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I am the care giver for my 88 year old father who has just started showing signs of dementia. He has always been a proud, highly respected man. Last week he stopped putting on clean underwear each day. He smells bad. How can I tell him to change his underwear without humiliating him.

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Does he put on PJ's? if so does he remove his underwear to put them on? Take his clothes and toss them all in the wash when he gets ready for bed.
Is he taking showers or baths? If so take his clothes and toss them in the wash then.
If he is using cloth underwear remove those and replace with disposable pull up underwear. They are more absorbent then cloth underwear.
Pretty sure the odor is from poor toileting so he may need to be supervised in the bathroom.
Forget the "proud, highly respected man" he is now an 88 year old with dementia and he will need help and supervision. You can still treat him with respect and he can still be proud but you need to help him. When you do help him help him with respect and kindness.
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So here is the issue that you may wind up with if you don't address this - and I know it is hard because talking about certain things are always going to be uncomfortable. As odd as it sounds, I'm actually MORE comfortable talking to my FIL about these things than my husband or my SIL and my FIL just rolls his eyes now and we laugh about it - which probably tells you how odd our relationship is...but I digress.

If he is smelling bad - that could be a sign of more than just dirty underwear. My FIL wears Depends and if we are smelling anything unusual - that's a problem. My SIL and BIL live with him full time and she has a nose like a bloodhound. Changes in urine smell, strong odors, feces smells, other types of smells - not to put too fine of a point on it....but you probably need to pay attention to it if you can smell it and it's not just the typical "elderly person" smell if you'll pardon the term.

We have found when we are smelling certain smells with FIL - its a sign of a yeast infection on his skin or a UTI if his urine is smelling really pungent or even dehydration as it was this last time.

I did actually talk to him. I was gentle - which anyone that knows us know that's NOT how we usually do things but in this case I managed LOL. But we were taking him to the doctor for a UTI test because his urine could be smelled from 10 paces in the Depends. So I opened the conversation and told him that he had to drink more water, than he couldn't sit around in a wet Depends, (to which he responded he changed it every day and I said that only worked when he used it for emergencies and we were aware that was no longer the case, and he HAS to change it at least when he gets up in the morning and before he goes to bed at night since he is in the bed 12 hours and only goes to the actual bathroom when he is awake).

In our case he is mostly competent and if he has dementia it is very early stages, so he manages himself in this regard and CAN manage his own toileting. But his hygiene has slipped recently. He has a bath aide three times a week that takes care of his bathing.

But if you are smelling him I would caution you to be sure you know WHY and WHAT you are smelling because it COULD be an infection of some kind that needs to be check out.
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Does he live with you. If so, leave a clean change of clothes out for him.

Me, as a daughter I would never have done intimate care for my Dad. Had already told my brothers that. So he either lived with one of them, or it was LTC. The only reason my Dad did not have a hygiene problem was because of Mom. He had no Dementia, just lazy. Mom made him shower and laid out clean clothes.

Hopefully, you have a husband or a brother who can talk to Dad. Be aware that that smell has to come out everytime you wash. Bleaching helps but regular use will damage elastic and the cotton on underwear. I use Purex powder for colors. Works well for my DH who has Prostate problems. Even drying in dryer does not bring the smell back up.
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