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She's currently 75. Suffers from severe asthma, and really bad dementia. Anytime we try to get her into the shower, she argues with us and tells us no. She also has a problem with bladder, and when she has an accident, she still refuses to take a shower. I'm starting to get worried as she has begun to smell very badly along with her room.

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Try a bidet attachment to her toilet! My mother was the same way & not only did she forget what to do in a shower but I think the water felt like pelts on her skin making it almost hurt with too much sensation overwhelming her dementia. A sponge bath once a week works great as a substitute & in times of diarrhea a bidet is perfect. She probably won’t want to do that either but it only takes a minute. Good luck :)
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my brother 74 is the same way, when we had an aide he refused anything the aide wanted him to do. no one can get thru to my brother and very limited family members go to see him. his daughter once a week and i go every other day. i tell him to wash, he lies, i tell him to change, he saz he does, but i see his chair and clothes are soaked. idk what the answer is bc he does smell. i tell him but makes no diff. he use to be a clean nut. he does listen once in a while, i have given him powder, deo cologne so that maybe he would do these things - NO! i spray orange spray around him bc I can't stand the odor, i do the rugs with the cleaner, i try. the doctor says he isn't ready for a home bc he has his faculties. so i pray alot, wear a mask, and do what i can
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Docfriday: Perhaps you can hire an aide to come into the home to bathe your grandmother.
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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.
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Kelkel Dec 2022
You’re very thoughtful. That is great advice!!
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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!
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AngieGuido74 Nov 2022
what if the person doesn't have altztimers but just refuses to bathe or wash the hair. i have brought the hair products where you spray on hair, i have the wipes to wash yourself and my brother doesn't use them. i am not going to wash my brother and he def doesn't want an aide to do it. so.......
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Hi. My Dad is 94 and refused to shower when I first started his care two years ago. Instead of arguing with him (he is fastidious and always had to scrub down the shower after he was done) I just started giving him a ‘sponge bath’ outside of the shower, but on his shower chair. He washes his front side and I do the back, always draping a towel over his lap for modesty. Even now, he will still soap up and rinse off with no arguments. I highly recommend ‘sponge baths’. I put it in quotes because it’s much more thorough than just wiping him off. If you respect his/her modesty and privacy it really is a good alternative. Good luck to you!
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When I was going through a severe depression I had this awful fear of showering. I would tip toe up to the shower curtain just to open and peek in and then shut it back abruptly. Only when my depression eased was I able to begin showering again. Could there be some psychological reason for her fear?
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My mom is 95 and also refuses to take a bath she is in memory care now. I still have to take her to Dr. appointments. I finally had to tell her I wasn’t going to come and see her or take her anywhere if she didn’t take a bath. After her screaming and crying she got in the shower chair with help. If they think your not going to do some of the thing they like most maybe they will shower or bathe it has helped me with my mom. But she still scream’s and cry’s over getting a bath.
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tothebeach23 Nov 2022
That is exactly what we had to do. Mom liked going out to eat, and we had to tell her "No more going out for anything. No eating out, no hair cut, nothing, until she showered."
It didn't always work, but more often than not.
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She may be modest, and not want to undress. The bathroom may be cold, and she may be terrified of the shower or tap spray. With dementia, you have no understanding of what she's feeling or thinking.

There is a product called Sudz (I believe that's correct). There's no rinsing involved, so you coujd give her a nice WARM bed bath.

Is she safe, content, and pain free? Those are the priorities.

P.s. Check out the wonderful Facebook group called Memory People. It's run by people with hands on experience.
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Memory Care! Contact an Elder Law Attorney to help figure how she (not you) can finance that care. Meet with a Geriatric Psychiatrist who can figure out why the refusal is happening and offer medication if that is indicated.

p.s. Has she tried baby wipes?
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My mom did the same thing , I had home health care come they would shower/bathe her twice a week, we gradually just started taking over … she still argues but I’m getting it done . Good luck ! 🙏🙏
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Of course, a person with 'really bad' dementia will argue and not do what is in their best interest for their health. A person with dementia cannot make these decisions. Their brain does not allow it.

Try:

1) getting a caregiver in there to do showering. She may feel embarrassed doing this with family member(s); and
1a) Many people respond / react differently to people in professional roles, other roles, when they are not family due to family bonding/history.

2) Do you get her to the toilet? Do the 'showering / cleaning there.

3) Do bed bathing as much as possible. Get the wipes, use warm water.

It sounds like your grandmother needs to be in a facility - they handle these needs. If she has 'bad dementia,' as you say, why is she at home with you?

Yes, the room will smell bad / horrible / awful. She likely won't smell it. It is a hygiene need / health safety.

You are the grandchild... why isn't one of your parents handling this need? I find it curious why you are writing here (and good that you are) and not her own child/ren.

