Before moving my father to AL/Memory Care, he only showered twice a month which was frustrating but fortunately, he didn't smell. At AL, he refuses to shower most of the time but does "wash up" at the bathroom sink. After he had COVID and his quarantine ended, I visited and told him he needed to wash the virus off. He surprisingly got in the shower for me and while I got everything ready for him (including the shower temperature that he agreed was fine before he got in), he started turning the temperature dial and made the water too hot, then too cold. Dad also has trouble dressing and I believe doesn't like showering due to the confusion and forgetting what to do, along with frustration around dressing. He doesn't like being helped. Some on this forum may say "help your father bathe, help him dress" which I and the aides would gladly do, but my father is an easily irritated dementia patient and still struggling with his loss of independence. I would say what so many others here have said: have everything ready for the shower, warm the bathroom before entering, calm demeanor. Dementia, to me, is a very mixed bag of emotions and behaviors for my dad. My approach is one day at a time - if I or the aides get him to shower, great. If he refuses, I don't make it a big deal.
My mom is 88 and may have this issue also! So I started early evening telling her she should take her shower tonight because we have stuff to do tomorrow morning! (Even if we don’t). But she goes right up and takes her shower! It works 80% of the time good luck! It’s the hardest thing I have ever done but I know in my heart it is the most rewarding!
My husband who has dementia fought taking showers until I started going into the bathroom while he showered. I hand him shampoo (child’s no tears type), soap, washcloth, etc. Then I help him with warmed towel and body lotion. No more problems.
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.
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!
Call her primary and ark for home health to assess her for homebound care through Medicare. This would include a bathing aide. They are professionals and can have her clean before she has time to protest.
Here is what I wrote in general regarding the issue of bathing in my book "Dementia Care Companion" available from Amazon at:
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?
Preparing for a Bath · Choose the best time for bathing, when the patient is not tired and is more cooperative. If they are anxious or resist strongly, postpone bathing to another time. · Prepare the bathroom in advance so it is warm and inviting. · Make sure the water heater temperature is at a setting that reduces the risk of scalds. · Prepare all the needed items beforehand so you won’t have to leave the patient alone during the bath. Your attention must be fully dedicated to the patient during bathing times. · Remove unnecessary and unsafe items like razors from the bathroom. · Play the patient’s favorite music or sing a tune that they are familiar with and enjoy. · Set a reward for bathing, such as going for a drive, ice cream in the park, or dinner at their favorite restaurant.
During a Bath · If the patient is uncomfortable with you in the bathroom, do not undress them completely right away. Alternatively, you can partially cover their body with a towel. · If the patient does not allow you to undress them before going into the bathroom or the shower, do not force the issue. As their clothes get wet, the patient will be much more amenable to removing them one by one. · Have the patient hold a small towel or a bath sponge in each hand to keep them occupied. Otherwise, th
You will need to take the parent role. You need not give her an option. What you say is... okay time for a shower, let's go in the bathroom and get our clothes off. Or it's time to change, we are going to shower them put on some fresh clothes. She can probably use the cloth on herself she just needs to be supervised. Some insurance will pay to send some one to assist with bathing. Or if she is on hospice they should be sending someone over to you. It won't be everyday but twice a week at least.
I gave a lengthy response to this here. I will not add to my dialog. BUT, one thing I can say. When my husband got dementia, I read a little on it, and found a local support group where I could attend meetings with people going through the same situation I was with my husband. It really helped me understand him, what he was going through, what I was going through, etc. Now that I am going through memory loss, no family member is looking out for me, I think they are blind to what is really happening to me, one who had a good career, but now going through memory loss and mostly always forgetful of common things.
Sorry for your feeling so alone. Have you gone to a neurologist for testing to confirm your feelings of memory loss? I received a call from a long time friend recently, who called to let me know she had been diagnosed. A few days later I received a call from a class mate who has been living in an ALF for several years since her husband died of a heart attack in 2020. He had been her caregiver for several years. She had moved to a new ALF and wanted me to know. She has been very happy with her decision to move to an ALF. Her children are in the midst of living their lives and she is being well cared for. I was delighted to hear from both my friends and it was a nice reminder for me that I need to contact them often for a chat. Wishing you well.
