Mom is living alone in her home of 48 years and seems fine. But I'm wondering if she's brushing her teeth or bathing and she resents concern.

Toni, you say she was diagnosed with Alzheimer's 3 years ago and eventually you and your husband will have to move in and hopefully the communication will be worked out by then. That ship has sailed, she will only continue to get worse.

I am actually horrified that she is living alone and you are giving her broken brain the decision making authority.

If someone can't move in, like today, you need to find a facility. She is a complete danger to herself and this is really a negligent approach. There are a thousand pitfalls in a home for someone that has no short term memory and other things going on, which you would not know about because she can't tell you. Alzheimer's robs more then short term memory, people lose the ability of doing things, they can't remember how to brush their teeth, they can't remember what the toilet looks like, they may or may not eat or drink, medication, forget it dangerous and should be managed by someone else.

Please don't let another day go by without putting a plan together to get your mom the care she desperately needs.

I deal with this question almost daily in my work. I see my clients daily so I can check things.
1. Teeth - check the toothbrush & toothpaste. Brush will be wet. If you keep the Past a certain way you will know if it's been moved or squeezed.
2. Bathing - Towel will be wet, same with bar of soap. Again be very observant. Hang a clean towel for her or fold a certain way. You will see if it's been moved.
3. Clothes - Put clean clothes out
4. Body - Seniors only need to shower etc. 2-3 time a week. Yes, they must keep botton are clean daily. That trick is keeping Wipes by the toilet.

The most important thing with your question is be very observant. You will get alot of clues from that.

Re the teeth brushing and bathing - so what? this seems more like your concern than hers. She doesn't have to have a bath to keep clean and hygeinic. You do not say if she has a shower available or only a bath - in which case she may be very uncertain of it being slippery or having to climb over the edge safely. The no short term memory is more of a problem, I don't see quite how you can say she seems fine but has no short term memory. This is what ensures she is safe, doesn't put cooker on and forget it, or walk somewhere and forget where she has come from. It sounds as though she needs an assessment and whilst I agree 95% with gdaughter you should not force her to do things because you think she should, (after all what is the worst that can happen if she doesn't brush her teeth or have a bath?) I do think you need to force her somehow into having an assessment. This maybe making an appointment for her, it maybe telling her the appointment is for you but you want her to come along and working with assessor to go along with this and ask her questions whilst seeing you, it maybe getting someone to come to house with you and doing it there. Until you have that it is hard to be sure how much is your concern and how much is really a problem. I got round the bathing problem with my mother - although she wants to but I cannot assist due to back problems - by arranging for someone to come and assist her to just be there in case of a fall, and slowly then introducing the cleaning - not going to work for everyone and no use if she needs more than once a week or whatever care, but it was a way of getting someone in which she could see sense in and having an outsider's view of her condition having done so. Hope you can work something out.

We're going through the same thing...very early in the process. Be very careful of who you hire and make sure you are assured the agency or you yourself if hiring privately do a background check. As I had been told, (and my mom is very similar to yours) while they may reject family helping, they may be more open to an outsider. We had an aide over to meet us all, very low key and agreeable with no mention about the shower/bathing made. I expect if they hit it off, over time the aide can encourage/suggest. If that doesn't work I don't know that we would continue considering the rate is $22/hour typically a 4 hour minimum. If you have the aide come anyhow, to do the other tasks, your mom may get used to and warm up to her. The agencies have more experience doing this than we as family members so they can be helpful. The teeth brushing...I know...my relationship with mom has been antagonistic. Short of standing there, let alone getting her in the bathroom there is no way to deal with it. Its just an unfortunate battle that we may have to accept losing with this disease. If you can get her out, maybe schedule more frequent DDS visits for routine cleaning. We sometimes struggle getting my mom to get her out, but once out, she is like a duckling following others and agreeable and cooperative....

Make a dental appointment.
Tell her you and she are going out for a ride if you think she'll resist going.
This behavior could also be from depression.
Has you mom had a medical work-up recently?

