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I'm the youngest daughter in my family, staying with my 86-year old father due to cognitive short term memory loss and brain damage. We have three caregivers that alternate shifts from a caregiver agency while I'm at work, and then I'm with him the rest of the time unless I get relief from siblings.

When I remind my dad to shower or brush his teeth on weekends and holidays, I'm met with rude behavior including cursing and statements such as "you're my daughter, you don't tell me what to do!!" "You're the baby, you better show me some respect!" (These are super nice statements...he gets really mean). Some weekends, I just let him stay in the same clothes from Friday to Monday because he gets so explosive. Tonight, it was the same thing. I asked him to take his partial out to brush his teeth. I reminded him that it's been four days since he showered, he needed to shower and brush his teeth.

This weekend he has been spitting food particles from his mouth. I suggested he use the Water Pic to get rid of the food lodged in his teeth. It's always the same response, negative and mean. Always saying that I'm controlling his life, disrespectful, and other derogatory things. I feel sometimes like I just want to go home to my husband (which has been so patient and understanding during this ordeal of my being away). My father can't take care of himself though. I have tried to get him into a AL, but he fought me on the subject. I need some advice please. How do I communicate with this man so he understands that he needs to keep up good hygiene? If you have ideas on how to get him to go to the AL, that would be appreciated too.

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MBuckley,
My heart goes out to you. We all struggle in our own ways to help our fathers, mothers, etc. Caregiving is the hardest job I've ever had, yet the most rewarding. I've learned so much in the last 18 months as the primary 24/7 caregiver for my dad. Today, my driving 'mantra' to myself goes something like this. #1 - As hard as this is for me, it's no match for what it's like for him. #2 - How can I re-phrase my wording and actions so that I honor his struggle while preserving his dignity.
Just like in cetude's response, I have found routine is essential for smooth days. I have supper ready at 5. We finish around 5:30. The kitchen is clean by 5:45. Bath follows. As soon as I've helped him dress from the bath, I hand him his toothbrush with the paste on it and say something like, "Sir, your toothbrush is ready to go in your mouth." I have stopped asking, "do you want to brush now?" I have stopped telling, "you need to brush your teeth." I have stopped pointing, "there's your toothbrush." I simply say, "Sir, this is ready to go in your mouth- to clean your teeth."
My father was an officer in the military - he always appreciated routine. So, it works for us, when everyone does pretty much the same thing, at the same time. Sometimes my mom helps him, sometimes one of my siblings helps (when they come into town) - but always at the same time of day, and in the same order. I've shortened what I say, and prepared more of what he needs, with lots of simple compliments, "Your teeth are sparkling!" "Those pajamas look great on you, sir!" ... and lots of "sirs".
You have a lot going on - you have a career and a husband. You're mind is constantly filled with responsibilities. My only suggestion is to make the hours you're with your dad as simple and focused as possible and find a way to make it a place you find joy for yourself, in that time- that will result in a change in him too - not always, but many times! My best to you, truly~
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Brushing his teeth with the men's cologne, I can see it now.....
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The act of intimidation, e.g. "Wouldn't it be nice to use those new BLISSFULLY soft wash cloths and towels and to use the new bottle of mens' cologne that I bought you and to get your teeth brushed all shiny and bright so that I can take you out to that new steak house? They offer 20 oz. T-bone steaks, you know."
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As RayLinStephens implied, bathing more than once a week isn't critical, especially if he has no problem with incontinence. Oral health is more important. When I was taking care of my father, he got so that he went for more than a week but finally he would go in (didn't want help) but would use up all the hot water and take over an hour; at least the job got done. I was more concerned about his getting his medications, getting sufficient and proper food, "regularity", and general safety and well-being. Fortunately, I had no grief from him and he often mentioned that he appreciated what I was doing for him.
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As Countrymouse said: "don't waste your breath trying to correct his thinking or reason with him about everyday tasks. Better his dental plate waits until the next caregiver's visit than that you have a huge fight over it, you both get upset, and it still doesn't get sterilized. "

I deal with this with my 96 yr old DH and have learned, "pick my battles." I leave him to his own resources as long as he doesn't smell. Really, he isn't eating much or exercising much so he's not working up an odor.

