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My mother has been living with my husband and I for 2 years. Her personal hygiene is just awful. Her not changing her wet underwear is the worst. I know I sound like a broken record to her, but I do care about good hygiene. Showering is also a problem, I have to ask all the time. I got rid of her underwear and bought underwear that has a bladder pad and panties that are nice looking as well. She does not want to change them after they get wet, then will let them dry and put them back on, if I don't catch it. I am getting pretty good about that though.

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I can't leave any of these issues up to her, as they will not happen. I make sure she getting a bath at least 2 times a week. No choice, don't ask anymore, we just do it. This is why we moved her in here as she was paying for a caregiver at senior living center for a shower twice a week, as was not getting done.
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When the dementia patient is unable to really be aware of their hygiene, need for toileting, etc. they must be constantly supervised and monitored to ensure that they are clean. You can't just leave it up to her to take care of things, past a certain point of her capability. If she's not doing it, I would step in to handle it for her. Things you might say to her, likely aren't going to inspire her, since she likely will forget and that's why she's having the problems in the first place. I'd try just being positive, no blame, just checking her and changing her on a regular schedule. And not allowing her to stay in her room unaccompanied, where she might urinate. A bath aid is also helpful, if that seems to be an issue.
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I hear all of you. I don't ask about taking a shower, I tell we will be taking a shower tonight. Most of the time this works. I try to be kind with my words, but sometimes just to shout to get my point across. Cleanliness is so important to me as I can smell the urine on her. I smell it everywhere in her bedroom, pees on the floor of the bathroom, if she waits too long. If she would just change her panties when they get wet, like she did with the other panties... So also have a problem with the skin picking, her arms a legs are just horrid! Picked up fidgety items and they don't work either. just drives me nuts. I can't cover them, she'll just take them off. Thanks to all of you. Don't feel so alone here.
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jpark -

I know this may not be something you want to do, but can you "guilt" her into changing the underwear or letting you help her to do it? Tell her that if she develops an infection due to the wet underwear not being changed, the doctors are going to want to know why it's happening and may report you to APS for not taking care of her properly, and if they feel you can't care for her, they may recommend placement in a nursing home. (Please don't take that the wrong way - I am *not* saying you don't care for her properly.) I had to take this tactic with my mother when all other efforts failed. I had to tell her, "Mom, I don't like having to say this to you, but there is an odor in the house because your underwear is staying wet with urine. Please let me help you keep clean, so that you don't get an infection from it. It's not healthy for your skin to stay wet like this.  If you develop an infection, I will have to take you to the hospital, and they might say I'm not taking care of you well enough and want to put you in a nursing home."  

I hated having to take that step, but it worked for a while to get her in the shower.  There were also times I had to be downright firm with her (to me, I felt I was being mean to her and I hated it).  She would put on this little girl voice and say, "Must I shower??" and give all kinds of excuses - she would shower after this tv show as over.  Then it was after lunch.  Then dinner.  Then it was too late, let's wait til the morning.  At these times, I would look at her and say, very firmly, like you would to a child resisting a bath:  "Mom, there is an odor in the house from you not showering, and you are not the only one living here.  It is unfair that I have to live with this odor when I am here to help you bathe.  You are taking a shower today, and that's all there is to it."
I absolutely hated being like that with her, because to me, I felt like I was being disrespectful and mean to her, but I wasn't yelling or screaming at her and I didn't physically force her to shower - but this was the one thing she would respond to when all other attempts failed. 
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jpark, you could have been writing about my own mother. When I moved into her home to care for her when my father was dying, I found that she couldn't tell me the last time she showered. She literally couldn't remember - that's how long it had been. The tub had about an inch of powdery dust in it and cobwebs on the faucets. Not kidding. She said she "washed up" every day - I found out that meant she ran a wet washcloth over her face and front of her neck (not the back, which was caked with dry skin and dirt), and maybe her armpits if she thought about it. Nothing else got washed - ever.
So, when she took a nasty fall trying to walk into the hospital to visit Dad, and smacked her forehead and nose on the concrete, the next day, I insisted she shower, proclaiming the comforting benefits of warm water on her sore joints after that fall. It worked - that time, at least. I did struggle with her for the rest of her life to get her to shower. She insisted getting the tub made her feel she would fall and it was too hard to step over the side of the tub. So I spent $800 cutting the side of the tub down to make an opening for her to simply step through. That worked for about 2 weeks- then right back to the resistance again. Even in the nursing home, the staff had to bribe her with sweet treats (not my choice of bribe!) and such to get her to shower. They finally got her to use the walk-in tub, and she *loved* that!

Bottom line: You can't physically force her to bathe - but you can bribe - and maybe that will work. Find something she really likes and tell her she can have it after she bathes. Be gentle about it - sometimes it's a pride thing -they don't want you to help them or see them naked - but it has to be done.
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She does have dementia and is being treated with meds for the dementia and depression. I get her a shower 2 or 3 times a week, because of the not changing the wet underwear. She only started a couple of weeks ago since the incontinence underwear I bought.
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Does she have Alziehmer's, dementia or other health problems that could be factoring into this? Even if she doesn't, it would be a great time to ask her doctor about writing a script for bath aides to come in and bathe her 2 or 3 times a week. The elderly don't need showers every day but should be having full baths or showers at least twice a week. If she doesn't have dementia, let her know straight up what is expected of her in terms of hygiene if she wants to live with you, or if she doesn't want to do that, she can find another place to live.
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