Hello, fellow caregivers! My mom no longer cares to keep herself clean, and if you tell her, she’s offended. Help! 😞

One thing I learned is that you cannot ask someone with dementia if they want to shower, because the answer will always be no. They lose the awareness that they once had. They don't think about bathing, they can't remember when they last bathed and they no longer recognize that they smell or have on soiled clothing, etc. So I stopped asking and I would say to mom, "it's time for a shower". When it became too difficult for me to do, I eventually added that level of care to her assisted living plan. I told her that the showers were difficult to operate and that they had to help every person in the shower or they would be sued. She seemed to like that explanation and would then allow one of the aides to assist her. If she was in a mood or if the aide asked instead of stating that it was time to bathe, she would come back a half hour later and approach the situation differently to get mom in the shower. It's exhausting and I'm sure you can tell from my post that I don't have a lot of patience. :-/ I come by that honestly from my mother.

Do not feel defeated or guilty if you have to place your mom. Her safety and care and your mental health are all equally important. I chose to place mom and I go in an assist when I can. There is nothing wrong with that.

The urine is not going down her leg into the shows JUST because she's waiting too long. Her depends is already FULL and not holding anymore.

At this point, you need to get her into care. She clearly can not do one of the things she needs to be able to do on her own that would keep her out of care.

Ask dad to make bath time TOGETHER part of their daily routine. Consider a bidet attachment to the toilet that will gently swish warm water against her bottom and lady parts to help with clean-ups. Also, consult her doctor about physical therapy to help retrain her bladder and pelvic floor muscles.

I suggest getting a shower chair & safety bars all around. Hire an aide to take care of that at least a couple days/week. The other days. remind/encourage mom to wash herself around. Also, place chucks under her wherever she sits or sleeps. It’s more than what you can handle alone. Hugs 🤗

You are a good person because you want to help your mom and dad. From what i read on this forum so far alot of people here are regretting it but my respects bc you want to be there when you can. I suggest try different tactics with mom when suggesting her to be on top of hygiene. A smile goes along way and promise her that she will feel better after. Positivity is a great tool in all this. Ive been watching over my folks for 2 years now. They are all ive known my entire life. Poppa is 86 and momma is 85 with some Dementia. Only child at that and not easy. Be aware your mom might need an upgrade to diapers. Any UTIs yet? I learned the hard way momma had become full incontinent. Going on a little over 2 years now and i feel like im running an old age home but im glad they are still in their home and still together. Im close to 24/7 care,,,,,, and now poppa showing signs of memory loss and repeating himself but what choices do i have???. It has been a little draining lately but im all they have. Their only real connection to the world. Good luck with your mom tho. Maybe you could make it a thing to celebrate when and if your mom chooses to look at her hygiene differently. Like take her and you both get mani-pedis. Do it anyway to break up some of that acute bashfulness as you describe. Try recommending her to wear crocs, since they are easier to wash and or probably throw out her smelly shoes,,,,, if she lost some pride in her appearance you may have to guide it now. If you choose??? But good luck and May God Bless you on your journey.

TinaMarie27: Perhaps mom requires placement in a managed care facility.

My advice : have her dr insert a pessary into her vagina. It will help with the leakage and make that more manageable .
As far as hygiene my mom's the same way. I finally figured out her real issue is the fear of falling . If you can possibly figure out a shower chair and hand held shower she would feel safe with and have your dad just stand by in the bath room to reassure her perhaps.
Her dr can order home health a few days a week for shower assistance too.
Who changes the diaper?

It's not that mom no longer "cares" to keep herself clean but the fact is she can't do it.
Just as you would not expect a young child to keep themselves clean you can not expect a person with cognitive problems to do many of the ADL's.

Mom needs more help. Or if that help is unavailable mom needs Memory Care.
A caregiver can be hired.
Mom needs to be toileted every 2 hours. Yup you read that right. Every 2 hours she should get up and go to the bathroom. This does a few things.
1. It keeps her moving
2. She changes position so that she is less likely to develop pressure sores.
3. Hopefully you get her changed before her incontinent brief is overly saturated.

