My grandma refuses to take a shower. What should my family and I do?

Good Morning,

Oftentimes with dementia the elderly get afraid of the water. Durable medical equipment (insurance) will cover a shower chair or a "transfer" chair, railings in the bathroom, and a shower nozzle that is not too harsh on the body like a regular shower head would be.

I put my mother's towels in the dryer and we have a whole set up. She has a special robe she walks in with, another "Spa" bathrobe from Lands End "after" her shower and I put a towel on the chair and 3 facecloths on the handicapped bar in the shower. I also give Mom a hand towel to put in front of her to give her dignity. Even though it's my mother, I want to give her some privacy.

I test the water, walk Mom and "sit her down" safe and sound. I have her help me hold the soap dish and we do her hair first. I give her a choice of shampoos and now she is ok with it.

I wipe her face after shampooing her hair. The water temperature is not too hot but you have to watch the shower nozzle because the water temperature can change in a flash.

I put warm towels from the dryer on Mom, walk her out with her Spa bathrobe and sit her in a chair with a plastic pad on it and an extra hand towel. A small bottle of water and 2 kleenex are in the chair and another hand towel and comb is on the bed.

I close the bedroom blinds because Mom thinks sometimes people can see in which is not true but she thinks so.

Mom combs and her hair and I clean up the bathroom. She has her make-up plastic box that I bought from the Dollar Store with all of her beauty treatments in it which she enjoys.

Mom always says, "you are so good to me". Sometimes we sing in the shower, "at the car wash" and Mom laughs her head off. You have to keep your sense of humor.

I forgot to tell you after all this my clothes are soaking wet.

Then baby sister will call and say so, "did you do anything today"? I just respond, "ah nothing".

I'm trying to leave you with a laugh.

You need to associate positive feelings with it.

Mum went through a phase where she argued or would say the shower kills her. Now, it’s pretty effortless. I would always reassure her how fresh she feels after and this somehow worked and got drilled into her. I’d also heat the room up beforehand with little area heater if winter or use heat lamps in warmer times. I’d play her favourite songs and sing along while undressing her. I’d treat it like a spa treatment (Mum I want to make you pretty, do your hair nice) etc etc etc,... but always firm, no questions.

Later I trained my mum to think that a shower was a necessity after a bowel movement, lol. This typically works out to be twice a week. It’s not to say she must have a shower after every no2 (we do use baby wipes too), but it’s easy to have her associate it. this is also the case if she’s had a bad urinary accident. I’d use myself as an example too (I’d bluff and say I did no2 and thus need shower, or I’ve had an accident and need shower). It was about making her feel indifferent and not ashamed. Obviously it wasn’t really the case but made more a connection.

She now happily goes into shower.
she does a bowel movement and I say, guess what,.. and she says “I need to have a shower”. After each shower I ask how do you feel, good yeah” and she says “Yes, very good, thank you”. Then there’s a reward of dinner or late night snack and hot drink ;) sometimes a foot massage by machine / lotions.

There will also be certain times that she would be more likely to go in the shower, whether that is morning, night or midday depends on your Mum. My Mum likes evening showers :)

She has a shower stool and non slip mats. And yes it might be a little counterproductive eating after showering but have to compromise on some things.

You just need to make it a positive experience based on her personality.

Good luck!!

Not wanting to bathe is very common with dementia patients. They are especially afraid of the shower. The noise and force of a shower over her head is very scary. They also dont like to be naked and cold. And NEVER announce, "Time for your bath!" Get everything ready, then gently lead her into the bathroom. Say, "I'm just going to wash your feet," then once she sees how good it feels, you can move on to other areas. Keep her warm and clothed the whole time, leaving only the parts you are washing exposed one at a time. I try to get my mother to wash her private parts by handing her the washcloth and telling her step by step what to do. It is empowering and dignifying for her to do it herself. For the hair, I have my mother lean forward over the kitchen sink and have her hold a towel over her face. You could also buy one of those stand up salon sinks and have her sit in a chair. My mother loves feeling like she's in a salon. I also use a warm wet washcloth or wet wipe for each diaper change. It's really the most important part to keep clean at the very least. Good luck.

My mom's primary told her she had to shower twice a week. The other days she had to get a good & thorough sink bath.

Mom was extremely afraid of falling & got very cold. We had a shower chair. Her towels were warmed in the dryer so she could be wrapped up good afterwards.

This did help a lot. The only person that she allowed to shower her was her evening caregiver. Tell mom either she showers or she has to move.

