Moms hygiene has gotten so bad. She won’t bathe, change her clothes, or socks, brush her teeth. She says she hand washes her underwear. I can’t find them. She can’t remember she wore the same out fit 27 days out of 30. I’ve taken to taking her laundry with me home when she is at the hairdresser, but she gets mad when I return them. I try to get as much cleaning done while she is gone. I finally put out summer clothes. She still finds that one sweat suit. It’s hitting 90. She will not allow home health in. She does not think she has a problem. How do I get her in a tub? She is one stubborn lady. How do I get her to allow me to help? She was one of the most cleanest people I knew when she was younger.

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When my father initially got to the "no bath or clothes changes needed" in his vascular dementia he still had some reasoning left so making him aware of deficits was enough to motivated him most of the time.

First, we worked on awareness. I took one of my older digital cameras and turned on the date stamp as large as it allowed, then made a chart with seven spots in each row for a 3"x5" photo and 4 rows. I took a photo of my Dad every day, printed in on plain paper on my home office printer, and posted it on the chart. I used a yellow marker to "frame" the photo when he took a bath. Seeing himself in the same clothes as they became more wrinkled and dirty, and as his beard grew from not shaving allowed Dad to really "see" he needed clean clothes and a shave (although not necessarily a bath). If you cannot take the photo in person, maybe you can setup a web cam in a common room of the house and take a daily photo from it.

Second, we compared his smell to someone Dad knew in his younger years who was gossiped about due to his smell. Years earlier there had been an older mentally retarded man in our community (brain damaged from a breech birth) named Boo who lived alone and didn't bathe very often or wash his clothes (family didn't help him much either). So I would ask my father if he wanted to be the community's official smelly resident now that Boo was sweet smelling his way down Heaven's golden streets.
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Lack of interest in personal hygiene and maintaining that there is no issue with it Is a sign that Mom needs help and probably should no longer be living alone. Not being clean is an invitation for infections and skin diseases. Displaying unreasonable anger when you return her clothes clean is another sign that she needs help. It’s time for a doctor visit and maybe an evaluation of Mom’s mental state. If you have any sibs, ask for their help in finding a solution for Mom, or speak with her doctor when you go.
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