By the way wearing shoes is good, she is more stable on her feet and less likely to slip if the floor is wet.

A hired caregiver will probably be able to get mom to shower where you and dad have problems. Sometimes having family help with showers and cleaning after toileting can be difficult where a "paid professional" would be accepted better.
So hiring a caregiver 2 or 3 days a week might be a solution at this point. But it may be that you and dad need to talk about placing m om in a MC facility if they can not have caregivers more often. And you being there 2 days and nights allows them to rely on you and they think that they are more independent than they truly are. (I am referring to your dad as well)

Have your mother evaluated by her doctor, if possible. You are no longer able to help her. If your mother still refuses home or facility assistance, get APS in to help your mom.

Her inability to stand in the shower without falling is a Big Problem! No wonder she is not bathing to her previous standards! Get a shower chair or bench so she can sit! Also, one of those hand-held shower heads, which can simply be screwed on in place of a standard shower head nozzle. With some place for it to be hung or attached to the wall, so it is easily accessible while she is sitting.

If you're considering leaving wipes near the toilet, just do it! Also, make sure there is a wastebasket next to the toilet and that she understands the wipes can not be flushed! If she starts flushing them down the toilet, they will end up with plumbing problems. Even the "flushable" ones can build up and clog the pipes.

You can buy incontinence pad inserts to use inside the depends. Much like menstrual pads, they add more absorbency. It could be that her depends are not a good fit, make sure they're not loose around her legs.

If she does continue to allow urine to flow down her legs and soak her shoes, consider buying some shoes that are easily washable, like crocs. A couple pair so that she has a dry pair to wear while the others are being cleaned.

If her depends are leaking, it's not only going down her legs, but also likely soaking her bed and furniture with urine. That will make the whole house smell!
Get some soaker pads - washable, and/or reusable to place on her bed and her favorite chair. Google Incontinence Pads. Walmart's Assurance are a good brand of disposable pads I like the extra large ones. I use one disposable on top of a washable pad on the bed for my husband. It makes for easier cleanup during diaper changes. He can not get out of bed to use the toilet.

Consider having a home care aide to help her with bathing. She may be oddly less bashful with a stranger whose job it is to help with showering.

Is she a Christian? If so counsel her that cleanliness is said to be next to Godliness. Does she believe in life after death? If so let her know that heaven will be the cleanest place ever. When the Bridegroom comes for her and His Church, she wants to be well groomed and dressed for the occasion.

Patients' resistance to bathing and getting help to clean up is very common in the early stages of dementia.

Here is a relevant quote from the book "Dementia Care Companion" which is available from Amazon at: https://www.amazon.com/dp/B0BFV21P1V  

Bathing

Regular bathing is a central part of any hygiene program, and remains so during the course of dementia progression. Bathing is essential to warding off disease and other health problems, such as skin irritations, rashes, and infections.
During the early and most of the middle stage of dementia progression, bathing is a source of stress and consternation for the patient and their caregiver. Arguments, crying, even aggressive behavior are often part and parcel of the bathing ritual, as the patient refuses to surrender to the necessity of this basic hygiene task. Even into the late stage of dementia, when the patient is wheelchair bound or bedridden, they may still resist the idea of bathing, and get anxious or aggressive at bath times.
After the bath is a different story. Being clean and properly groomed is a great morale booster for the patient and the rest of the family. Seeing the patient with trimmed nails, tidied hair, cleanly shaven (if appropriate), and wearing clean clothes offers a breath of fresh air in the otherwise drab daily routines of life with dementia.

