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She wont bath or brush her teeth or anything that concrns cleanliness. When approached with any of these things she gets extremely mad.

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You may need to call in Adult Protective Services she is definitely endangering her own health and you don't want to be accused of neglect if she is living with you.
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We've done everything that the boards recommend: A handheld shower, pre-heating the room, supplying ONLY what she needs in the shower (a washcloth, soap, and shampoo), I turn the water on a warm, gentle stream...and still very often she refuses the shower. In her mind, she remembers her prior hygiene habits. She often says "I took a shower this morning!" But she perhaps hasn't had one in a week-or more! I've noticed that certain triggers work. If she thinks she has a doctor's appointment, someone is coming to visit, or she's "going home" she will usually shower. It isn't a guarantee, though. Yesterday (Sunday) she got up convinced that she had a doctor's appointment, so I took that opportunity to suggest bathing and she went very willingly to shower.

She's like a petulant child, too. Sometimes she cusses me and throws things. Sometimes she is just super passive-aggressive ("Do I smell good enough to suit you now?" "Am I clean enough to sleep in this bed for you?") It is very hurtful to try and do your best to take care of your loved one and be treated in such an ugly manner.

I've used the line about Medicare dropping her if she is recalcitrant about the doctor. I've also just told her I'm taking her "home" and she gets in the car, and five minutes later she doesn't remember why she's in the car.
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Understand that when you are dealing with someone who has dementia, you have become the parent and they are the child. Engaging in a battle of wills with that person will leave both of you stressed out and exhausted. And, in my mother's case, on occasion the battle would become physical. Try cajoling her with pretty soaps, candles, spray colognes, etc. or promise her a trip out for lunch/dinner, or her favorite meal at home if going out isn't possible. She is acting like a petulant child and won't be forced into anything. Threats won't work, but bribery with rewards for good behavior might. You can also consult with her doctor to ask for help based on their experiences.
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You say that she's been diagnosed with Alzheimers. Did that happen before she started refusing to see the doctor? In that case, she may not be able to understand why she needs to get clean and that it can cause some health problems. And her getting angry is not unusual either.

If she's living alone, that may need to be changed. Normally, professionals in AL or Memory Care know how to work with dementia patients to get them bathed. You can also do some reading about the issue. Teepa Snow has some helpful videos on You tube about dementia care as well.

It's not likely that you can just wait it out or hope that she'll change her mind. Sadly, the caretaker has to take measure to manage the struggle, if she resists. Resistance to care is quite common with dementia patients. I'd work on creative ways to get her to a doctor. It's challenging, but, there are various ways to get her to a doctor. Some family members say the appointment is for themselves and they ask the LO to come along for support. Or that they have to get a flu shot or mandatory check up.
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Try telling her that her insurance requires she go in for a check up or they will cut off her benefits, then get her MD on board (before the appointment) with addressing this? Ask if she'd prefer living in a facility where they would do all these things for her?
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if you happen to be lucky enough to have heard an inside joke from the person's family from long ago that may have convinced other people to do something, you may use that joke in this situation. For instance, my foster dad would run around half naked. I convinced him that the people in the TV could see him and that they were watching that he better go dress up. He was finally convinced enough to go clean up and dress up and look his best for the people in the TV because he was always watching TV. This joke was based on something he told me when TV first came out and everyone came looking like they crawled out of bed and sprawled out in front of the TV. The joke pulled by his dad convinced everyone right away to get up and go clean up dress up and do their hair and sit very nicely in front of the TV
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Don't know if you are handling all her care responsibilities these days? When the refusing to shower, brush teeth & most grooming necessities start to occur your role becomes more difficult & challenging. A visit to her doctor for a check up may be a good idea, but, this may be due to the progression of the ALZ. Sorry for her, & you, but it may be a new stage of the disease. It's not her fault to not want to. She may be forgetting how & confused with all the steps involved. She may be afraid of falling, or water. It's overwhelming to her. As a caregiver to my brother with ALZ, he/we went thru this. He would not shower at home, yet, no problems at a facility he loved, big $$$. This was at an early stage of the disease, he was not incontenent, could still handle all everyday skills. Their bathroom handicap accessible, shower bars, seats, no shower lips or a tub in sight, making it an easy task and safe for any & all stages. It was open & visually appealing. His private bath at home lacked a separate shower, had a closed in look. After a respite stay, he showed me the bathroom, "How nice," I said. I asked him, "Do you like this?" A tear was my answer, I had a perfectly ok bathroom but not for him. I felt confident of my decision to make necessary changes. A happy ending I thought, it looked it, but no. I tried encouraging & suggestions to no avail. Questioned the staff at the facility 1 too many times,"Just needs direction, no assist," they would tell me. If you, like me, are a primary caregiver I have heard no from day 1 to almost everything. This was early in to the disease, I was still learning, ?s all the time. I soon realized, "No," would be it no matter. You may have to call in for assistance for her & a learning tool for you. I did & it was a break from the first day. I listened, hidden from view, heard water running, her in control voice, no begging or pleading needed. Her demeanor was calm, she was in charge, but she allowed him to feel he was, that he still had control, needing no one, yet he really did. That day was a break through, a happy one, but sad as well. I realized how serious this disease was & that I had so much more to learn & work on to caregive. My technique yes, but so many things, my voice, body language, my presence even. It wasn't useless. Get all the knowledge you can, it is powerful. It will aid you as you go along helping your mom. You can do this, if you chose, a personal choice, but there will be curves & roadblocks along the way. Stay strong & focused. Take care of you as well. Blessings
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I have read that a number of things can contribute to the refusal to bathe. For some dementia patients, the sensation of water hitting the skin is painful and a sensation that their brain cannot easily tolerate, so, patience and new techniques are required. The patient may also genuinely believe that they have already bathed, so, in their mind, they are clean. Their brain can't process that that they are wrong. And I've read about fear of water too, though, I've never seen that.

Do you think that she will swish a rinse in her mouth? My LO's dentist recommended ACT dental rinse to cut down on plaque between brushes or if she refuses to brush. There's only so much you can do and you have to pick your battles.
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They have a professional hairdresser who comes to the Memory Care facility to cut and style the residents hair. (Professional basin and hose too.) My LO who has severe dementia, still enjoys having her hair cut and styled though. Even when I mention it, I can see her body seem excited. I requests that she get cut and styled each time the lady comes in.
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My old client hated to shower. I know she thought she could fake out everyone, but no shower for a week and you're also incontinent? The smell was a dead giveaway. My job with her did NOT include showering, luckily, but unluckily, it did require me to be in close quarters with a dirty body. Her refusal to shower or bath was the deciding factor in her family placing her in LT care. One person who smells atrociously can make a whole house smell. I think it's very sad, but nobody could get her to do anything. Thank heaven she had a standing hair appt each week. At least she "looked" groomed for a few days.
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