Basic Hygiene I can’t get her to Bathe

Cjberry

Please help!! My mom won’t bathe, brush her teeth, or take meds!! My brother and I trying take care of her but she just won’t cooperate. We simply can’t put her in assisted living it costs 8,000 a month!! Any suggestions we are at the end of our ropes!

Lor2014

Can you find someone to come in to bathe her once a week? If it's someone she doesn't know, she may respond better. Just a thought. Or can you get wipes and at least have her wipe herself clean? I feel for you. This is such a difficult journey. {{{hugs}}}

Rescue mom

Not wanting to bathe is a common problem, if you read through a few pages of this forum, or search (sometimes the search function doesn’t work so well) you’ll find lots of threads with lots of tips on all those problems.

With bathing, as said, the PWDs often do better with a different person helping. Maybe hire an aide to come in just a couple hours a week, just for that. The PWD also may want the room hotter, or be afraid of shower water. Maybe insecure about their own movement/safety, afraid of slipping or falling? A shower chair could help. So many problem areas with bathing, but also a lot of tips from others who’ve dealt with it.

Does she just forget to take meds, or flat refuse them? A pillbox or dispenser may help with “forgetting,”, but they will lose the ability to even use a pillbox and/or bottles. Somebody has to put the meds in her hands and watch her take them.

If it’s flat refusal, even if you hand them to her, you need to get tricky. Many meds can be ground up or broken and added to food or drink. (Check with pharmacist, some meds are not supposed to be broken up). 

Pharmacists can also often give you a liquid version of the same med, which is often easier for them to take, or for you to add to another food or drink.

harshedbuzz

The answer to this will depend, in part, with what is driving the behavior.

If you are merely suggesting a shower/bath, she may assume she's already done so if that was her custom before dementia or if she finds herself already dressed. Sometimes this can be managed by getting a shower/bath ready as soon as she is up and guiding her through it.

Or it could be her decline included the executive function/cognitive skills around steps taken to bathe. If that is the case, having help in the bathroom to assemble what's needed and prompt throughout might be a solution for a time. Some PWD are more likely to cooperate with a HHA rather than an adult child or spousal caregiver.

Some PWD seem to develop sensory issues are this activity. Often their temperature regulation is poor, making the experience unpleasant. Warming the room with a space heater and using warm towels can sometimes work around this for a time. One gentleman here has a DD who gets mom to bathe buy making it a spa-like indulgence when she won't under any other circumstances. A trip to the salon might be easier for getting her hair clean.

As the disease progresses balance or feeling unsteady means a shower chair might help. But there are those who loath the feel of even warm water and will fight around this. Some people do bed baths or even use wet wipes and dry shampoo. 

Teeth are harder, she may need hand-over-hand help in this department. Sometimes a sweet childrens toothpaste is more readily accepted. 

At some point many caregivers hide medication in a treat if their pharmacist gives the OK to do so. At this point in the disease progression, many families consult with the PCP around creating a more palliative care plan which might mean weaning off some medications where the benefit no longer outweighs the risks and drama involved in taking it. 

By this stage, a PWD shouldn't be living alone; is one of you living there? If you haven't consulted a CELA, you certainly should. There may be ways to qualify her for Medicaid to help pay for a MCF or SNF depending on your state. 

HB

live in daughter

Hi Cjberry, here are some things that worked for my Mom.

Bathing- my Mom was fearful of falling. She did not want to take showers. We had a shower chair that she could sit while showering. Two of us guided her in the shower. My sister would help to bathe her in the shower. We had safety bars installed in the shower- we also changed the shower head to a hand held one so we could direct the water more gently for my Mom. We had a heater in the bathroom because she was always cold. Even with all this it was a struggle at times to get my Mom in the shower. You may want to figure out the best time for your Mom. We found early afternoon was best for our Mom- she had energy and was more mobile at that time.

As time went on we switched to bed baths. We would bathe our Mom first thing in the morning before she got out of bed. Two of us would give her a bath- head to toe. By working with two people the bath went quicker. We also put lotion on her skin with a fragrant scent that seemed to calm her.

Teeth brushing- we used an electric tooth brush. We found my Mom would allow us to brush her teeth with the electric tooth brush vs hand brushing. At times my Mom could not spit out the tooth paste so we would rinse the tooth brush in water and then brush her teeth with the water to rinse.

Meds at times were an issue for my Mom. Instead of going back and forth with her sometimes we let her refuse the medication and try again in a half hour. Most times she would take after the half hour had passed. Other times we would crush meds- be sure to check with pharmacist what can be crushed. Extended release meds cannot be crushed. Sometimes we would give my Mom meds and find the med hours later that she had spit out. We counted that up to a missed dose. 

Hope this helps a little. 

WhatNow?

Hi Cjberry, 

It seems as if we all earn our badge with the things you are having issues with now.  I know my sister and I did with our mom.  

The thing about this disease is it really keeps you on your toes.  I would definitely recommend learning about the disease and reason why people with dementia do what they do if you haven't already.  It does help to some extent to give ideas of  how and how not to approach things .  I would say the other part of it is learning what works for your loved one (I know not really what you want to hear).  You have to take their personalities and their fears into account and really be a detective in trying to find out why they may not want to do something or what situations might make achieving a goal more attainable.  Definitely easier said than done and the same thing doesn't always work every day.

My sister and I both had to try all kinds of things to get mom in the shower and to take her medicine.  Once we found something that work we would share it with each other.  So much of it is trial and error.  

One thing that worked with my mom, for showers, was only approaching her about a shower if she was already up and moving.  I usually caught her as she was getting up from the table from lunch.   I would also frame it as a favor to me...if she could take her shower now, that would allow me to take a shower later and have hot water, etc.  She did live with us at the time.  I also found not really phrasing it in a question too much, more of a gentle hey I got your towel and clothes ready for you so you can take your shower now, so I can take mine later and have hot water.  That also seemed to help.

For medicine, every night she wanted to know what each pill was for, what it was, who prescribed it, how often she would have to take it etc.  So after many arguments and tears, we started to provide her a piece of paper with a picture of the pills, the name of the drug, and a very high level description of what it was for....cancer, memory(this can be touchy), vitamin, etc.  I would also give her, her pills in a "fun" dish and just made it part of the routine.  We did finally get to a point where we didn't need the paper.  We also made sure to give her all her pills at the same time.  Also, we worked with her doctors to prescribe extended release drugs where they could so we didn't have to give her medicine more than once a day.  They were a little more than non-ER drugs for what mom had to take, but I figured all of our sanity made up for it.  

Good luck!  Keep trying and alternating between you and your brother.  I hope you guys get some ideas here and  find something that starts to work for you and your mom!