Barriers to Bathing
Patients’ experience of bathing changes with dementia. What was once a refreshing and relaxing activity devolves over time into a stressful and overwhelming sensory and cognitive burden. The noise of the running shower and the exhaust fan, the beads of water pelleting their skin, the impossibility of getting the water temperature right, not knowing where to begin or what to do next, and a myriad of other problems conspire to make for a truly unpleasant bath-time experience.
Physical Barriers to Bathing
·        Is the bathroom cold?
·        Does the noise of the fixed showerhead annoy the patient?
·        Is the running shower making the patient anxious?
·        Is the floor slippery and the patient is afraid they may fall?
·        Do they have difficulty adjusting the water temperature?
·        Is the patient suffering from some pain or discomfort?
Psychological Barriers to Bathing
·        Does the patient believe that they already took a bath or don’t need one?
·        Are they worried that they will not remember how to bathe?
·        Are they afraid of being alone in the shower? 
·        Do they feel vulnerable when they take their clothes off?
·        Does your presence in the bathroom embarrass the patient?
·        Is the patient suffering from depression or apathy? Do they lack motivation to do anything?

Bathing Alone
Gradually, I had taken over the household responsibilities from Mom, but she still managed to bathe on her own. I used to feel so happy when I’d see her cheeks rosy after a shower. One day I checked up on her in the shower. She was scrubbing her face so hard that I had to intervene. “Okay, now wash your body,” I said. She started scrubbing her face again. “Mom, wash your body.” But again she went back to scrubbing her face. That’s when I realized she had been only washing her face all this time.

It may be a while before you have to be physically present during bath times. Keep in mind that even while the patient is able to manage on their own, dementia makes it increasingly difficult for them to do so safely. It is important to take precautions early on to prevent accidents before there is one.
·        Adjust the water heater temperature to a setting that reduces the risk of scalds.
·        If you have the option, install a faucet with separate hot and cold controls, rather than a single-lever combination faucet. Patients usually find it easier to manage separate controls.
·        Install a handheld showerhead. They are more comfortable to use and less noisy.
·        Install a bath seat or shower chair with backrest and armrests, so the patie

A person with dementia will often respond this way.
There are a number of reasons why, i.e., the water may scare them, they may feel like they are drowning (if in a shower). With dementia, she doesn't have the brain functioning to respond as a 'normal' person would. She is scared and confused.

Do not fight with her. That won't help either one of you. And will exacerbate the situation.

Google:
How to help a person with dementia bath
Why do some elders resist bathing?

Educate:
* You are dealing with confusion and fear due to a parts of a brain that no longer work.* Go to: Teepa Snow and watch her webinars, free information, You Tubes, buy her books.

Needed changes
It might be time to research assisted living facilities.
This will become unmanageable for you if the situation isn't already.

Know your mother will not change.
She will continue to resist / be combative (not her fault).
She may already need 24/7 care.
She may ruin the house (i.e., wood floors, carpets) and/or fall / cause injury to herself).

In the interim of making major needed changes, you could try:

1. Letting a caregiver bath her to avoid her feeling embarrassed with family doing.
2. Try a sponge bath.
3. Consult MD re medication.
For you ...
4. Put air fresheners in her room, in the bathroom.
5. See if you can put lavendar or something in-between the mattress and sheets.


Know her behavior is not unusual at all. It is a matter of how to manage it.

Gena / Touch Matters

My wife is doing the same thing with the excuse I can't step over the bathtub (after her stroke). One UTI after another, I decided to spend $18K for a walk-in shower with seating to be installed next month. If this doesn't work it's likely AL for a trial run. With that hanging overhead, hopefully making her life easier will help.

