needs help (it is a step for you to accept though) but if you are her full-time caregiver, it is up to you take the necessary action.

(My Mother detested me helping her bathe but got used to & seems to like the aides that help her now).
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My first thought is that, while you perceive she is independent, I am afraid that your mom no longer has the ability to look after her own hygene without support. Coming to that awareness will help you in the long run.

Now that we acknowledge she isn't independent, we can strategies what works for her.

First, ensure you are working with her geriatric physician to assess her overall skill with activities of daily living (ADL), and are giving proper supplemental vitamins and/or TX medications to address the cognitive decline.

Second, be sure the shower is still safe for her. If she has to step over the side of the tub to get in, she needs help in and out of the tub. She might need a shower chair and a moveable spray nozzle that she can control. An inhome assessment might be useful for you to see how your mom is doing with all of her ADLs

A few simple strategies to try might include:
Ideally, you help her keep a calendar. Put bathing, shampooing hair, laundry, etc, on her calendar.

Schedule a weekly event for her to dress (and shower for) that may be Church, a salon appointment, a lunch out. Gentle reminders to bathe before these events might help.

I use Alexa to set routines for my mom and find she will respond to what the Alexa says to do easier than me nagging her.

Finally, if it is an issue for you to assist your mom, hire someone to come in to ensure she is clean. Skin can breakdown very quickly in the elderly and if she is not showering she might not be seeing cuts or ulcers that can become dangerous.
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Perhaps a calendar with bath days on it, then put a green x through the day after the bath is finished.

Do a search on this forum for bath issues. It is a common problem with dementia and there are lots of good ideas about getting baths done.
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CarylorJean: Imho, hire an aide whose sole purpose it is to bathe your mom simply because she won't do it on your direction. Come up with a ruse as to how to get this aide into the residence.
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Bribe her by offering ice cream or some treat if she bathes or showers.
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My MIL hasn’t showered or bathed in over a year. She moved in with us at the beginning of August and at first we asked the PSW’s to push, but it quickly ended in screaming from her, and getting all worked up. We knew without a doubt that we were beating a brick wall.

I’m having a behavioral specialist PSW come in next week. Do I think she’ll be able to wave her magic wand and make my MIL cooperate? Hells bells, no. But I’ll keep an open mind and try whatever she tells me to. If I hear anything worthwhile, I’ll pass it onto you.
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