Do what you need to do. Expect resistance (and anger). Be psychologically and emotionally prepared.

Dementia, from the point of view of the person inflicted, means they experience new situations, people, changes very differently than "we" do. Read Teepa Snow's website - about bathing. Teepa is the country's leading expert on dementia. (Whether you mom is diagnosed with it or not, it is one of the signs - not wanting to bath.)

If she is living along and has NO short term memory, she is not fine. A pot left on the stove too long is eventually going to happen if it hasn't already. It means that a shower she took 2 weeks ago could be fresh on her mind today and she actually remembers taking one. Going over very early before she gets moving around too much in the morning is a good time to say, why don't you hop in the shower and I'll fix some breakfast. If going daily is not something you can do, get the home health person to go early and do same as previously discussed. While she's eating, sheets can be changed, refrig, etc. Most dr ordered home health (when disabled issues) is 2-3 times a week. Someone needs to be looking in daily to see what's going on. You can't really count on her telling you she did these things because, in her mind, she may think she did. Explain, this help is to help her stay in her own home.

She may respond best to a non-family member.

Tell them you want her to feel like she is getting “spa treatments.”

I am going to be blunt. Your mother does NOT want the feeling of being supervised or controlled and you have no way on earth of knowing what she does or does not do unless you are there watching her. It is sad, but if she doesn't do basic things, she is going to develop problems. You can sit her down and explain it but I doubt things will change. So what I would do is to tell her YOU are going to oversee her care with a caregiver or whatever you decide to do. If she rebels, and she will, tell her that you will then place her into a facility where she will be controlled 24/7. She has just those two choices. But you have to be very tough and firm - and do not think of taking her in with you. I fear what will become of you and your life if you do that.

You could be talking about my Mom! Her ? independent living got so bad that she came to live with my husband and me 1 1/2 years ago. There have been challenges.
Unfortunately bathing is a big problem. She thinks she showers daily but its more like once a week. She gets nasty when I try to make her shower. The UTI's have been a problem. She absolutely refuses outside help.
Sometimes I resort to bribing her. Like, after you shower, we can meet so and so for lunch. Sometimes I suggest bringing her coffee upstairs to the bathroom so she doesn't have to navigate stairs twice. I have not even attempted the teeth issue. She has dentures so I guess she takes them out to clean occasionally. I have the supplies there. So sad for her.

This was my mother! She had "low vision," aka legally blind. One time when I was " on vacation" [insert - yea, right - never sat down], she comes to me & says "I want to brush my teeth, but something's not working." I told her it would help if she removed the cover off the tube of toothpaste. Your elder may be tricking you. And why? Answer - because they don't want to lose their independence. Your mother is NOT the only one who gets angry - most do.

This sounds like my mother. And I live with her.
She would not let me help her with bath, personal care.
I have hired an agency to send an aide in four hours a day weekdays. The side cleans her up in the morning, gives her a shower, gets her dressed, walks her, talks to her, etc.
I can handle the house. I can't be hit and punched while caring for her. So while my siblings balk at the cost, this is a Godsend.
And I get a few hours out of the house, which helps me.

tonipoindexter;

As ShenaD pointed out, if you don't live there, you really have no idea what she does or doesn't do! I discovered after we took mom's car away and had to provide food or trips to grocery that she wasn't cooking anymore. She was eating mainly frozen dinners and packaged foods like graham crackers and fruit cups! Even her beloved muffins, which she would cut in half and freeze for later were not being eaten, as she'd forget she had them. Worse, she resorted to cutting up grocery bags to wrap them up although she had more than enough plastic wrap, tin foil and freezer baggies!!! If I didn't leave enough trash bags in the bottom of the trash can, she'd use grocery bags there too (much too small!) She would ask for more paper towels, TP, plastic wrap, etc and stash them away and forget she had any!!

