For DH's family, MIL'S refusal to bathe at the end of her life was the straw that broke the camel's back. She just--stopped bathing, completely. The smell was awful. For someone who had been beyond fastidious in her grooming, this was a really sad development.
The occasional incontinence sure didn't help.
When she started putting up a fight, biting people and raging at anyone who came near her--DH's OB simply started checking out ALF's. Dh was POA, but he never did a thing with his 'power'. He also didn't care that OB basically stepped up and did it all.
Somebody who does not want to bathe, can become incredibly strong and combative. I couldn't believe that the 3 sibs working together could not get her in the tub. (She didn't have a shower, thought they were low class).
Honestly, sounds like you need to find mom a care facility. If she can only take herself to the bathroom but nothing else--what is her QOL at this time? She needs CGs every single day. Bathing is just one of the many ADL'S she is incapable of doing.
You can get away with 'bed baths' between showers--but you cannot do it forever.
Good Luck with this. Honestly, it was the fighting over not bathing that landed MIL in a NH.
Unfortunately, lack of bathing becomes a common problem.
Bathing actually has many steps & requires much planning & short term memory to accomplish. Add feeling cold, stiff or pain & no wonder people refuse. Then add lack of smell & loss to reason & they don't underdtand why bathing is hygienic & necessary.
What to do?
The ususal answer depends or what level of help the person needs; 1. Prompting Leading into the bathroom & prompting each step. Then comes 2. Assisting. Doing the task together. (With family or an aide) Then 3. Full Assistance. The person is bathed by another (shower, basin wash or bed bath).
As most types of dementia are progressive, bathing is part of the wider picture. What other ADLs now require prompting or assistance? Meals? Meds? Toileting?
As independance slips into semi-dependant, then dependant, choices about home need to be made. Home vs Home + carers vs Nursing Home.
My guess is that everyone is so wrapped up in keeping her at home that you're stuck in that way of thinking. You're enabling her to live at home, and that isn't good for her overall health, as you now realize. Not bathing can lead to sores that won't heal. Skin fungus. Her odor will cause family and friends to avoid her. In short, it's a terrible situation. It's unsustainable.
You need a plan to get her 24/7 care, preferably in a facility where she can socialize. Professionals will know how to bathe her and keep her clean. You will be freed from the bondage of running her household and lying to yourselves and others that mom's fine, just fine, she just has a little mumble mumble problem but she's going to be all right.
Dementia changes everything, and when it's this serious, things cannot go on as if they were normal. I wish you luck in finding the help mom needs.
Moving her to an assisted living facility or memory care facility will not guarantee that she gets bathed. If she is combative there, they may not bathe her much.
I have been fighting to bathe my husband, and care for his skin for 9 years. He suffers dementia as the result of a stroke, but his general health is not declining. He could live like this for many more years, and has been kicked out of Nursing homes because they could not safely manage his combative behavior.
I have learned to compromise. He is not as clean as I would like, but I manage to wrestle him and get a quick sponge bath in when I can. Here are some of my tips: Make it a part of their regular routine. For instance, when you wake up, we wash your face, and upper body, under the arms, and get a fresh shirt. Have a basin of warm water and soap ready in advance, a nice soft wash cloth, and sprinkle a couple drops of their favorite scent in the water, so it smells familiar to them.
Try and be as soothing and calm and gentle as possible. For me, fighting my stronger husband, I have learned to get in and out very quickly, before he can grab my arm or pull the cloth out of my hand.
I use disposable washcloths (large wipes) to try and get under the arms, then I use a 3" or 4" square gauze pad, (2 of them, actually) and pre-apply antiperspirant to the clean dry pad, and sprinkle with a little anti-fungal powder, and simply tuck it under their armpit. Let it stay there for a moment while I do the same on the other side, then those can be removed and thrown away. I use a lot of disposable products to help prevent the spread of bacteria.
I don't get too ambitious and try to wash the whole body at one time. I wash the lower part of the body when I do the first morning diaper change. Again, warm water and soap, some disposable cloths, and try to quickly saturate the area enough to get the skin clean.