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.
Depending on funds they have no rinse soaps and wipe cloths or a flannel and a bowl with a little disinfectant and have a hospital bath instead bathing gets harder as we get older the painful undressing - the time the challenge of getting in and out of baths and non altered showers its a minefield maybe compromise baths replaced with woke downs when life gets less scary and it becomes a routine maybe add a proper wash in my father went thru a stage like that now its routine he takes himself to the bathroom and has his wipe downs and afterwards we say its nice to feel fresh and clean isn’t it and he now agrees work with them in a compromise
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.
My mom was also refusing to shower all of a sudden. I realized she was having a hard time adjusting the temperature of the water..she was washing her hands at the kitchen sink one day and I noticed she pulled her hand back quickly . The water was so hot but she couldn't figure out how to make it cooler.. so i assumed she wasnt able to adjust the shower. after seeing this I started offering to get the shower ready when I was at her house. ( I was with her every day,)She went from showering every 2 weeks to showering at least twice a week. Try running the bath or shower for her, get the water temperature comfortable.
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.
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.
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.
good luck! It’s the hardest thing I have ever done but I know in my heart it is the most rewarding!
You or an aide need to bathe her.
Make sure the room/bathroom is warm enough.
Have wipes, washcothes, towels, clean cothes etc ready.
Bath or clean up time is part of the routine, not a request.
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.
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!
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?
Preparing for a Bath
· Choose the best time for bathing, when the patient is not tired and is more cooperative. If they are anxious or resist strongly, postpone bathing to another time.
· Prepare the bathroom in advance so it is warm and inviting.
· Make sure the water heater temperature is at a setting that reduces the risk of scalds.
· Prepare all the needed items beforehand so you won’t have to leave the patient alone during the bath. Your attention must be fully dedicated to the patient during bathing times.
· Remove unnecessary and unsafe items like razors from the bathroom.
· Play the patient’s favorite music or sing a tune that they are familiar with and enjoy.
· Set a reward for bathing, such as going for a drive, ice cream in the park, or dinner at their favorite restaurant.
During a Bath
· If the patient is uncomfortable with you in the bathroom, do not undress them completely right away. Alternatively, you can partially cover their body with a towel.
· If the patient does not allow you to undress them before going into the bathroom or the shower, do not force the issue. As their clothes get wet, the patient will be much more amenable to removing them one by one.
· Have the patient hold a small towel or a bath sponge in each hand to keep them occupied. Otherwise, th
Have you gone to a neurologist for testing to confirm your feelings of memory loss?
I received a call from a long time friend recently, who called to let me know she had been diagnosed.
A few days later I received a call from a class mate who has been living in an ALF for several years since her husband died of a heart attack in 2020. He had been her caregiver for several years. She had moved to a new ALF and wanted me to know. She has been very happy with her decision to move to an ALF. Her children are in the midst of living their lives and she is being well cared for. I was delighted to hear from both my friends and it was a nice reminder for me that I need to contact them often for a chat. Wishing you well.
I thought that bed baths would be basic, routine care.
they have no rinse soaps and wipe cloths or
a flannel and a bowl with a little disinfectant and have a hospital bath instead
bathing gets harder as we get older
the painful
undressing - the time
the challenge of getting in and out of baths and non altered showers
its a minefield
maybe compromise
baths replaced with woke downs
when life gets less scary and it becomes a routine maybe add a proper wash in
my father went thru a stage like that
now its routine he takes himself to the bathroom and has his wipe downs
and afterwards we say its nice to feel fresh and clean isn’t it
and he now agrees
work with them in a compromise
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.
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.
Maybe Google one, and see if there's someone who will come out and help her with that. ◡̈
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.
https://www.agingcare.com/topics/93/bathing
https://www.agingcare.com/topics/92/hygiene