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My mother has lived in assisted living for 5 yrs. The aides give residents two showers a week but she refuses help. They are very kind but my mother won't comply. I think the only way to solve this is to tell her that as so many residents have fallen in the shower it's now the facility's rule that everyone has assistance with showering. Any suggestions?

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Hi Veronica91:

My mother was living in her own home of 40 years prior to the move. The no showers isn't new. She never, ever took showers. She always took a bath once a week and washed up everyday.

The staff has been diligent about checking in on her in the morning during her wash up to check her skin - something she doesn't appreciate one bit. Lol! But I certainly do. And she definitely changes clothes. The only problem we've had there is that she finds the new pajama pants I bought her quite comfortable and has decided to add those to her day wardrobe. Not a problem, but it makes me smile.

The staff and I have had a conversation about trying to get her to take a bath in a tub they have available. We last agreed to give it another month of settling in and trying for a shower, with plans to revisit at our next family care meeting. That is coming up in a few weeks.

Thanks for the question and concern. I appreciate hearing from others as I negotiate this brave new world with my mom. :-)
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TJLang, You say your mother is in dementia care was she in AL before that and is this a new behavior since the move?
You also note that she washes herself daily and changes her clothes. Are you personally satisfied she actually does this?
More important than bathing is for someone to check her skin so that any sore. rashes etc can be dealt with. This can be done sometime when she is minimally dressed such as in her night gown so she does not have to be stripped naked for the whole world to see.
I realize showers are much quicker and easier than getting someone in a bath. If her memory care does have a tub but she can't get in perhaps they could lower her in with a hoist so she can enjoy an occasional soak. Give her some bubbles if privacy is a big issue
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My mother will have been in a dementia care unit for 2 months on January 30th. She has refused to take a shower and doesn't understand why the people keep asking. She washes herself everyday and has no body odor. I ended up explaining that my mother has NEVER taken a shower. She was a bath person, as I believe many of her generation are. Unless hygiene and odor become a problem, I think leaving them to their privacy and dignity is best. So much has already been taken away.
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Oh, gosh. This is one of my biggest problems with my mother and one which I've tried the most to work with her on. The AL she lives in has some very persuasive aides and on occasion the Director of Nursing has come with one of them to add a little additional "persuasion" when too much time goes by and mom simply will not cooperate. I believe they have her complying at least a couple of times a month at this point but truthfully I've come to the point where I can't let myself become obsessed with the issue. The reality is mom is 94 and European and, of course, bathing on a regular basis wasn't such a big deal the way she grew up. Sponge baths, etc. were the norm and she seems to do well with cleansing cloths such that, while she may not smell "fresh", at least she doesn't stink. Her skin is very dry, though, so I and the aides try to moisturize as much as possible without making it seem like this is the way it should be. You have all of my empathy and sending hugs for patience and fortitude.
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Mom showered today! After more than a month! The towel wrap during the shower (sitting on the shower chair) worked and it kept her dignity and temperature warm during the process! After the shower she announced "I can't imagine why people don't want to shower when it feels so good!". The aide and I had to smother our laughter. Dementia is full of twists and turns! BTW: As others have indicated, an elderly person can be kept reasonably clean with sponge baths, clean clothes, etc. Just because an elderly person does not shower does not mean you can't get near them because of the smell (e.g. losing ones cookies) as has been suggested here. There are lots of people in this world that don't get to shower regularly, including some of our military personnel. Mom does feel better after a shower (she just doesn't remember that until she has just had one), and it is good for cutting down on the potential for infections (e.g. UTIs, etc.).
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Thank you GodsAnointed your answer is the best! My mother doesn't have body odor and she changes her under garments and clothes daily. I was over reacting to the fact that I didn't think she was showering properly. Thank you for your response.
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#1 Elders need to bathe else someone can't get near them to tend to their needs without "losing their cookies," e.g. vomiting.
#2 When I get up in age, will I really give a darn about someone seeing my naked body?
#3 No, I will be REALLY glad to have someone bathe me because I have lost that skill.
#4 Modesty will have left the building!