Gena
Touch Matters
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When my mother was soooo ill and couldn't get out of bed we used "No Rinse" its what is used in the hospitals. They lay in the bed and you can wash their hair with it and body with it and not have to rinse them off. Easy. Also, I think someone suggested to change clothes everyday, once the clothes are off - wash with the "No Rinse". Hard yes but its like giving a child a bath, you are the boss.
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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.
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Countrymouse Nov 2022
You can't just stick somebody with severe asthma and severe dementia in the shower. The breathing difficulties would terrify her.
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Get out the hose and hose her down
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Cover999 Nov 2022
Lol Good One
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Something else that may work for cleaning your grandma's nether area is a sitz bath. I use a plastic tub which looks like an upside down cowboy hat. It sits on the toilet bowl. I fill with warm water and baking soda. Mom just sits down into the seat and gets a "butt soak" for about 10 minutes. No soap or rinsing needed. We do this in between showers. This may be something to consider for cleaning your grandma. I got my sitz tub in Amazon for under $20. I hope this helps.
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Luta65 Nov 2022
@Natasana,

The sitz is a good idea, but the baking soda is way too caustic for tender genital tissues and could break down her peri-area's natural oils and cause sores and discomfort. If you're using something so caustic, even in tiny amounts, you have to start rinsing this off and not leave that base solution of her perineal tissues. By breaking down the skin's natural flora, you open her up to UTIs and a host of other problems. Best to try some activated charcoal powder that is thoroughly rinsed off (must because it's black powder) but very odor-neutralizing. And use a peri lotion after.

There's a new brand of body odor products called Lume' that lasts for 72 hrs and has no harsh chemicals. I'd look at that product or something similar and find any other way to deal with the odor.
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My dad was the same way. Having an aid come and bathe him was sometimes successful, The turning point was when he went to memory care. They put it on the calendar. They showed him the calendar. They reminded him the day before that he was having a shower the next day, They reminded him in the morning that he was having a shower in x-number of hours. They even wrote him out a daily schedule at one point. That's what finally worked for him.
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Doc, search this forum for this problem. This is a common situation and there are really great ideas, you just have to look.

Best of luck, it is a challenge.
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"Let's just do your hands". Warm sudsy basin of water and some disposable washcloths ( I used Dove facial cloths). Introduce a nail file to gently clean under her nails. Some nice hand lotion afterwards.

As mentioned by others, make it a no stress moment. Give it awhile, and add on: "let's just wash your face with one of those washcloths you like", etc. Invent a new pleasant routine and hope for the best.
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I agree with cappuccino42 make it all about what’s best for her because you love her. Good luck.
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Geaton777 Nov 2022
Dementia robs people of their abilities to work from logic, reason and empathy. Respectfully, talking to the Mom about the "reasons" why she doesn't want to shower will just exhaust her family because it will go no where, or just in circles and stress everyone out. Teepa Snow, a dementia and carergiving expert, has some excellent videos on YouTube that taught me a lot about it. I highly recommend them.
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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...
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Cover999 Nov 2022
How to dry down there?
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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!!
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Cover999 Nov 2022
TMI on the BM. 🙂
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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.
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Cappuccino42 Nov 2022
Sounds very familiar ;) we also sing/listen to old hits and I end up soaking wet afterwards and Mum also combs her own hair hehe
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Lotions and creams for dry skin may be used instead of always bathing. However, I think facility placement because care level is beyond your capacity.
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Can you get a seat for the shower and give her a sponge bath? Make sure the water is warm (a temperature she finds comfortable) and that she is in a warm place. If that doesn't work, try baby wipes. Get disposable pads to lay under her on chairs and in her bed. Is she wearing disposable incontinence panties? All the best...
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I found shower care through Concierge Home Health. They visit for an hour to provide shower and bathing care. It’s been great and removes a lot of stress from me to simply make sure my dad is clean.
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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
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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
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Dementia patients are often afraid of the shower, the noise, the feel of water on their skin. At this point she probably needs to be where professionals can take care of her. She may need anti-anxiety meds now.
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Cover999 Nov 2022
Can you blame them? The first few seconds before the water warms can be a "shock"
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Often, a "neutral" person who is trained in dealing with this scenario will be successful in getting her to shower. For my Aunt, one of their neighbors was an experienced aid and she gets the job done 2x a week.

Otherwise, you can start with just "sponge bathing" in the bathroom with the goal of getting her showered completely. Is the bathroom nice and warm? Is there a shower seat and a hand-held shower head? Grab bars? Secure bath mat? Good lighting? Try to make it like a spa treatment with soft music and aroma candles. Fighting about it only makes her resistant because she is losing her abilities of reason and logic and empathy.

Hopefully you have also removed all her real undies and replaced them with incontinence briefs only. This will help.
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