Our mom lived alone and wasn't close enough to visit daily (more like every other week.) She also had short-term memory issues, mainly repetitive questions or statements (the first inkling I had, but in retrospect there were some other minor subtle "clues".) However, once you really get involved you realize it is worse than suspected (see above!)

We also tried the home aides, with plans to let her stay in her own place as long as possible. It can't hurt to try, but be aware that all too often they will reject this "help." We started with 3 days/week, 1 hour (the minimum offered) and all they had to do was check she took her meds and ensure she was okay. One was definitely more "industrious" and would sweep the kitchen and/or clean up the bathroom. Mom would get embarrassed or something and either try to get her to stop or would contribute. I didn't really care what they did for the hour, so long as the meds were checked (used a timed locked dispenser) and she was okay. We upped this to 5 days/week, but in about 2 months or less she refused to let them in! That ended that plan.

Time for plan B. It took us time to find a place we liked, and the one we chose was still in the rebuild phase, so we had to limp along and wait. Moving her was another challenge!

Is it possible for one of you to stay there for a week, maybe alternate you and your daughter so it covers 2 weeks? Then you will have a much better idea what her real needs are. Use an excuse, maybe like you're having work done and need a place to stay for a week. Don't offer to help or do things she doesn't seem to be able to right away, just monitor (of course you can work together on making meals, cleaning or whatever, just don't take over - you need to see what she can and can't do.)

Once you have a better idea of what all her needs are, you can look into hiring someone, but be prepared for refusal. If you are lucky, she will be okay with help. As others noted, neither you nor the aides can force her to do anything, but if the aides are any good, they can coax some people to accept some help. If she is like some and refuses help/aides, you will have to start planning for another solution (AL or MC.) Mom's self-image/perception was certainly out of whack - she and your mom might THINK they had bathed, brushed, cooked or what have you, but in reality it was weeks ago! Mom considered herself fine, independent, etc. and would tell you or anyone else she was, but she wasn't. Even now I had to resort to cutting the size tag out of new clothes, because she wouldn't consider like/dislike, she would look at the size tag (Oh, that is too big, I usually wear a medium!)

Towards the latter part of her living alone, we had some cameras installed, to monitor the door and downstairs area - observing to be sure no one gets in, she didn't wander and could see now and then she was okay - while watching the video clips, I noted she started wearing the same clothes over and over, even up to 6 days one week! This was NOT her norm...

If you want to prolong her ability to stay in the home, get a home health aide to come in regularly. At first, you should be there with them since it may be asking too much for mom to accept a stranger in the house. Have them do things around the house like make a snack for mom, vacuum, mop the floors....anything that improves the home environment without getting too personal. After the person leaves, point out one or two lovely things about the caregiver or what they provided. Reinforce the positive. Brainstorm a short list with her on what the helper can do for her; no right or wrong answers, no arguments. Post it on the fridge. After mom adjusts to a outside person being in the home, then, you can work to improve her self-care mainly nutrition and bathing. In otherwords start small and work toward bigger goals. Don't expect very much until she adjusts to this new arrangement. Your mom has been independent for most of her life and it is a big adjustment to let people in. Mom and dad were not open to outside help. I found a fantastic helper (the second one to try; the first didn't work at all) She understood how to slowly and respectfully provide more care. For example, she noticed that the blanket on the back of the couch was in dire need of a wash. She kindly asked if it would be all right to launder it. Mom, thankfully, agreed. We oohed and aahed over how beautiful and "like new" it looked! Small success, yes, but it provided one piece of a foundation of trust and kindness that allowed for her to be effective. In my parent's case there was more than one caregiver involved. Some worked better than others with mom and dad so I found that it helped to keep a daily log for all caregivers to write down what was accomplished each day and address any concerns. We were quite a team! There are other issues concerning short-term memory deficit. These were addressed as well. A med machine was brought in. Mom got lifeline; I would suggest the type that registers a fall. I bought mom a Keurig and a microwave and posted simple instructions by each in large bold type. I also taped a clear message on the kitchen table that she remain in the kitchen while preparing anything. If she isn't quite that bad memory wise, a loud timer that can be worn around the neck can be set to remind her of her cooking task. Sometimes, it isn't just memory issues, it's hearing deficit. Tooth brushing is trickier but again, I posted a reminder on the bathroom mirror to help mom remember. Lots of hearts and smiley faces, not admonishments:)

