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Sandy5691 Asked May 2022

I've hit a stalemate with my father over hygiene issues. Any helpful suggestions?

My LO with undiagnosed dementia goes months without showering, or even changing clothes. Yes, I know all the reasons and yes, I've tried every imaginable support, modification, encouragement etc. You name it, I've tried it. Nothing has made one bit of a difference. He insists that he showers when I leave the house. He doesn't. I tried upping my game and putting some pressure on him. He got angry and said I'm exaggerating and that I don't know what I'm talking about. Total stalemate and I don't expect it to change. His clothes are soiled. He stinks. It has been this way for at least a year.


How do you resign yourself to such poor hygiene being the norm?? And how do you let these power struggles wreck your relationships?😔 He would never in a million years have allowed his own elders to be so neglected.

BLeks2021 Jun 2022
This may or may not work, but sometimes asking a person with dementia for his/her help can create a more pleasant mind set. Could you ask Dad to help you with an experiment? You could propose to Dad that you would like his opinion on new skin cleansers for yourself. Have 2 bottles of no-rinse body wash and ask if he would use one on each hand/arm/underarm so you could see on someone else (him) how well it cleans. You would need to come up with a plausible reason such as you are preparing for when water restrictions come around. If he does it, gently offer to get him a clean shirt from the closet. Next visit, 2 different products for legs and feet. Private parts may be a challenge, but you could say, using the water restriction angle again, that you really couldn’t ask a friend to help you because it would be embarrassing. Of course this could take multiple visits, but breaking it down to certain body parts for each visit and asking HIM for the help could work.

NancyIS Jun 2022
Sometimes men are more willing to let male aides assist them with showering, etc. Connect with a local social worker to see if your husband is entitled to in-home aides, and what other things he (and you as his caregiver) might be entitled to. Hopefully your husband will accept them. His undiagnosed dementia may make that more difficult. But before you do any of that, make sure all of his paperwork is in order (hopefully he is still able to sign legal papers if it is not). He needs to set up powers of attorney for medical and financial matters, a living will with his advance medical directives (such as "no rescusitation", as an an example), if he is still capable of thinking about and communicating them, and a will if he (and you) have assets. You should do the same, if you haven't done so. Most financial institutions have their own POA forms as well, and you need to be on file with Social Security and Medicare to speak on his behalf. You can do that with a phone call, while he is sitting next to you to respond to their questions. You have to make a Plan B, in the case that his dementia gets worse and you are no longer able to care for him. Sadly, dementia is likely to get worse over time. My mother had advanced dementia and was unable to walk, speak or feed herself at the end. Even though she was small and didn't weigh a lot, she was a dead weight at the end and it took two aides to lift her from the bed to the wheel chair or geri chair (a very supportive chair on wheels that reclines). I like the idea of just taking his clothes away to wash them when he goes to bed. Also see if you can get him to switch to adult incontinence underwear, if you want to go with disposables. All the best to you both!

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Moxy234 May 2022
I went through this with my dad (he had undiagnosed dementia) and found it so hard. I tried everything and there were times we would argue and I regret that. He did have a shower afterwards but it wasn’t the answer and I wish I’d found this forum for advice.
i think making the shower feel safe is key, you could try water shoes like Lea said. Towards the end, dad had bed baths by his carer and that worked a treat. It became part of dads routine and they were brilliant.
good luck x

Taarna May 2022
Hygiene needs to be part of his usual schedule. Instead of asking him to bathe, tell him is is time to bathe - same time of day, every day. Make sure to take soiled clothes away and put out only fresh clothing. He will fight you on this until it becomes part of his usual routine. Might talk with doctor about antianxiety medication to use while he is transitioning to this new routine.

ACaringDaughter May 2022
You have to strategize like he is a young child.

Offer treats. Offer outings. Stay firm. stand behind the deals you make. Don’t go on that drive or watch his favorite show together until he complies. When he falsely tells you he took a shower, tell him kindly, “you need another one.”

Go shopping with him to get his favorite smelling soap. Pick something that he chooses so he feels “in charge” like the “man of the house.”

Bath and Body Works has some excellent products. They have a line designed for men. Even the drugstore has lots of great choices that he can make - to give him back a smidgen of power and control over his life.