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Yes, it sounds like she may need help from your description. However, I think you may be in for a little bit of a fight on this one. I'm not sure but I kind of suspect it. Anytime you have freedom and independence, you really want to do everything for yourself. Every responsible adult can understand this. However, in some cases where dementia and even Alzheimer's is involved, it just seems like they still don't want to give up their freedom and independence, and I don't blame them. However, I'm just not sure there's going to be any easy way to get her to accept help bathing, which is why I strongly suspect you may be in for a big fight if she happens to be combative. Even my foster dad who's in the Alzheimer's ward is very combative because he doesn't really want to be there or have all those people around him. He'd really rather be home, and anyone can understand. However, any time you're dealing with a demented person, there's going to be some level of difficulty, especially as it progresses and they become physically combative. The patient probably needs to be in a facility that can offer more help than assisted-living can offer. I know sometimes this is necessary, but in other non-demented patients, independent living is still possible as long as they can still function as my grandpa figure did and his kids eventually wouldn't let him drive anymore and they most likely came around him to help him and eventually got him a hospital bed. Sometimes as we age a little extra help is necessary depending on the person's needs. Some people do need a POA whereas others need a guardian. Not every aging person needs either, Grandpa didn't. He actually amazed me and even he was sharp into his old age. I can only hope that when he passed, it was peaceful and painless.
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Hi God'sAnointed - I agree with giving mom ber independence, space and dignity. But now, I wish mom could still shower herself. Unfortunately, she requires 24/7 care with bathing and toileting, food, etc. At 94 having gone through the mill, her dementia is a significant impediment, to say nothing of safety issues. If mom started at ther feet, by the time she got to her knees she would have forgotten she washed her feet. Poor thing - it is sad - so trying to find ways to make it as comfortable as possible for her and wasy to give her incentives and perks to make showering something which has good connotations. Oh well! Hoping tomorrow will turn out to be a shower day :)
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One thing to remember is people are usually self-conscious and don't want strangers seeing them undressed. If your mom is still able to bathe herself and don't force her to let strangers around her if she's undressed, this will only cause further issues including her not wanting to undress at all for fear someone will take advantage of her. Definitely don't force this on her unless you want a bigger fight and more problems. As long as she still able to bathe herself then let her bathe herself
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Thanks Veronica91! I am still thinking a light wrap towel (I can sew velcro on a towel or by one, tho those are heavier) she can wear in the shower and (!) it can be used as a washcloth - it will be wet and soapy and can be used to scrub her "down there" without much exposure. Obce done, wring and throw in the washer for next time. I thought of the bathing suit thing, but that would only reinforce mom's feeling that she is exposed while others are not. Thanks!
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Trying i was talking about a sponge bath f thats the only way you can get her smeling like a rose again. I have suggested before that people do actually climb in the shower with their loved one. If you are shy you can wear a swim suit. Mom can actually keep her bra and panties on while you do the exposed bits, then take off the bra, wash to the waist and drape a towel and finally" drop the drawers" and have a second towel ready to wrap around the waist. You will need a hand held shower which makes it easier anyway but it is a simple matter to unscrew the existing shower head and screw on the hand held. A cheap one is about $20. You can also probably find a used shower chair pretty cheaply too. I think I paid about $5 for mine. The trick is not to strip them naked all at once.
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Hi Veronica91, Can you please say more? Are you talking about a sponge bath or a shower when you say one arm at a time? Mom needs a shower desperately and I'm about ready to climb in with her if it will get her to shower (though I hate the idea!) Ha ha! See, we all like our privacy :)
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There is no easy answer to this except hire a couple of ladies from the Amazon. Everyone feels vulnerable when their private space is invaded, think about how you feel when you get the restroom stall with no lock. That being said when i was taught how to bathe a patient the golden rule was never expose anything you are not actually washing, i.e. only one arm not strip to the waist. Personally at almost 78 if does not bother me in the slightest but hen it is not a pretty sight.
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I have to agree with those that say leave them their dignity and give them space. It is easy for someone to say they MUST, but ever try forcing an elderly parent especially with dementia, to do something? It is not worth what happens. Mom also has an issue with her privacy, dignity and I think it makes her feel vulnerable. I like the shower towel idea! The AL facility may be concerned with fall precautions and their liability, or maybe how thoroughly mom is washing herself (which declines, too). Can they monitor/be present but let her do her own thing (do they use shower curtains?) Good luck!