Great idea on the home assistance! My father stopped brushing his teeth, and refuses to do so. I've tried the swabs, the wisp brushes, and mouthwash. Unfortunately his teeth are now breaking. His fillings are so old that we would need significant dental work to even attach the bridges for the broken teeth. Anything you can do to at least encourage the mouthwash will be very helpful!

As to brushing her teeth - just check her toothbrush - if it dry as a bone then she isn't using it but if it is damp she is - a simple check like this is easy

As to bathing - put something in her towel as it is hung up & if it still there she hasn't used it - maybe a wash cloth or a sock so that it looks like it was hidden when the towel was folded

Then when you have your information you can either drop the issue or go on to the next phase - if you think you want to hire someone & you are paying for it then give it a gift [which it basically is] with a card etc for whatever occation you can find

I agree her personal hygiene isn’t the biggest problem. What if she forgets a pot on the stove and starts a fire? Or like in my mother’s case , eating 3 week old meatloaf(🤢) .
My stepfather forgot how to brush his teeth about midway thru Alzheimer’s. My mother has vascular dementia and refused to shower at home pretty early on. I think she was afraid of falling but now at the ALF (with more advanced dementia) claims she can do it and has never needed help( not true lol)
I didn’t notice your location but 24/7 in home health care in my area is double cost of a very nice ALF .
Truthfully, there comes a time when their judgement is so faulty you can’t allow them to make the decision. Imo safety is much more important than pride.

This happened with my MIL and she was diagnosed with Alzheimer’s shortly afterward. Get her legal paperwork in order immediately and start looking for care in a facility. I’m sorry to say...someone who bristles when you tell her she needs to bathe will not get better with this. My MIL is in a memory care assisted living facility and she very much resents being told she needs to bathe or brush her teeth. I think she is embarrassed by her lack of competence and does not want to be called out on it. My MIL would not accept help from anyone in her home.

I hate to say it, but this sounds just like my mother at the beginning stage of dementia. My mother would get angry if I mention that she needed a shower, cleaning out the fridge, and I notice that she wasn't doing the dishes (she has a dishwasher), then she started letting in stray cats in the house. Ugh!


Sounds like dementia:(
Just my 2 cents!

You don't say how old Mom is, but I'm guessing she is eligible for free HomeHealthCare and they will check on her weekly (I believe her physician must request the HomeHealth) and you will get a better idea of how she is doing.

We had it for my Dad and later for my DH and I was always thankful to have an extra pair of eyes on them.

I have concerns that brushing teeth (or lack thereof) is the tip of the iceberg here. Loss of short term memory and beginning to neglect daily activities such as brushing are HUGE signs something is amiss. If she'll let you, it may be time to partner with her on some issues. For one, start making sure finances are in order, look into legal paperwork (health care proxy, living will, power of attorney) before there is further degradation. If she doesn't allow you to help, it may be time to exert covert actions on her behalf. How you approach it depends on her reactions to the initial discussions. Read, read, read - starting with all subjects on this forum. Note the "tags" that applied to your original post. Each is a link that will bring you to more information on each topic.

I fear for you and your mom that significant changes are coming, sooner rather than later. As much as possible, plan now to get ahead of them. Because when the time comes, you may be in a state of panic to be able to be helpful. Good luck to you.