Play his favorite songs while he’s in the shower. Encourage him to sing along. Let him watch a show he likes while soaking in a tub. He will start loving the experience of getting clean.

If all else fails, hire a CNA to come occasionally and assist him with his hygiene. Make sure to find the right person with the right temperament so your dad does not feel humiliated.

It was uncomfortable for me to help my dad in the shower, so I hired a man to help with this. Dad was much safer also. He took dad for a skill-level-appropriate short “work out” first, to maximize the benefit to Dad. Dad felt better all around.

My Dad had been gone now for years. I really miss his smell, even when it wasn’t ideal. ❤️

Beatty May 2022
Did you brush your teeth son?
Mmm nodding.
Why is your toothbrush so dry?
It didn't get wet! I see.
Please brush your teeth now.
OK. But doesn't.

Same.
Needs a 'Mother' to stand by & keep directing or physically wash him.

An aide (the more no frills matronly type the better) can set the pace with a Right, let's get you washed up then.

BlueEyedGirl94 May 2022
We were blessed to be able to get a bath aides through the VA three times a week. Otherwise FIL just stopped. He started getting yeast infections especially around the areas where the Depends meet skin. He's a 300 pound man and as far as we know if there is any dementia it is very early stage because his primary doctor insists he's just fine. So the reason for not showering, we just couldn't get it out of him. Best guess was that he had some fears, got tired easily, some laziness thrown in because it took too much energy and it was just easier not to. But dear God the fight when the bath aide first started (now he loves her). You would have thought we asked her to flay him alive. Every single thing we asked her to do of course she had to have HIS permission and he didn't want to give it. In fact for the first few weeks he wouldn't even let her in the bathroom. And then he wouldn't open the shower curtain. And then he wouldn't let her touch him (we considered a male bath aide but that went over like a lead balloon. He had other biases there). She has been coming for over a year now and we are finally down to the sacred final frontier. The family jewels and his backside. He is a "private man" and will not let her touch those. We believe he has concerns....because she is a very young woman. So we leave him that dignity and won't fight him on that for now even though the biggest reason he really needed the bath aide in the first place is for safety. At the very least she can tell if he is getting himself clean when he isn't looking and he doesn't have to try to stand for very long to do it.
I think it is different for each person and you have to tailor the approach. For us, until we realized we could get the bath aide we had to be content to get him to take a shower periodically and before doctor's appointments at the very least. He doesn't get out much. But we put our foot down on not letting him leave the house unshowered. And on some level HE knew that he had to smell bad even if he didn't smell it. Because he had a habit (a very bad habit) of dousing himself in this very strong, very cheap cologne/aftershave periodically so maybe he got a whiff of himself or maybe he just knew instinctively that after a certain point he probably must have an odor and he probably needed to mask it. In any event, THAT made it worse.

cignal May 2022
i've already answered but just wanted to add that compassionate lying may be necessary on your part; something like intentionally spilling something on your dad that he can't just let sit may help to get him out of his smelly clothes, and while he's changing, have an antibacterial wipe on hand and some gel deodorant. this worked for me a few times with mom. when she allowed me to help her change her clothes i had wipes on hand and said while we're doing this let me just wipe your underarms, and then i loaded her up with the gel deodorant (gel because it smooths on so easily and you can really load it up) and that gave us several days of mom smelling better, at least on her top half. when approached directly with a request to shower they will always refuse, but when something happens in the moment they are less likely to.

MargaretMcKen May 2022
Smell – it’s true that elders can’t smell their own body odor when they live with it all the time. People who live semi-traditional lives in desert conditions don’t waste water on washing. They all smell the same, and don’t notice it. In town, social distancing works well!

I worked as accountant in a factory that made leather jackets, and after a year or two I couldn’t smell leather. I miss it!

If father takes any clothes off to go to bed at night, sneak in and grab them, substitute clean ones.

If it all really bothers you, toughen up. So he gets angry – so what? He will also get hungry if he doesn’t get a meal until after he’s washed, and that might change things.

This will get worse, probably for years. Sooner or later, something is going to ‘wreck the relationship’. What is your sticking point?