If mom is getting up and going to the bathroom herself, place some wipes near the toilet and encourage her to thoroughly clean her skin when she goes.
If she is able to do so autonomously, she may feel more comfortable using disposable wipes to perform her own sponge bath every day.
I think for some, there is a fear of the water, not liking to get wet, or fear of slipping in the shower or bath, so they may be more open to a sponge bath.
There are caps you can buy for washing the scalp and hair. I don't use these, but that may be an acceptable option for her. You place it on the head, massage gently, then, simply remove and throw away. No running water needed!
Another tip for a combative bather, give them some part in the process. It will help them to feel they have some control. And keep their hands busy :) Such as: have them hold the dry towel - use a small, hand towel, not a huge, heavy bath towel. And tell them they can dry after you wash. That worked with my husband a couple times, then he got wise to me and would throw it down!
I was a homecare worker for 25 years and have had more people with dementia who got combative with necessary hygiene care than I can even remember.
The best bet is to hire an aide and tell your mother that she is a nurse sent by her doctor to make sure she is washing up regularly. Make an official looking "chart" and say it's from the doctor. Then check off when she's washed up, showered, changed clothes, had her hair washed, etc... Then tell her as many times as it takes that her doctor will put her in a "home" if the "nurse" reports back to him that she refuses to get washed up.
I've used this one many times to get a stubborn senior with (and without) dementia into a shower or at least washed up. If this doesn't work and it might not, there's the other approach. You have to wear her down.
Nothing until she gets showered or at least washed up. No tv, no conversation, no meal or snacks, nothing. Let her carry on and cry until she tires herself out, then get her washed up. Hygiene care is very important and must get done.
Caregiving is not for the faint-hearted. Sometimes you have to be tough to get it done.
Sometimes a shower isn't possible anymore, but just washing up can be enough to prevent skin breakdown and skin infections.
After Mum's stroke, she didn't want to get up and dressed in the mornings. She doesn't like the change in temperature, or any change for that matter. Even when she became more like herself for a few years before dementia symptoms became obvious, my mum required carers in the morning to get her washed and dressed. If family carers need help with just one aspect of daily care, I'd say this was it. Professional carers know how to move infirm people without hurting them and they know how to preserve someone's dignity, even if that person no longer does.
The occasional incontinence sure didn't help.
When she started putting up a fight, biting people and raging at anyone who came near her--DH's OB simply started checking out ALF's. Dh was POA, but he never did a thing with his 'power'. He also didn't care that OB basically stepped up and did it all.
Somebody who does not want to bathe, can become incredibly strong and combative. I couldn't believe that the 3 sibs working together could not get her in the tub. (She didn't have a shower, thought they were low class).
Honestly, sounds like you need to find mom a care facility. If she can only take herself to the bathroom but nothing else--what is her QOL at this time? She needs CGs every single day. Bathing is just one of the many ADL'S she is incapable of doing.
You can get away with 'bed baths' between showers--but you cannot do it forever.
Good Luck with this. Honestly, it was the fighting over not bathing that landed MIL in a NH.
Maybe Google one, and see if there's someone who will come out and help her with that. ◡̈
Bathing actually has many steps & requires much planning & short term memory to accomplish. Add feeling cold, stiff or pain & no wonder people refuse. Then add lack of smell & loss to reason & they don't underdtand why bathing is hygienic & necessary.
What to do?
The ususal answer depends or what level of help the person needs;
1. Prompting
Leading into the bathroom & prompting each step. Then comes
2. Assisting. Doing the task together. (With family or an aide) Then
3. Full Assistance. The person is bathed by another (shower, basin wash or bed bath).
As most types of dementia are progressive, bathing is part of the wider picture. What other ADLs now require prompting or assistance? Meals? Meds? Toileting?
As independance slips into semi-dependant, then dependant, choices about home need to be made. Home vs Home + carers vs Nursing Home.
