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I have worked for months to obtain home health care from a certified nurse assistant for my mom to help with her hygiene. She is 94, has dementia, smells terribly of urine, and has dirty hair. This is not who she is or has ever been. Finally now that we have help, she refuses to let the CNA help her shower and has dug her heels in. I suspect this is due to modesty and embarrassment but it could also be purely irrational due to dementia. The CNA has tried twice without luck and has said she will no longer be able to come if it happens again because she has too many other patients who need her. I live out of state and have a brother in the house who doesn’t feel comfortable with the situation and is quite frustrated. My only idea is to ask her to wear a bathing suit but she may still refuse and that won’t help with her private area anyhow. Any ideas? Thank you!

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After my ‘brutal’ suggestion, I was thinking some more about your ‘bathing costume’ suggestion. If you really think it’s a ‘modesty’ issue, you could try this one. Get an old sheet (Op Shops usually sell them cheap, particularly singles and doubles). Cut a head hole in the middle, and put it over her head like a burka. Make it black or navy, and you can laugh about ‘your burka’. You can sponge wash underneath it, or if it works well you can get the whole thing wet in the shower with M inside. Much easier to get into and out of than a bathing costume, and the experiment would only cost a couple of dollars. It doesn’t help much with the hairwashing, but it certainly would keep her ‘modest’.
Helpful Answer (1)
Reply to MargaretMcKen
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The hygiene aid needs to find motivators may get her to do it: we used to tell my Aunt (who had memory impairment) that we were having guests that day, or she was going to the doctor, or church or... etc.

We hired a neighbor who happened to be an experienced caregiver to shower her 2x a week for several years. My Aunt never "loved" her shower time.

Make sure the hygiene helper comes in the morning since in the afternoons your Mom may be sundowning or just tired and cranky.

Otherwise, like others have suggested, you may need to settle for a lower cleanliness bar.

Your Mom's ability to cooperate with basic things will only continue to diminish. Long-distance caregiving only works if you have a very trustworthy and reliable team at her end. There's lots of management. I would consider a facility near you.
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Reply to Geaton777
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If the two answers below do not work then you have to go to plan C , placement in a facility.

I had the same problem with my mother , as well as not changing her depends , clothes , not letting hired aides in the home etc. The doctor told me she had to be placed in a facility. The doctor said at some point most parents with dementia need to be placed because they will not listen to their ( adult) children . They believe they are in charge because they are your parent. It becomes unmanageable at home .
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Reply to waytomisery
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Fear can be huge. Pain. Cold. See if you can identify anything. Sometimes you can't - It's wanting to be in control.

Here's my usual ideas.

Soft Touch:
- Can Mum sit to be washed?
- Has taken her usual meds (including any for pain).
- Bathroom nice & warm.
- Lots of good visuals, lovely looking bottle of shampoo, nice fluffy towels.
- Calm voice
- Give as much choice to Mom as possible eg Do you want this scented soap or this plainer one?

Bribe: AFTER your shower I'll fix you a lovely warm drink/apple sauce/icecream etc.

Still no?
Trickery: Top & Tail.
Lets brush your teeth & wash your face. Oops I spilled water on your shirt. Let's change it. While here, let's wash your top half & underarms. Let's stand up briefly. We can do a quick wash below.

Still no?
Meds to take the Edge off that Stubborness: Inform Doctor. See if appropriate for anxiety meds.

Outnumber: Hire a 2nd Aide.
Just until this is routine. When outnumbered many people give in.

I think ALL of thise tactics had to be used to get my Mother back in the habit of showers! But it was done & hygiene has been restored.

Good luck!
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Reply to Beatty
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The only suggestion I can make is fairly brutal. Both you and your brother tell her she stinks, and if she doesn’t allow the carer to wash her you will both arrange for her to go to a care facility. There she will have no choice anyway. If she says that you can’t do this, you tell her that if she refuses you will stop all care. No food, no shopping, no washing, no outings, no companionship – nothing. And mean it!
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Reply to MargaretMcKen
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