Natasana May 2022
My mom 86 had an odorous netheryaya and hinterlands situation. She could not smell it herself but others could. It was made worse because she wore pullups. She resisted taking showers for various reasons primarily she didn't want her hair wet, she didnt want to get cold, she was afraid of slipping. The easy answer was a sitz bath, using what looks like an upside down cowboy hat placed on toilet bowl. I fill it with warm water and about a tablespoon baking soda. Mom pulls down her pants and just sits on the bath a few minutes. No scrubbing, no soap, no drama...just a soak. The baking soda takes care of the odor and soothes irritation, the warm water rinses away whatever is there. You just pour the used water in the toilet when done. She can pat dry with a hand towel and then pull up her pullups and pants. No fuss no muss. Works like a charm for us mostly. You can find plastic sitz tubs on Amazon. Mine cost under $20.

lealonnie1 May 2022
You can watch Teepa Snow videos on YouTube; she is a funny & informative dementia expert who has wonderful tips on bathing elders with dementia using a hand-under-hand technique to allay their fears (among other things).

https://www.youtube.com/watch?v=7OLrilAeT1U (Teepa Snow Bathing Video)

https://www.google.com/search?q=teepa+snow+hand+under+hand&oq=teepa+snow+hand+under+hand&aqs=chrome..69i57j35i39j0i512j0i22i30j0i390l3.5919j0j15&sourceid=chrome&ie=UTF-8 (General Teepa Snow videos)

Not wanting to bathe is a typical issue elders have when suffering from dementia, due to a variety of reasons. Your LO may honestly believe he 'just showered' or not realize he has body odor, or a million other 'ifs' can be at play with a broken brain. My mother lived in Memory Care AL during the last nearly 3 years of her dementia journey, so the CGs had no problem getting her into the shower. Now I, on the other hand, probably would have had one helluva problem doing so! LOs tend to act a lot worse with their caregivers who are relatives than they do with 'strangers' who are their caregivers.

I will tell you that my mother became a bit combative at one point with taking a shower; she was insisting the shower floor was 'slippery'. Nothing worked to allay her fears, until I had a bright idea to get her a pair of water shoes from Amazon. Like those you'd wear at the beach. Those did the trick for her. But I realize that there are 1000 other reasons demented elders won't bathe, fear only being one of many.

Try hiring someone to come into your home to give your LO a shower; a same-sex CG might be best. And don't give your LO a choice in the matter; the CG should be firm and matter-of-fact about NOW is the time to get into the shower Mr/Mrs Jones, so let's get ready.

The bathroom should be kept warm also, in case your LO feels cold and is not wanting to shower for that reason. With dementia at play, diagnosed or not, you just don't know WHY they won't shower b/c logic and reasoning escapes them now so telling you 'why' isn't an option (most often).

Here's a good 33 page article to read called Understanding the Dementia Experience which does address hygiene and bathing:

Understanding the Dementia Experience, by Jennifer Ghent-Fuller 
https://www.smashwords.com/books/view/210580

The booklet is a free download.

Best of luck!

Sample May 2022
I have a similar problem. My wife is in a wheel chair after a fall and other issues. After returning home she refuses to take a shower she stinks because she wets her diaper. I have tried everything to get her washed but it always leads to a fight. I have equipped the showers with every aid you can think of and will help
wash her. It is hard to be close to her because of the hygiene issues.
any suggestions how to persuade her to let me wash her?

Countrymouse May 2022
"What's wrong with them? My hands aren't dirty!"
"Well. If my hands looked like yours, would you want me to touch you?"
Client walked to the kitchen sink and scrubbed his hands with soap and a nail brush up to the elbow.

Mind you, I wasn't thinking when I said that to him and I felt bad about it afterwards - I didn't mean to make him feel ashamed.

But sometimes a blunt "that sweatshirt smells to high heaven! And if there aren't things living in it it's only because they've walked out in protest" is better than trying to be nice (and as a spouse you're allowed to say it).

We have also had absolute failures, when nothing we could try made any difference and we had to admit defeat.

Could you get away on your own for a couple of weeks, try leaving him in the hands of an experienced aide, see what happens? If nothing else at least you'd get a break!

Midkid58 May 2022
I had this issue with my FIL at the EOL. He was exahausted all the time and his 'not so perfect' hygeine had gotten worse. He was bowel incontinent and wore thong style underwear. You do the math on that.

