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Mom won't shower. She says she does but the smell burns your eyes, quite evident she isn't. Bathroom is so close but she's going in her pullups... I have her in assisted living with "incontinence care" but it's not working. Last 2 independent living places kicked her out for the smell being THAT bad.

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It could be nonenal (old people smell) combined with lack of showering:

https://www.agingcare.com/articles/old-person-smell-174839.htm
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PeterG, your Mom could have showered a couple of hours ago but sometimes prescription medicine can cause the urine to have a heavy smell any time she uses her pull-ups.
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Is there dementia at play here? You give no info about your mother or what issues she suffers from. Incontinence and refusal to shower normally goes hand in hand with dementia/Alzheimer's.

What do you mean, the incontinence care is 'not working'?? If the staff is changing her brief every few hours, the program should be working. She also needs to be showered 2x a week, is that happening at the AL she's living at currently? She's obviously past the Independent Living stage now, with incontinence issues at play, but I wonder if she needs Memory Care now?

If Alzheimer's/dementia is at play, here is a blurb about not showering from a very good article on the subject:

Grooming and bathing are disrupted when the person forgets how and when to do things. They may forget what the steps of washing are. They may forget that they need to wash. They may be unable to remember how much time has elapsed since they last washed or changed their clothes. They may also believe that they are clean and take offence should anyone suggest otherwise. Dealing with such situations in a manner that is kind and jovial, rather than confrontational, is important. One fellow, who needed to help his wife bathe as she was no longer able to do so herself, was puzzled because she was calm and cooperative until he helped her step out of the bathtub, and then she became agitated and wanted to get covered up immediately. As it turned out, as soon as she saw her own reflection in the mirror, she thought there was another person in the bathroom, and she was embarrassed. As you can see, the cause of the distress for a person with dementia is not always readily apparent to the rest of us, who can take intact thought and reasoning for granted.

If a person with Alzheimer disease is looking at a solid black area, or a solid white area, such as a bathtub, they may perceive a yawning bottomless hole. Putting a coloured bath mat down may increase the likelihood that they would be willing to step into the tub. Putting blue food colouring into the water may allow them to see what they are stepping into as well. Generally, with altered depth perception, it becomes challenging to judge how high, deep, long, wide, near or far things are.

If you send clear signals through your tone of voice, facial expression and relaxed and confident attitude, that you mean them no harm, they may trust you to the point where you are able to help them with their personal care. People with Alzheimer disease become extremely sensitive to the body language of others, as they no longer possess the judgment and insight to understand the situation, so they evaluate the threat posed to themselves by the frown or aggressive stance of the other. It is important to exaggerate your body language communication to let the person with Alzheimer disease know that you intend them no harm. A smile on your face, a relaxed tone of voice and body stance, a sense of calmness and reassurance, perhaps a hug, all communicate that you mean to help, not harm. If you feel like you’re overdoing the positive body language, you are communicating your intent effectively for a person with Alzheimer disease.

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My mother lived in Memory Care AL and the staff was able to help her shower 2x a week, even when her dementia was very advanced. In the beginning, she refused to shower b/c it turned out she was petrified of 'slipping'. After careful thought, I got her a pair of water shoes on Amazon which did the trick and she stopped being afraid to get in the shower. It's important that your mother has staff to 'hear' her and figure out what her fears are about showering. And to have the ability to coax her into the shower once they allay her fears. This is why Memory Care AL is best for elders with dementia: they have staff who know how to deal with these issues, vs. AL who do not.

In any event, let us know your mom's mental and physical issues for better advice.
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