Sounds like you should get her a shower chair, if standing up in the shower is too difficult. They are not expensive on Amazon. And it may be better if she wears sneakers for balance, rather than shoes. They have the advantage of being able to be washed. You can get multiple pairs

I'm a single 69 yo male. My 87 yo mother has lived with me since 2019 after my stepfather of 30 years had to go into memory care. Mom also wears diapers, and they often leak in her bed. I have machine washable pee pads on her bed that help a lot. I can almost count the number of baths that she has had since 2019 on both hands. I even had a walk in tub installed, but she has rarely used it. She does "clean" herself, but just with dry toilet paper. I have never seen as much as a damp towel in her bathroom. I have begged and pleaded with her to bathe, and she always comes with an excuse like she gets too cold, or the hot water doesn't last long enough, or the tilt of the earth is off (that's a joke, but you get the idea). I have a heat lamp, and a space heater in her bathroom and I can get it so hot that it is like a jungle, but she still won't bath. I also installed an electric bidet to add some hint of hygiene. She only likes it for the heated seat, but she won't use the actual bidet features. From what I have been reading, hygiene issues with the elderly is a very common issue, so I know that I'm not alone with this. In the last 7 weeks, so has been in the hospital four times and now she is completely immobile, so the situation has become even more dire because now I have to change her and clean her myself. I finally found a service that is coming to my home for an hour every single day and they change her and sponge bath her, so that has helped a lot. They also have an option to come out for a few hours for a minimum of 3 hours a day for 4 days a week and cook / clean / laundry, etc., but I didn't need that. I have an electronic lock on my front door so I don't need to be here. She gets enough from SS to cover the cost of the daily one hour visit ($50 for the hour). This has been a godsend for me because I'm not retired, and even though I work mostly from home I still have to leave occasionally to meet clients or to run errands.

If possible you need a care help
that said
A lot of elderly suddenly decide it’s a good idea to stop washing
my dad did and it was stern words which were met with well I’m old who cares
my sister was very firm
daily routine to wash
swap showers and get a wash basin and flannel and a little disinfectant or tree oil in the water
we keep my dad’s prescription back by saying we will help remove top layer clothes and then turn fur him to wash/wipe private areas
hold a towel up fir her if you’re facing her
and say you’re not looking!
maybe you need disposable pants and pads into them if leaks are heavy
—
Older folk come from a proud era
if you haven’t someone to explain to her each morning we’ll have a quick wipe down and fresh clothes then get a care person in even for the once to show her it’s not as painful as she thinks!
it’s now a routine with my dad
we found btw
he has a slip in bathroom why he didn’t want shower and it was getting painful lifting arms etc changing
so he needed help
i imagine your mother does also
Without stressing her too much I wonder if a ultimatum coujd help
its either help you or the doctor will put you in a home for medical staff to help you?
We always reward my dad
ok we’ll have a quick wipe down then tell him how nice he looks then say let’s have a nice cup of tea and biscuit now

I am sorry that you are going through this. I have been battling the same issue with my Husband who was diagnosed with Dementia. My battle he wears the same clothes for days and will sleep in the. When asked to change clothes or to shower I get " I just showered this morning and put these clothes on fresh' even though he just got out of bed. And didn't shower or change the day or night before. If there is a solution out there would be great to hear. One thing I started doing was sleeping on the couch. When he ask why I am sleeping there I simply say because you stink. I am not sleeping in that bed until you shower and change those clothes. This still causes a fight, I just say it once and walk away.
Sometimes he will shower and change and some times he wont. I know that this probably doesn't help. I am not going to argue with him.

We use Prevail instead of depends and they have better absorbency. We’ve tried a lot of brands. Thats helped contain some clean up.
Good Luck.

I hope and pray that I will never subject myself to living conditions like you describe or more importantly that I will never subject my son to having to deal with anything remotely like what you describe.

If you could ask your mom from 25 years ago, if she ever got to the point where she is now, would she want you to do what you are currently going through? I certainly hope she would have said NO.

The last couple of years of my dad’s life with dementia, showering, changing his clothes, and general hygiene got worse and worse to the point where it was almost nonexistent. Hospice aides convinced him to shower once in two months. He got a bacterial eye infection from his own filthy hands touching his eye. Sometimes he would crawl rather than walk, and more than once in his way out of the bathroom he would smear sh*t on the walls. After that, the hospice aides told my mom to cover everything he touched or sat on and also wipe everything down constantly with Clorox wipes like the TV remote, counters, doorknobs, etc. It’s disgusting and obviously impossible to stay on top of. My mom was adamantly opposed to putting him in care despite it all until days before his death when there was no other choice.