My DH didn't want to rock the boat, so he wouldn't support me in getting dad to bathe (shower). This was almost 20 years ago, and I am MUCH tougher now.

I finally told him he would be going NOWHERE if he didn't minimally do an 'undercarriage wash' and put on fresh underwear. No more thongs. Also the pants he's take off that were soiled and gross weren't even attempted to be washed. He wore new ones.

I understood that a shower was daunting to think of taking. Sometimes I'd get in there with him, allowing him the dignity of leaving the thong on and then taking it off at the last minute to clean. I bought highly scented soaps (I remember Irish Spring, it had quite the pungent smell).

He was never a super-groomer, but as he aged and was so tired, he just couldn't. I did a LOT of 'bed baths' but nothing gets the privates as well as a good shower.

I did figure out to enlist the aid of his oncologist, who would tell him to listen to me--and maybe he was a little afraid of me, IDK.

Dad loved to eat out, at least once a day. The way he smelled had people asking to be moved away from us. He also would have blowouts in restaurants. I cleaned up more than one mess and then tipped the waiters, etc, enormous sums of money for the fact they had to disinfect the whole area.

We were never successful in getting him into Depends. The MidKid who cared for him is not the same MidKid. I've learned a lot. Fecal matter stuck to delicate skin for days on end is irritating and miserable.

I suppose had he still been married this would have been his wife's problem, but he had been divorced from DH's mom for 20 years. It was up to SIL and me.

I was always respectful and gentle, but firm and wouldn't cave on the absolute necessity of him showring 3xs a week, or as needed and not going to restaurants in dirty clothes. It was for his dignity--and I alwasys respected that--but it is still a memory I don't cherish.
Cover999 May 2022
Blowouts. LOL
cignal May 2022
this was one of the reasons we put my mom into memory care. we couldn't get her to shower or change clothes and she got combative or claimed we were being mean when we tried to insist. she said she couldn't smell herself and was shocked when we told her we could. but still wouldn't shower. she would do it if she had a doctor's appointment to go to, but even then she didn't do a very good job and still smelled bad when she came out of there, and wouldn't let us help. now she's in a facility and she is clean and wearing fresh clothes every day. the first week or so she said they were "mean" there but i know all they were doing was making her actually get out of bed every day and shower twice a week. i am grateful they were willing to be "meaner" than we were and broke her of this habit. she now is used to it and doesn't complain. she's not happy to be there and asks to go home every time we see her, but she doesn't complain about not being able to sleep all day or never shower.

Loralovesbread1 May 2022
He needs to be diagnosed with dementia by his physician and a neurologist. He needs to be put on medication, as well.

Llamalover47 May 2022
Sandy5691: Perhaps it is time for your father to be placed in a managed care facility.

Tmbr304 May 2022
Music, I put ABBA on before she even wakes up. I ask her to give me her clothes so that I can start the wash and it is happening. I want her to shower at night but absolutely will not. I trim her nails outside on the way to the car I stop on the path and get it done, she has no time or wherewithal to object like she would if I announced it. Sneak attack.
Beatty May 2022
'Sneak attack' Yes, agree - this has worked for me.

Never tried sneak attack with ABBA, this is a new one 🤣🤣🤣. This is AWESOME!

I can picture a sunny morning, a bright bathroom & someone singing cheerfully.. Love me or leave me, I want a shower, please believe me, yes I do, I do I do I do I do I dooooo.
Dolciani May 2022
It is sometimes painful and difficult for the elderly to manage a shower or bath. Buy some (large) adult bath wipes so he can cleanse himself without getting in a slippery shower.
volunteer to do his laundry once per week as he will probably wear the same clothes every day. Buy a soft toothbrush and some mouthwash. Good luck, I lived thru this with my Dad and found that arguing and nagging got nowhere but gentle suggestion after buying everything worked better.

againx100 May 2022
This is so hard. I don't know if you can/should really resign yourself to this. Is it acceptable to just let it go? IDK. Can an aide come in to help him? They're much more cooperative with a stranger than they are with us.

Daughterof1930 May 2022
Does he see a doctor? Does he live on his own or with you?

JoAnn29 May 2022
Its time to place him. He should not be alone at this point. He can no longer reason. Or he forgets he didn't get a shower.

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