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caalimenti Asked August 2012

What to do about father not bathing?

WilmatheCat Aug 2012
Hi Caalimenti, I went through (and am still going thru) the same bathing issues with my dad (he's 94 and has Alzheimer's). He'd say "I showered this morning or I'll do it later or I'm not dirty", and no matter what I said or how many different ways I tried, he was not going to shower. Not only that, but gradually he also stopped undressing at night (sleeps in his clothes) or ever changing his clothes on his own. So, whenever the opportunity presented itself, I'd do whatever I could (or that he let me do) to clean/freshen him up. This didn't happen often, and was mentally exhausting for me as I always had to be thinking up 'creative' reasons why we needed to clean him up. Sometimes it worked first thing in the morning, sometimes before he went to bed. Sometimes I could only get his upper body done and then get a clean undershirt and shirt back on. Occasionally he would shave himself and when he was about done, I'd go into the bathroom and say "hey, you've got a little shaving cream on your neck" and then grab a wet face cloth and wash his face, then head, neck and ears. If it was going ok, I'd say "oh no, I got some on your shirt, let's put a nice clean one on" (I'd already have everything ready in case it was a go). I'd help him off with his shirt and attempt to get the undershirt off too, again usually telling him that it was dirty or had a hole in it or whatever would work. If it meant "accidently" smearing some shaving cream onto his shirt, I'd do that too. I'd then either use the wash cloth or the pre-moistened bathing cloths and at least get his upper body done. He would never, ever let me do his privates. If by chance when going to bed, he decided to take his pants off, I'd again have the pre-moistened cloths ready and wipe down his legs and feet. If he was ever willing to change his underwear, I'd leave a wet wash cloth and towel next to him and ask him to wipe his privates after I stepped out of the room (sometimes it worked, sometimes it didn't).

Anyways, in the 2+ years that dad's lived with me, I've personally found that there's no forcing the issue or repeatedly pushing him to wash, change clothes, undress for bed, and it certainly doesn't work to explain or try to reason with him why he should - that just gets him upset, anxious and irritated and angry - all the behavoirs I try to avoid at all costs.

Now my dad's on Hospice Care and a home health aide comes in twice per week to wash him. It has to be a male aide. My dad absolutely refuses a female aide. I once tried putting on a lab coat and impersonating a nurse - didn't work. The male aide presents himself as a "doctor" telling my dad he's come here to give him a check-up. (my dad was in the Navy for 10 years and readily accepts 'authority' figures). Even still, sometimes the male aide encounters resistence when asking my dad to remove his pants. When this happens, I've instructed the aide to back off trying to do everything and just maybe do a shave and head wash, if this goes ok, move on to upper body. If my dad does take his pants off, the aide needs to make sure his lap is covered with a towel. If my dad won't let the aide wash his privates, give the wash cloth to my dad and ask him to do it, while aide supervises. In other words, one way of doing it won't work all the time. Whoever is going to handle the washing has to be prepared to try different approaches, has to recognize when to back off and perhaps even step out of the bathroom for a few minutes. Very rarely is the aide unable to fully wash dad, sometimes it can take up to an hour to get it all done, other days my dad will strip down, let the aide do everything he needs to do and be done in 20 minutes.

Sorry to ramble on, but I so identify with what you're going through. Judging from the condition of my dad's boxers, I knew he could no longer wipe himself properly and thoroughly, so was very concerned about 'butt rash/irritation' and I'm guessing you're probably very concerned about the same thing. Please feel free to ask about any other specifics or if I can offer any other suggestions as I've gone through so many different scenarios when it's comes to getting my dad cleaned up.

I also fixed the tub for safety. Covered the bottom of tub with anti-slip strips, installed 2 grab bars, got an adjustable hand-held shower spray as well as bath chair. My dad did get in the shower about every 3rd time with the male aide here, but that hasn't happened now for the past 3 or 4 months. A shower or bath would still be ideal, but that's not going to happen anymore - and it's not like he's out digging ditches. So my feeling is as long as he's being cleaned and freshed up and his skin/private areas are being checked on a regular basis, that's as good as it's going to get and that is good enough!

caprica Aug 2012
Oh, my dear! For sure then - see if social worker can help get assisted living arranged before you get back to work so that will all be squared away. All the best!!

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caalimenti Aug 2012
Thanks again for your reply. I am an only child and I have no relatives.
I am the only caregiver and family that my father has. I have had to make all
the decisions on my own with the wonderful help of a social worker.
I go back to work in a few weeks. I've been caring for him for over 8 years.
I'm thinking that it is time for assisted living. He is so stubborn and argumentative.

caprica Aug 2012
Thanks for additional info!

In this case then, since you will not be able to reason with him because of the dementia - you can try letting him know that the Doctors and Nurses have expressed concern about his hygiene and in order for the State not to consider him being neglected, you have to have a printed sheet for a weekly record of showers (tell him can be every other day - or three times a week at least), brushing teeth daily, etc., to show the Dr., and you have to have the aide come back again to help him with the shower, or be on hand if he wants to shower himself - but that the Doctor said the bath aide or Nurse has to sign sheet that they have showered him, or were present and on-hand to help with shower if he choose to shower by himself, otherwise an assisted living facility will be something the Doctor has to discuss with the family. to make sure he is where this can be done, if is not being done at home.

Try this and let us know what happens. If you have other family members or a spouse that can be present when you do so - would help diffuse any resistance or push-back if may be an issue.

All the best!

caalimenti Aug 2012
Thanks everyone! My father is 97 years old and has dementia. He is very mobile, uses a cane and has not fallen. I had a home health aid come in to help him shower but my father refused. I had my father in 3 days respite at a nursing home and the nurse there also said that he also refused to take a shower. My father will 'lie' and tell everyone that he already took a shower. I worry about his skin and odor. Not sure what else to do...Thanks again!!

aberry Aug 2012
Yes, we need to know what his health is like. Does he have dementia or parkinson? Has he fallen lately? Observe and ask questions and see why he does not want to bath. Could be he is scared of falling, or even that he forgets how it is done...

caprica Aug 2012
Hi Caalimenti!

What is his condition - health/mobility? Depending on situation, he may need prompting, or someone scheduled to come help him with showers.

This was an issue for my grandfather, and we got him a male bath aid, which helped him feel more comfortable - plus it was scheduled, so we would always say "so and so" will be in next morning for shower time, and remind him in the morning so he could mentally prepare himself on days he wasn't feeling so up to doing anything...encouragement to use cycle exercisers and short walks - and when bedridden, just had to go with sponge baths. Eventually we broke in female bath aides too, and after a while either were fine with him, including family members.

Grandma and other female relatives for sure much easier on issues like these. I think for guys who are used to "handling or fixing things", more of a struggle and adjustment gap when their bodies, minds, health decline.

Let us know more...all the best!

JessieBelle Aug 2012
Tell us a little more about your father. Is he able to stand without fear of falling? Is he able to bathe himself without assistance? Sometimes when someone has dementia, you have to tell them they are going to get a shower, then get things ready for them. They can also take "dry baths" if someone knows how to given them, but these don't seem to be as good as the normal showers to me.

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