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My grandma lost her sense of smell a few years back, a fact which she readily accepts. She lives with our family, and we've all noticed she does smell pretty bad, but nobody knows how to address it without causing offence (she is a very prickly woman). She showers genuinely maybe once a month (but insists she does so more frequently) and also suffers with incontinence (but insists she does not, even though we are all very aware of it). She is perfectly sound of mind (medical professionals have attested to this), just very stubborn and proud.


I tried to bring it up to her the other day, and was met with complete denial and now she won't speak to me even if we're in the same room. I understand that it is a sensitive and embarrassing subject, I just want her to have the best quality of life and I think hygiene is super important for this.


Any advice on what I can do?

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How is grandma of "perfectly sound mind" if she showers once a month but "insists she does so more frequently"??? I am of sound mind and know when I shower, and if I do not, then I will STINK. I will take no offense if my husband tells me I stink if I haven't showered for a month, because that's common sense, which grandma is no longer in possession of, with or without the nose of a bloodhound.

Refusal to shower is not an "embarrassing and sensitive subject" for a person w/o cognitive or mental health issues. It is a socially accepted norm in our society and an expectation, especially when living as a guest in someone else's home.

At the minimum, grandma needs a new doctor or neurologist who understands dementia and how to test for and diagnose it properly. And she needs to be taken by the hand to the shower 2x per week and bathed by an aide who's experienced in such matters, or by a family member. Watch a few Teepa Snow videos on the subject on YouTube first.

Give grandma a choice....she either plays by YOUR rules now or goes into managed care. Tough love is required now, not walking on eggshells.
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I am afraid there is more here than loss of sense of smell though it is common in many dementias (notoriously in Lewy's). I am afraid that taking a shower once a month would be recognized by someone with cognition as not enough.

Sad fact here? You tell her honestly and it will be hard.

I faced the same problem.
Before his diagnosis with Lewy's my brother had loss sense of taste and smell. He knew this. He was a most controlled, monklike and fastidious man with an emaculate house. Nevertheless he hated deoderants all his life and used them grudgingly because he knew he needed to. When I visited him shortly before his diagnosis I noticed that not only did HE suffer from underarm odor, but he was not washing his teeshirts often enough and they were no longer coming clean with washing.

I had to sit him down and tell him that the smell of underarm odor was not only on him, but in his closet and on his clothing.
He couldn't believe me. He said to me "Well, __________and _________ never told me I smelled!!!!!" (His ex and his best friend). And I had to tell him "Perhaps not, but they would never tell you ANYTHING that had the power to hurt or upset you, and so your little Sister is left with the job".
We did the clothing. ALL of it. And he again used deoderant.

Later after he was diagnosed, as we got him into ALF, I made certain that it was in his care plan that there was no longer any sense of smell and he had to be reminded about shower and deoderant.

You cannot avoid honesty. If there is dementia present you are going to have to do more reminders than you wish to. It hurts to have to do this. It hurts you and it hurts the one you love. But you are doing this out of love. And it has to be done.
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Oh boy. I was avoiding telling my mother directly that she smells, but I did just that after less direct attempts, including offering help with showering, didn't work. She didn't care. Her attitude was "so what." Apparently, some people reach that stage as they age.
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Trust me, she hasn't actually lost her sense of smell. She is now not seeing the need to shower. This is a very common early symptom of dementia. We had to hire someone to give my Aunt a shower 2x a week and all the years of doing this my Aunt disliked doing it and never saw the need.

Your family can start by giving her a false reason to shower, whatever you think will motivate her: we're having visitors tomorrow; you're going to an appointment tomorrow; etc.

If some of the smell is from being incontinent, then all her cloth undies should be thrown out and replaced with disposable ones.

But as others have suggested, she really needs a diagnosis. Hopefully someone is her PoA...

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

https://www.agingcare.com/articles/elderly-parents-who-wont-shower-or-change-clothes-133877.htm
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She readily admits that she no longer has a sense of smell.
You should be honest with her at that point.
"Grandma I know you have a medical condition and you can not distinguish odors. Because of that we have noticed that you do have a body odor. I know you are particular about how you look and this is something that you need to take care of. If you can't do a good shower yourself we can get someone to help you." "We can have someone come in 2 or 3 times a week"

You also remove ALL of her regular underwear and replace it with disposable pull up underwear.

If she does not agree with this simply tell her that you are going to have to look for Assisted Living facility for her as you can no longer tolerate the odors from both the body and the urine.

this is a tough talk to have but pull up your big girl pants and do it.
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Try to find a bather to come in and help. For whatever reason many elders will accept a bather before a family member and she may be frightened that she will fall on her own.
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I suspect your GMA has some cognitive decline, that doctors are not picking up.

Also she could get UTIs and other issues not showering. I tell ya I don't feel to clean down there is If go 3 days without a shower, she can't be very comfortable
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Can you convince her to use body wipes? Will she allow you to help clean her? I have the same issue with my mother, so when she goes through her phases of refusing to shower, I'll escort her to the bathroom (she has knee problems) and hand her wipes to clean herself with to minimize the odor.

Another thing is, and I hate to say it, but sometimes letting them get dirty inspires them to eventually want to get clean, because it's not about them not wanting to clean but doing it on "their terms", even if those terms means not cleaning up right away after an accident or once a day. I know this, because had some absolutely miserable showdowns with my mother. I'd beg and plead and warn her that she'd get a UTI, and this would turn into her twisting my words around and saying that I was accusing her of having an STD and sleeping around. The last showdown we had, she absolutely refuse to clean up even though she was absolutely disgusting. I left her alone, but cornered her in one part of the house, as she was tracking "stuff" everywhere.

By magic, after a few hours, she finally decided that she wanted to take a shower because she was so grungy, she caved in. After this incident, every so often, she calmly asks me to help her take a bath, like once or twice a week, as opposed to weeks. There are days when she absolutely has to take a shower, but that's when I volunteer wipes, which are better than nothing.
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I had the same problem with my Mom . I would like to add somethlng to keep in mind even if you get her to shower .

I didn’t realize my mother was not putting deodorant on the correct place until I was with her at the hospital to get ready for discharge . She was putting it on the sides of her breasts not her arm pits . Besides having dementia, it was very difficult for her to raise her arms due to very arthritic shoulders . I hadn’t realized how difficult it was for her sooner because I had not seen her dress herself .
In retrospect I should have realized since she needed help getting her coat on for years .
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