It really sounds to me that they need to be in AL at a minimum. Good luck!!!

Yeah the family had to put up with my father's refusal to shower for over a year. It was dreadful. We couldn't do anything about it. Believe me we tried. The aide tried to get him to take one, my husband offered to help him. We put in a walk in handicap accessible shower, nothing worked. We gave up. We kept the windows open especially in the upstairs bedrooms. It was really bad and the smell did not dissipate at all.

I lived in the basement and limited the number of times I'd go up to their living area because I gagged on the smell.

He is in a LTC facility now, and thankfully he gets a shower a couple times a week.

There's nothing you can do about it. As awful as it sounds, just leave him to his lousy choices.

You poor thing it's the same with my "father", he resents me trying to help and I can't go over there because of the stench

I told him I won't go over until his house is clean or at least sanitary.

do they accept your help in other situations?

I’m so sorry you are going through this. It sounds like your brother was enabling them or scaffolding their independence at the very least. At this point if they refuse help, Alva is correct. You may need to let them (and the rest of the family who aren’t working with you to find better solutions) live with their choices. If they were being rational they would agree to sell the house and move into Senior housing (low income) at the least. It does not sound like it is safe or healthy for them to remain where they are living like this. Like many of us have experienced, a crisis will end up driving the next move. One will either end up in the hospital or die, and that will give you (and your siblings I hope) a chance to make a change to get them into a better, safer living situation.

Welcome, Tina.

You describe in your profile your parents-- a couple who is living in a hoarded home with animals they are not cleaning up after. Nor cleaning the home nor themselves.

Almost all who have Hoarding Disorder also sink eventually into poor self-care of themselves. Quite honestly, other than forced removal from a situation, this isn't at their age "fixable" in most cases.

Truly, being one hour away from them, and no one else helping, there is little to nothing that you can do about this. I am certain, given what you are dealing with, that you have watched episode of hoarding issues on the several TV programs out there; there are also many books on this issue.

Frustratingly you are attempting to deal with this, but one hour travel to and from them will net you several more hours ARGUING WITH THEM and all to no avail. The situation will remain what it is.

Hoarding is now a DSM-5 diagnosis. That helps with one thing only, and that would be getting psychiatric help. To be honest, short of placement, no one has a clue HOW TO HELP. I include psychiatrists.

I would firstly go to Facebook if not already there and join Hoarding Disorder Support Group. While it won't HELP much you won't feel so alone.

Secondly, I would speak with APS in their area. I would ask their advice only. Do know putting them on a county watch list may result in their eviction, and APS may-- if this is unsanitary-- report them for placement, guardianship of the state, and a nursing home. (Quite honestly may be the ONLY answer; certainly they will not give nor should you attempt being POA here).

Other than the above there may BE no answer here.
You will get "the call". It will be either: A) that the County is evicting them from an unsafe environment (likely already in tear down condition with cat pee ruining floors). Or B) that neighbors reported to APS and APS will want you to get guardianship (talking 10K and you will lose unless they have diagnosed dementia). Or C)the call will come from the hospital or the coroner.

I don't know how long you can sustain participating in this mental illness with no good effect. NO effect, if you're honest. Other than personal frustration and grief.
Not everything can be fixed.
I would consider seeking counseling for yourself with a GOOD licensed Social Worker in private practice of counseling, one with some experience and knowledge of Hoarding. You will there learn all the options (they are few and ineffective).
I am so sorry. Not everything has an answer. I couldn't wish you more luck and I hope you will update us.

For starters, get over your 'bashfulness'. You're an adult. Start acting like one. Every living creature pees and craps, your good self included. Is it gross? Yes, it is but it's a fact of life and no need to be bashful about it. Get your mother some incontinence pads (like Poise or Tena) that she can use with her Depends. This will certainly cut back on the leakage.