You CAN offer to soak his teeth for him, assuming he has plates or partial dentures. I have taken DH's partials out to soak. It's just awkward for me to brush his teeth - so I brought him the brush, some mouthwash and a basin and helped him to do it himself in the living-room. He can't stand for long periods of time. I intend to start shaving him this way too.

4 days won't kill him but make sure that the caregivers during the week are attending him or you will have problems with pressure sores and bacteria - yeast infections - and the list goes on. If you have any doubts, call their agency - today - now.

What we tend to forget is, most of these seniors grew up with one bath on a weekly basis and some only bathed in the creek. My DH didn't have electricity until after WWII and all water had to be fetched from the creek for daily use. It was not "squandered" on cleanliness, with 11 children.

At 86, I was having to shower my DH - he could no longer do it on his own. As the daughter, this could be awkward for both of you - so he chooses not to bathe. Bathwipes (baby or adult) do work wonders! There is even a foaming soap that doesn't need rinsing - what a God-send it has been for us. He can bathe in any room and you can ask him to wash his privates and you can wash everything else with the cloths. Yes, you can use regular washrags and a basin with soap and water. I learned years ago to take all the basins from DH's hospital stays; and anything else that is in the room that would be tossed. The nurses will tell you what they have to toss.

If you try to "HELP" and/or "ASSIST" him in his needs, instead of telling him what to do, you will get better response from him. It worked with my Dad and now with my DH.

Praying for your sanity as I speak.
Hugs,
linda
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We tell my mother with no more than an hour or so notice that she has a hair appt. It is typical for it to take at least that long, but she is able to pull herself together eventually. We set up appts for every two weeks, just for a wash and blow dry as that is the only way to get her hair washed. As for the bathing, I went so far as to set a deadline in my own mine, to make suggestions, my dad made suggestions, all to no avail. Called a well-regarded home care agency, nurse came out to do assessment, observed mom and connected with her immediately...and mom, typically a meddling busy body left the room we were in. The nurse observed her level of function...mom was dressed and using a feather duster...and told me basically to just let it go. I was shocked. Nurse said they had seen many people go for VERY VERY long periods of time without bathing. I felt I was left off the hook, and it still bothers me...I feel worst for my dad who sleeps with her. We just had to get a new family medicine doc and I will be communicating with him about her. In the end, as awful as it sounds, I think this nurse nailed it...it just isn't worth the upset and screaming and rage to force someone. In your case with it only being a weekend, for me that would be a no brainer...let it go.
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i agree that sometimes the caregivers have tricks that you might incorporate. my mom has also become resistant to bathing. i have found a few things that work. First i never tell her what to do, that sets off resistance right off the bat. I will get the bathroom ready with a change of clothes and warm up the water. then i wait until she comes into the bathroom to use it. i follow her in and when she is sitting on the toilet, with her pants down, i will gently say, let;s get into the shower. once she is up i am able to get her pants off -bc they were already down and get her into the shower. when i have not been able to get her in the shower, i found that having shampoo and soap hear the kitchen sink was helpful bc i was able to wash her hair in the sink real quick. You grab what you can when you can. My mom hates wipes bc they are too wet. I found microfiber wash clothes at the dollar store (4x$1) that i like bc i can squeeze the water out and they are just moist. i will quickly use one on her face and another on her southern parts if she lets me. they leave almost no moisture but can get the job done. toss in a diaper pail with bleach/H20 and wash later.
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Just re read your post! You say you have 3 Caregivers throughout the week & they see him in the same clothes all week?

Shame on them! They are taking advantage of you. Just about EVERYTHING should be done by the Caregivers while you are @ work. I take that back......EVERYTHING should be done by them including setting you up for the week end with meals.......clean clothes and bedding as well as a clean house.

What exactly are they doing? That is what you are paying them for! Please answer ....I just am so curious what their duties are.
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Let it go over the weekend. Not worth the fight and you will be the only one losing and frustrated. Make a point to tell caregivers that he must be bathed, clean clothes, teeth brushed on Thursday and again on Tues or whenever next visit.