You need a plan to get her 24/7 care, preferably in a facility where she can socialize. Professionals will know how to bathe her and keep her clean. You will be freed from the bondage of running her household and lying to yourselves and others that mom's fine, just fine, she just has a little mumble mumble problem but she's going to be all right.
Dementia changes everything, and when it's this serious, things cannot go on as if they were normal. I wish you luck in finding the help mom needs.
My father who had mild dementia didn’t shower for a year and I gagged when I went into my parents’ home until I got used to the stench.
He is now in SNF gets regular showers and looks 1000% better than he did when living at home.
I thought that bed baths would be basic, routine care.
He suffers dementia as the result of a stroke, but his general health is not declining. He could live like this for many more years, and has been kicked out of Nursing homes because they could not safely manage his combative behavior.
I have learned to compromise. He is not as clean as I would like, but I manage to wrestle him and get a quick sponge bath in when I can.
Here are some of my tips:
Make it a part of their regular routine. For instance, when you wake up, we wash your face, and upper body, under the arms, and get a fresh shirt. Have a basin of warm water and soap ready in advance, a nice soft wash cloth, and sprinkle a couple drops of their favorite scent in the water, so it smells familiar to them.
Try and be as soothing and calm and gentle as possible. For me, fighting my stronger husband, I have learned to get in and out very quickly, before he can grab my arm or pull the cloth out of my hand.
I use disposable washcloths (large wipes) to try and get under the arms, then I use a 3" or 4" square gauze pad, (2 of them, actually) and pre-apply antiperspirant to the clean dry pad, and sprinkle with a little anti-fungal powder, and simply tuck it under their armpit. Let it stay there for a moment while I do the same on the other side, then those can be removed and thrown away.
I use a lot of disposable products to help prevent the spread of bacteria.
I don't get too ambitious and try to wash the whole body at one time.
I wash the lower part of the body when I do the first morning diaper change.
Again, warm water and soap, some disposable cloths, and try to quickly saturate the area enough to get the skin clean.
If mom is getting up and going to the bathroom herself, place some wipes near the toilet and encourage her to thoroughly clean her skin when she goes.
If she is able to do so autonomously, she may feel more comfortable using disposable wipes to perform her own sponge bath every day.
I think for some, there is a fear of the water, not liking to get wet, or fear of slipping in the shower or bath, so they may be more open to a sponge bath.
There are caps you can buy for washing the scalp and hair. I don't use these, but that may be an acceptable option for her. You place it on the head, massage gently, then, simply remove and throw away. No running water needed!
Another tip for a combative bather, give them some part in the process. It will help them to feel they have some control. And keep their hands busy :)
Such as: have them hold the dry towel - use a small, hand towel, not a huge, heavy bath towel. And tell them they can dry after you wash.
That worked with my husband a couple times, then he got wise to me and would throw it down!
The best bet is to hire an aide and tell your mother that she is a nurse sent by her doctor to make sure she is washing up regularly. Make an official looking "chart" and say it's from the doctor. Then check off when she's washed up, showered, changed clothes, had her hair washed, etc... Then tell her as many times as it takes that her doctor will put her in a "home" if the "nurse" reports back to him that she refuses to get washed up.
I've used this one many times to get a stubborn senior with (and without) dementia into a shower or at least washed up. If this doesn't work and it might not, there's the other approach. You have to wear her down.
Nothing until she gets showered or at least washed up. No tv, no conversation, no meal or snacks, nothing. Let her carry on and cry until she tires herself out, then get her washed up. Hygiene care is very important and must get done.
Caregiving is not for the faint-hearted. Sometimes you have to be tough to get it done.
Sometimes a shower isn't possible anymore, but just washing up can be enough to prevent skin breakdown and skin infections.
Even when she became more like herself for a few years before dementia symptoms became obvious, my mum required carers in the morning to get her washed and dressed.
If family carers need help with just one aspect of daily care, I'd say this was it. Professional carers know how to move infirm people without hurting them and they know how to preserve someone's dignity, even if that person no longer does.