My mom refuses as well. I have started to use small baby steps, saying we are just going to wash your feet. As I get her into the shower sitting in the shower seat and her feet are washed, I then ask if she would just do her private parts herself, once that’s done, I say let me help with your back… and so on. It works most weeks.
I have also found some wipes that are rinse free. On the weeks she will not cooperate, these help.
Scrubzz: Disposable Rinse Free Bathing Wipes

My mother is the same way (88), I just started getting thing ready. Her clothing bathing needs etc. Then I go get her, I just say hey I want to show you something. We walk to the bathroom, her first reply is I took a shower this morning ( she didn’t), I simply say you have a doctors appointment in the morning, do you want the doctor to see you like this? She’ll wait a few minutes then undress for her shower. I always ask her do you want to turn the water on? She’ll either say yes or no, you do it. Then she gets in, sits on the shower seat back to shower. I then stretch the shower curtain I front of the water, I have her reach back to recheck the temps. Then I release shower curtain and drape it over her knee. I say hey I’ll do your hair and back, you do the rest ok? All goes well from there. She would go weeks without a shower. So you just have to find different avenues to get what needs to be accomplished! It’s a tough situation as care takers we have to be creative. Just my thoughts

Bidet attachment to the toilet so she gets cleaned "down there" every time she uses toilet. Sponge bathes with soapy water and a washcloth work as well as a shower. At least, get her to agree to an airplane bath - "under the wings" (arm pits) and "under the tail" (bottom areas). Some women can be bribed with a "spa day" - bubble bath, scented candles, soft music...

If you want your grandmother to be clean and not smell, then you can't allow her to make the decision.

Getting around their resistance can be a learning process. My mother would never shower or even wash her hands if she had her way.

Being unwashed is not healthy.

Anyway, look up "nonenal" which is the name for "old people smell". It's from the hormonal imbalances that take place as we age and the fatty acids on the skin.

Mirai Clinical is a Japanese company that has developed products just for the elderly using persimmon extract that will neutralize the smell. They have soaps and wipes and deodorants and body washes.

https://miraiclinical.com/collections/body

My routine is that every Sunday, I coerce my mother into the shower - wash her hair and body. She has a shower chair and all she has to do is sit there while I wash and rinse her. I also have a shower head on one of those cord things so I can get into nooks and crannys. She doesn't like it but I don't allow her to decide. I also change her sheets and all bedding. (I wash her sheets and bedding in hot water and use vinegar in the rinse cycle.)

After it's over she always says how good she feels.

Every day I change her clothes. Again she will sometimes fuss but I don't let her decide. If she won't pull her shirt off, I do it for her.

You just have to take the bull by the horns.

Here is a link to various videos from Teepa Snow on how to bathe an elder with dementia:

https://www.google.com/search?q=teepa+snow+showering+dementia+patients&rlz=1C1CHBD_enUS896US896&oq=teepa+snow+on+showering&aqs=chrome.1.69i57j0i22i30j0i390l4.7448j0j7&sourceid=chrome&ie=UTF-8

You can also hire an aide specifically TO shower your grandma.

Make sure the bathroom is warm and she's not afraid of something specifically that you can remedy for her.

From the book, Understanding the Dementia Experience, by Jennifer Ghent-Fuller:

"Grooming and bathing are disrupted when the person forgets how and when to do things. They may forget what the steps of washing are. They may forget that they need to wash. They may be unable to remember how much time has elapsed since they last washed or changed their clothes. They may also believe that they are clean and take offence should anyone suggest otherwise. Dealing with such situations in a manner that is kind and jovial, rather than confrontational, is important.

One fellow, who needed to help his wife bathe as she was no longer able to do so herself, was puzzled because she was calm and cooperative until he helped her step out of the bathtub, and then she became agitated and wanted to get covered up immediately. As it turned out, as soon as she saw her own reflection in the mirror, she thought there was another person in the bathroom, and she was embarrassed. As you can see, the cause of the distress for a person with dementia is not always readily apparent to the rest of us, who can take intact thought and reasoning for granted.

If a person with Alzheimer disease is looking at a solid black area, or a solid white area, such as a bathtub, they may perceive a yawning bottomless hole. Putting a coloured bath mat down may increase the likelihood that they would be willing to step into the tub. Putting blue food colouring into the water may allow them to see what they are stepping into as well. Generally, with altered depth perception, it becomes challenging to judge how high, deep, long, wide, near or far things are.

If you send clear signals through your tone of voice, facial expression and relaxed and confident attitude, that you mean them no harm, they may trust you to the point where you are able to help them with their personal care. People with Alzheimer disease become extremely sensitive to the body language of others, as they no longer possess the judgment and insight to understand the situation, so they evaluate the threat posed to themselves by the frown or aggressive stance of the other. It is important to exaggerate your body language communication to let the person with Alzheimer disease know that you intend them no harm. A smile on your face, a relaxed tone of voice and body stance, a sense of calmness and reassurance, perhaps a hug, all communicate that you mean to help, not harm. If you feel like you’re overdoing the positive body language, you are communicating your intent effectively for a person with Alzheimer disease.

Remember that their short-term memory may not permit them to remember what you are doing when the two of you are part way through a task, such as a bath. People have found it effective to keep chatting throughout the task, as the continued connection and reassurance of a soothing tone helps the person with Alzheimer disease stay calm in a situation they would otherwise find threatening."

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

Jennifer is a nurse who worked for many years as an educator and counsellor for people with dementia and their families, as well as others in caring roles. She addresses the emotional and grief issues in the contexts in which they arise for families living with dementia.

Best of luck!

Look into a facility for her. She needs more care than you can provide. Refusing showers is common. Is the room warmed up prior? Is the room free of drafts? Is the water hitting her frightening to her or painful?

You could try to get an aid to help her with a shower to see if that makes a difference.