I lived long distance and couldn't get my mom to bath or change clothes (she smelled like homeless) unless I said we were going out to restaurant and she needed to clean up. She would bath but then that stopped/refused and she would only possibly change into some clean clothes.

It got very bad -- to which she hadn't bathed or changed clothes for months (she lived alone with no assistance). Finally adult protective services got involved but even they couldn't do anything. It took a year of documentation by them and me to finally get her doctor to sign incompetence (invoke my POA) and get her placed in memory care.

Its distressing and I have walked in your shoes. Thank god you at least have caregivers coming in and he allows it. My mom fired them everytime. Be grateful with that -- don't sweat the 3-4 days you are in charge. You will never get him to do what you want. You can only say, Dad if you wont be cooperative with me, we are going to have to look at alternative care and you may be forced to leave your home - blame caregivers and say that they are watching to see if he can take care of himself when they are not around....that may help you get him to cooperate at least in short term.
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The Caregivers should be showering him & cleaning his teeth. Let them be the bad guys.

Forget the wk ends...laugh with him about it saying its "our days off." He can't get that stinky in 2 days.........
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Does your Dad get into Pajamas at night?
My Husband would not change clothes but he did change into PJ's so I would take the clothes that he took off and toss them into the washer and put clean clothes in the exact spot he left his soiled ones. A few times a week I would take the PJ's and toss them in the wash and put clean ones on the hook on the bathroom door where he hung the ones he took off.

Luckily I never had the "he won't shower" to deal with nor the brushing his teeth. As a matter of fact he brushed morning and night as long as he could stand at the sink.

If he is getting angry is there any possibility that he may get violent? Keeping him home is great but at some point there is your safety as well as the caregivers that you have come in. Have any of them given any indication that he has become violent?
If there is any question about this you or someone else may have to seek Guardianship and at that point the Guardian can make the determination that Memory Care Facility may be safer for all involved. It does not sound like he would last long in Assisted Living before being transferred to Memory Care. And to move once is difficult but to have to move again once you have sort of adapted to your new living arrangements is even more difficult.

As far as fighting you tooth and nail because he does not want to do something, I bet this occurred when you were young and wanted something or when your parents wanted you to do something and you did not want to do it. It is what "we" do when we have to do something that we don;t want to do even if it is in our best interest. So do not let him "guilt you" ..You know what needs to be done for his own safety
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My mom has end-stage Alzeheimer's and the secret is routine--it's like taking care of a child with autism that routine is paramount. I no longer use a tub but a shower stall with chair--they are more receptive and my mom cannot possibly step into a bathtub. MAKE CERTAIN THERE ARE GRAB BARS INSTALLED as well. I bathe her two or three times a week using a hand held shower which also permits great pericare -- this prevents urinary tract infections. I use a little mineral oil for her legs and arms after the shower to prevent dry skin and itching and it works wonders. She has learned to brush her teeth twice a day and uses a water pic under supervision. Do it IMMEDIATELY after eating. Once they settle down they will refuse. Something in their brain will signal time to brush teeth after eating. As long as you do things scheduled exactly on time every single day you will have a lot less problems.  That's right--getting up, eating, sleeping, going to bed, exercise time, bathing, brushing teeth--everything should be SCHEDULED and routine. 
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I am in the same situation except my Mom won’t allow outside help. If caregivers are bathing him during the week then I wouldn’t sweat the weekends unless he is sweaty and soiled. It’s actually better for elder skin to not bathe daily. As for the teeth(my mom only has a few and refuses to have any dental work) I mix 1/3 of peroxide with mouthwash and it keeps her gums healthy. I heard this from a dentist. I would also approach with denture cup and hold it out to your Dad give him a minute to process then say you need to soak your partial. Any request you make of him and he refuses give him time to forget you asked then try again. It’s a waste of time to tell him he smells or a time frame of last time he bathed or brushed teeth. He won’t believe you and turn it into an argument. I know it’s hard and very stressful. Praying for your strength
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It sounds like a very stressful situation. Getting people who have dementia to cooperate with bathing is a common problem. And it seems to be more challenging when the family member who is trying to get it done. For some reason, bath aids or the staff in facilities seem to have an easier time with it. Maybe, it's due to their experience or just that the patient is less inclined to argue with a non-family member, but, it seems to work better. Have you tried a bath aid?

