Do you shower her. Can the woman stand using a bar for support.? I had my Mom stand with her back to me holding onto a bar. I had her spread her legs and took the hand held shower head and sprayed the area. Not once in the 2 years she was with me did she have a urinary infection.
My MIL is in a LTC facility and has short-term memory loss and mild dementia. Just 2 days ago the admin called us because she reported that the aid had put her fingers in her rectum when she was being cleaned after a BM incontinence episode. Of course, this "alleged" incident had to be reported, the police were called to attend an interview with her and admin. The aid was sent home for the day. MIL kept changing her story. Then eventually didn't even mention it. Nothing came of it because my husband (her PoA) didn't feel it was something to be pursued, that nothing actually happened. When my husband called his mom today, she didn't say a thing about it and didn't remember anything when he asked her. My point to you is to be very careful in this situation for your own protection. You should be informing your supervisor about this and only doing exactly what they recommend.
Give her privacy, either by standing outside the room or at least out of her line of sight, and verbally prompt her so that she can wash that area herself.
If she isn't able to, even with prompts and/or support, document her refusal, don't touch any part of her without her consent, reassure her and finish her routine; then come back another time and try another approach.
If she isn't able to, even with prompts and/or support, document her refusal, don't touch any part of her without her consent, reassure her and finish her routine; then come back another time and try another approach.