I go through this with my mom every now and again, I try to be as tactful and sensitive as possible while also stating that we can't smell ourselves mixed into the conversation.
You can't force them all that will create is resentment as much as I hate to have to say it this way truth be told you have to kind of get down to a child like level and make them believe they're doing it is all their idea, hopefully just leading them will cause them to deal with it otherwise it maybe time to have mom Evaluated by her Doctor I'm getting ready to go through that with my mom and it's taken me awhile to get her to understand the Evaluation doesn't mean she's leaving her home, I'll still be here to take care of her, for me it's mostly legal issues I want to avoid down the road, and even more importantly there maybe medication that could help, that Evaluation process is the beginning and it really needs to be done when any question of mental health is being raised.

Seems fine... has NO short term memory.

Um. What do you mean by "fine," then? And how long is it since you noticed this falling off in her ability to care for herself?

Se prob isnt eating also. I thought my dad was doing fine until he moved in with me. Then I realized he wasnt eating, bathing, was dehydrated, had been falling down, forgetful, etc. He also still isnt bathing or cleaning his mouth. A home health wont do any better because they arent allowed to MAKE someone bathe. I can get my dad to take a shower (I know he doesnt wash, just gets wet) about once every 3 or 4 months. I have to clean his teeth. There is a DDS mouthwash that costs about $9 if she will rinse. Its a godsend. Theres are the mouth swabs like the hospital uses. I clean his dentures for him. They will NOT do these things. Someone has to do it for them daily. An aide can clean teeth but thats about it and they do a crappy job or skip it altogether. As soon as my dad refused what an aide offered the aide would quit. I went thru 4 aids in 3 months and now I am his aide. I got hired by a company and I get paid for what I was already doing. Aides, in general, are a migraine. They are extremely unreliable, untrustworthy, mean a d unsanitary.

You don't say at all how old your mother is or whether she has memory issues in addition to the short term memory problem. I think it would be very good for you both if you were able to get someone to go in to help her with bathing and do some bits around the place. Once a week sounds good to start with and you can see if more is required as time goes on. I think that if you can discuss the possibility of not being wanted with the potential assistant then you should be able to work having a one off visit, and then the next week if mum has forgotten they went in you can "play" the "yes you do know her, she comes to help you bath/shower now that my back is too bad for me to help you" etc. Sometimes a lack of short term memory can enable us to achieve more in sorting out outside assistance.

If you think you are likely to get resistance from mom on someone coming in once a week maybe you could try giving it to her as a "gift" or having someone else give it to her, kind of like giving someone maid services. It might even be better received if it were an older relative gifting this, someone who knows what a luxury it is to have help with these things. I do think it's hard for many of our parents as they age to have their children bathing them and it's easier to accept from a "professional" like one would in the hospital plus they have the added benefit of experience with the best way to accomplish bathing while maintaining the patients dignity. But I also think having someone to come in to help and take the burden off of mom, "pamper" her because she deserves it is a great idea if you can swing it.

Thanks so much for the encouragement and ideas. Bananas are the only fruit she eats. But I'll slice up an apple in really thin slices and see if she'll change her mind.

I think it’s wonderful for you to hire someone for your mom.

My mom was extremely modest and for a long time would not allow me to help her bathe. Of course I had safety bars installed, mat in tub, etc and I listened for her but after awhile when I noticed her struggling more with everything. I insisted that she allowed me to help her bathe.

Now I have respite care help out too. She got used to having help and now truly appreciates it.

It’s hard for them to give up their independence. Also, that generation is extremely modest so they are initially embarrassed by having someone else help with private matters.

Hygiene is important. You don’t want her to get a UTI.

tonipoindexter, I think that is a great idea of having a home health person come in to help Mom with certain things. It's amazing how an older parent will take the suggestions of someone in uniform, compared to taking suggestions from their own children. Then again, we are just the "kids" and what do we know? :)

Now, will your Mom allow "strangers" into the house? That seems to be a common battle. My Mom would refused. Dad, on the other hand, would be holding the door open for the caregivers to come in to help him. Hope your Mom is the latter.

As for your Mom bushing her teeth, that's tough. Sometimes we need to pick our battles, and teeth bushing is usually down the list. Can Mom eat apples? That's nature's tooth brush.