I might also offer that, your dad's condition will progress and his needs will become even greater. I would explore options for future care. Can you afford around the clock care in his home? If not, then Memory Care might be an option. Since, you say that he won't consider it, I'd seek legal advice from an Elder Law attorney about the options. They can explain the process, proof you need, costs, etc. Does anyone have Durable Power of Attorney?

Also, are you discussing things with his doctor? That can also be helpful, especially, if you will need the doctor's input for a court proceeding.
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There are bath wipes out there that can be used for bathing instead of having to get into the shower. I have a phobia with being in a shower and use them all the time. They keep me sweet smelling and my skin soft. (I did check with close friends to make sure I didn't smell.) But the teeth thing.... does he take them out at night where you can grab them and clean them for him?
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MBuckley, you can also do a Search on this website. See on the top left the 3 horizontal lines right beside AgingCare.com? Click on that, and just type in the search: "won't shower" .. There are several discussion threads on this problem.

In the meantime, I found these 2 from the Search:

This one below - I now remembered that Dad couldn't smell how stinky he was.
When I would tell him he smelled bad, he said that he doesn't smell it.
https://www.agingcare.com/articles/elderly-parents-who-wont-shower-or-change-clothes-133877.htm

https://www.agingcare.com/questions/father-wont-bathe-207858.htm
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My dad reacted just like your dad. Reading your words - was exactly how my dad said to me. Exactly. I have watched how the caregivers and nurses interacted with my dad. They did not 'tell' him what to do. They would ask him if he can turn, etc... But, mostly, I think, he took offense from me because I'm the Daughter, not his mother. So, who am I to tell him what to do?

My dad refused to brush his teeth. He told me to buy chewing gum and that will be his toothbrush. I have bought so many toothbrushes and toothpastes to no avail. He will just keep it right beside him - and never use it.

Showering. That was also another sore point. It Used to work for a while (a year only) when I told him that my sis and her husband is coming this weekend. I would tell him that he smells bad and we don't want them to smell it especially since he showered only last week. He would only shower if a visitor is coming... But this only worked for a while. After that, he would only shower every 2 weeks... then it was every 3 weeks... By the time he had his stroke, he was going on every 4 weeks of only 1 shower. He would just go and change his clothes if visitors were coming. {I had to tell visitors to NOT sit on his chair. I'm sure they smelled Dad's urine on it, anyway.}
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If the caregivers are getting more co-operation from him, what about:

asking if they can pass on a few techniques
or
asking them to come in for one hour mornings and evenings over the weekends and holidays specifically to help your father wash and dress.

The important thing is his hygiene, it doesn't matter who achieves it; and if he's reacting in this hostile way to you why put yourself through it? It's not fair on you and it's not getting his teeth brushed!

On the ALF point, it comes down to your father's competence. If he is assessed as having mental capacity, the decision about where he lives is his to make - even if it is a stupid one! But if he has been assessed formally, by his neurologist and other qualified persons, as lacking mental capacity, then the decision lies with whoever has power of attorney or guardianship. If nobody has POA or guardianship, or is his health care proxy or anything like that, then you and your siblings had best get together and take legal advice on what to do next.

How did you get lumbered with being the live-in caregiver? And how long has this been going on? How much support are you getting from your siblings?

From your father's point of view, he may be angry, depressed and hostile for all sorts of reasons that are real, and would get anyone down, but are NOT YOUR FAULT. It isn't possible not to take the kind of remarks he's making personally because a) they are personal and b) they're coming from your Dad and you love him. It's horrible having to hear him like this. But you must remember that his brain is not working and this is not your real Dad.

For the same reason - that his brain isn't working - don't waste your breath trying to correct his thinking or reason with him about everyday tasks. Better his dental plate waits until the next caregiver's visit than that you have a huge fight over it, you both get upset, and it still doesn't get sterilised.
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Someone might be able to answer you tomorrow, it is late on the West Coast of the U.S. now.
Take care.
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