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We have gone through this with my mother-in-law, she does have dementia and it is getting worse every day. She has lost so much weight and fall asleep in her chair a lot. We had Christmas Dinner with her then my niece and her husband went to see her right after we left. She told them that no one had been there all day. Of course, we had been there 4 hours.
She refuses to have assistance bathing, She refuses to use her walker in the AL apartment. She has fallen several times, the nurses have called my wife several times a week informing her of the situation. My wife would like for her to stay in the AL but it looks like she will soon have to go to the Nursing Home. She has suffered from depression all her life.
I did not tell my wife but after watching her I think she may soon pass on. She has nothing to live for, she cannot remember anything. We have her in a wonderful facility with great caretakers. It's considered the best in our state. There is only so much they can do if she becomes too hard to handle she will go to the next step, that is, the Nursing Home.
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Bathing is a huge issue for the elderly. Requiring assistance from nursing or care staff is to be expected at some point, just for safety, if nothing else. And you can expect that if hygiene is not being maintained to a reasonable level, you will eventually wind up dealing with Adult Protective Services. Be aware that your own hospice staff may turn on you and your family, like ours did with us. We insisted on bathing head to toe once a week...we were able to get my mother in law to do this without too much drama. But, with visiting care providers, she was very resistant, even to tolieting assistance and depends changing. So the providers blew off her care while we were at work, and next thing we knew, we were dealing with APS. We fired the first hospice team, a second team decertified her for hospice (she was too verbal at the time) then APS insisted upon hospice, against our wishes (we were going to handle it all ourselves, to make SURE it got done right..taking a leave of abscence from work, if necessary). In the end, that is what we did. My mother in law died peacefully at home, but we had to step over our own hospice team, APS, and rely on our own PC for support. Be aware that these "professionals" may be more d*mn trouble than they are worth, and that it can lead to a fight over in hospice facility placement vs dying at home.
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You can tell your mom that, but if it's not true, and you get caught in a "little white lie", you'll have a hard time convincing her anything you say after that is true. My mom was an extremely modest woman who also didn't want help or anyone there while bathing. However, as she declined and became more child-like, she no longer resisted. My mom's facility had one or two aides assigned to each resident and once she became comfortable with their presence, she willing took her shower.
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.... I'm not sure why almost all the ones commenting have missed your question, they are all acting as if you needed suggestions on how to get her to even take a shower… When that was not your question. Regarding your question; First of all it's pretty darn cool she's held onto her sense of pride, showering & bathing help is a big privacy issue as we age .. you know, you've already thought of a good approach, so perhaps just try it and see if that's somthing she will accept. One thing, you hadn't mentioned her falling during her showers, so I'm a little unclear as to why you feel she needs "help to actually shower. Having an aid 'Near the actual shower,in the room where she's showering just in case she needs the help is pretty standard practice for facilities, so are u saying she won't allow them in the same room or what? -
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I like your idea. Residents not wanting to shower is a difficult situation. I was a caregiver in Assisted living for 5 years. We would use different ways to get them to shower it wasn't easy but necessary. We learned which caregiver worked best with each resident. Some of us were better with certain residents than others.
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Hi Susan. I had to appeal to my mother's money side and tell her that her long-term care insurance would not pay unless the AL assisted in her bathing. She tells people this - they have learned that she is like that and sometimes help her get in the shower, then sit back in the bathroom or bedroom while she bathes herself. They even get her to sign a paper saying she declined the bath for that day if she turns them down. Something like that. Money for her, something else for your mom?
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MaryKathleen, the problem might be that falling in the shower could break a hip. If they feel she is a fall risk, then they might be wanting to be proactive in helping her "bath" to help prevent such an awful accident. An aid nearby will not prevent a shower fall...they really need to be in there with her.
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Carol...I just scrolled to the bottom to tell Grandma1954 that, I too LOVED her "pointalism (or dot matrix) analysis"... A quite vivid and colorful way of saying "seeing the big picture" for sure. Nice Grandma..made me smile and so true!
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Bathing for elders is a frequent topic on this forum. Yes, in this case, tell the resident that this is a new rule, e.g. YOU MUST CLEANSE!
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Grandma1954 wrote:

"Little things may not seem like big things but adding them together can give a different picture. Sort of like that artwork that is nothing but dots until you step away."

I love Love LOVE your anology, Grandma...
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What will the AL place do if she doesn't accept help? Kick her out? Why are they insisting she have someone shower her? Does she need to exercise and gain some strength? Maybe this rule will move her to exercise she can shower alone.
If she can shower herself, maybe all she needs is someone in her room to be sure if she has a problem they can help. Is there an emergency cord in the bathroom? What about a "help I have fallen down" button she can use in the shower?
I know I wouldn't want some person seeing me naked.
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I have learned the hard way not to sweat the small stuff with mom. She had not taken a shower in years before moving in with me, and it showed OMG. She still does not take a shower, absolutely refuses plus now it's just not safe with how my bathroom is setup in my home. So this is what we do, myself and the aide: clean her private areas well when changing her Depends, manicure once a week as tolerated, pedicure once a month as tolerated, hairdresser twice a week as tolerated, sponge bath when major disasters happen with toileting which is several times a month at least as tolerated, denture cleaning twice a week as tolerated. All is stated "as tolerated" because it will never happen with a fight. If gently trying several times doesn't work, then on to the next day. I found that if it's not life threatening, then it's not worth fighting with her and getting her upset for days. Life is too short for my mom to put her through that type of ordeal. Love her, coax her, nudge her from time to time, but then leave it alone. Take care of yourself.
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If there have been no issues with showering with your mother, leave her alone! She obviously is very private about showing her private parts, and I suspect most elderly people are. If she has been in "assisted living" for five years without any other incidents, until she displays a danger to herself, leave her alone to shower or sponge bath by herself. You do not have to control everything she does. Give her some privacy, dignity, and self-worth.
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Ask her if she is just embarrassed. If she says yes, maybe you can try one of those shower towels that have the elastic on top. Since it is a towel, it can also take some watered down shower soap which can still scrub her body. The shower towel can then go into the laundry or hung to dry for a couple of shower times.
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Susan, I didn't see what your mother's ailment is. Is she in a regular AL? Does she have dementia? Is she able to communicate? If she can't communicate well, explaining to her why she needs the shower, may not be possible. I like the suggestions about checking on what, if anything, is different about the shower routine. Are they using the same shower room, do you use a shower chair, etc. There may or may not be clues there.

The next thing that I would consider is if she is in pain for some reason now. I'd explore any bones, joints, sore spots, etc. Does she have pain somewhere that she can't verbalize?

I will add that when my loved one was in regular AL, they had a very difficult time getting my loved one showered. It was a huge deal and they just weren't able to handle it. They called me about it. But, when my loved one's dementia progressed and she was moved to a Memory Care unit, that changed. The staff in MC were trained to handle her and it was never a problem after that.

I have noticed that in MC, they play music for the residents in the shower room. The staff person hums and sings along with the music. I think it helps the resident feel more relaxed and comfortable.

So, I suppose, that I would think that figuring out the best way to get mom her shower, would be something the facility needs to work on. Certainly, they deal with this all the time and they should have expertise by now.

Perhaps a team meeting with the facility might be helpful.
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