Next, you tell her plainly that she smells terrible. Then let her know that there are products that will take care of this and that there is going to be a home/health assistant coming in twice a week to help her with showering and to make sure her home is stocked with all the supplies she needs to stay clean and odor-free. If she gets offended tell her that stinking of urine is pretty offensive to anyone nearby. I was a homecare worker for 25 years and have dealt with every kind of senior stubbornness. In particular the kind surrounding incontinence and personal hygiene. I never pretended that the person didn't stink to the high heaven. I didn't back down or let a belligerent senior intimidate me either. No way.

I'd look a person square in the face and tell them, 'You smell and you're getting washed and changed whether you like it or not. It's my job but I also care about you so let's go'. This is how you deal with a senior who's stubborn about hygiene. Your father needs to step up a little too and start helping her to the toilet or at least reminding her to go herself every two hours or so.

You mention your mother can't stand in the shower. There's no reason why she has to. Get her a shower seat or bench. If she doesn't want you showering her, that's okay. If you're not trained to safely put a person with mobility issues into the shower you shouldn't attempt it because you or the person can end up getting hurt. The homecare aide you hire will do the showering. You and mother sit down and write out a shower schedule of what weekdays she will be showering on with her new aide.

Your mother needs you to give her some tough love now. So get over bashfulness and get to it to help your mother. If she gets stubborn and resistant about 'allowing' outside paid help to come in, both you and your father need to make it very plain that her choices are accept homecare help and work with them, or she goes into LTC. Usually the threat of a nursing home is enough to cure the stubbornness or at least put it in remission.

Good luck to you and please start looking at some homecare.

Interesting that she'll let you clean her feet but won't let you clean other places.
But bottom line she now needs a shower chair in the shower for her to sit on, grab bars, a slip proof mat, and a hand held shower head so she will feel more safe when taking a shower.
And you may have to just be in the bathroom when she's taking a shower as a backup plan, or hire bath aides(with her money) to come assist her.
And you may want to put a bedside commode next to where she sits during the day, so she doesn't have to travel far to use the bathroom. You just put 6-8 inches of water in the basin with a few squirts of Poo-Pourri in the water and then just flush it down the toilet when she's done using it and wash it out real good, and refill.
The extra large body wipes can be used for the in-between showers, along with the waterless shampoo and conditioner caps that can be ordered on either Amazon or Walmart.com.
But in reality it probably isn't smart for your mom to be living by herself anymore and she more than likely needs to be placed in the appropriate facility.

I have no advice, except to tell you that I've experienced the same with my aunt. Does your mom have dementia?
My aunt refuses to shower and refuses to let you help bathe her. She will fib and tell you she already bathed, and I know it's not true because you can smell her.
I offered to help, and she told me to leave her alone, that I was making her sick with the constant asking if I can help with that.
She also has incontinence. She will linger in a loaded depend and once when I attempted to take it off, well... it fell all over the recently shampooed carpet.
Before I got her house professionally cleaned, there was human waste and urine everywhere and all over the beds. She was offended when her neighbor let me stay at her house until it was cleaned. She took it that her house wasn't "picked up" enough with clothes and papers around. That wasn't it at all, but she couldn't understand or see that it was the unsanitary conditions of her home.
I haven't been back because of that. I had it professionally cleaned, and it wasn't cheap. I can imagine how bad her home is again now, as she's not going to pay that much to get it professionally cleaned and neither will anyone else.
I understand what you're going through. It's hard watching our loved ones declining and their refusal for help. Best of luck to you and her.

Here's a good article from the Caregiving Topics of this forum:

https://www.agingcare.com/articles/how-to-help-with-bathing-and-personal-hygiene-top-tips-from-caregivers-212010.htm

Resources/Caregiving topics/Hygiene in the menu at the top.