No shower for months

WDA

Hello,

I have read a bunch of archived discussions on showering/bathing but I am still at a loss of what to do. My mom does not shower and has no interest in showering. There is no bathtub in the condo but we did install and hand sprayer. She also is incontinent and stinks. Her condo is starting to stink too. When I try to bring up the idea of bathing, she first says that she does it "all the time". If I press at all, she gets very angry and says, "I will just stay at home and never leave my place again" (still insisting she showers regularly). This started a few years ago with fewer showers but now it has been months since she has bathed. She doesn't even bother for the doctor anymore (something that used to work).

She has had several cases of fungal rash and she rarely removes her bra (despite the doctor giving her written instructions to do this). She does change clothes daily and gets her hair washed and styled once a week. I also wash her lower legs when changing out her compression socks but that is all she will allow. She also refuses nursing help and has told too many that I've hired to "leave and don't come back." She also refused "assisted" living because she is not like "those people."

She has no formal diagnosis just "diminished mental capacity" - whatever that is - and I just don't know what to do. She is really gross smelling but if I point it out, she won't go over to the main building where they have meals (the only time she socializes with other humans). 

Is it better to be dirty and stinky and get some social interaction? The rest of the day she sits in her chair and refused to move or walk (also prescribed by the doctor). 

Any advice? I really want to help.

Thank you!

SusanB-dil

Hi WDA - MIL will not use the shower, but so far will 'wash up' with washcloth (or says she does, hmmm...). Her hair does get washed due to a precious friend-of-the family who did her hair for years. Similar situation, though, as she doesn't wash as much as she used to. There was a post a while back that the tub or shower base can look like a big void to PWD as their depth perception gets more affected.

You've probably tried fiblets for the caregivers to come in to help?  I'd probably let her doc know, too. Would she listen to the doctor if doc actually called her, maybe told her she HAS to have a caregiver for shower at least once a week?

M1

Welcome WDL.  So, is she in some sort of independent living facility?  Sounds like she probably needs memory care.  Besides the hygiene issues for her own health, I'd worry she may get evicted if there is a risk of property damage/offense to other residents.  You likely need to read your contracts carefully and make a proactive move.  I'd worry about her being alone anyway, from what you're describing.  Hope you have power of attorney, because you can't expect her to cooperate voluntarily, you'll just have to do it.

MN Chickadee

You have two things going on here - one is the need to get her washed up so she doesn't stink and suffer health effects, the other is you need to get her more care. Regarding the latter, you have so many signs that she is not okay alone in a condo. Most of the time the refusing to bathe and change clothes etc. is not the only thing going on; judgement is compromised in all kinds of ways. Mis-using medications even over the counter, all aspects of safety in the kitchen, eating spoiled food, forgetting if they ate and eating too much or too little, not knowing what to do in an emergency. Sometimes there is much more going on there you don't see if you don't stay 24/7 for a while. I would make an excuse like your home is under repair and stay with her a few days and get a sense of what is really going on. She is way beyond even assisted living, this is memory care stuff. There they have staff trained in dementia who come up with techniques to get someone to bathe and move around and whatever needs to happen. You can no longer wait for her to want to bathe or involve her in decisions about her care or bringing in help. It is not responsible to leave her in this state, it sounds like you need to act. I would also get her to a doctor under false pretenses or fibs about what it is for or whatever you have to do and send the doctor a note ahead of time about what is going on at home. Clearly she needs some further testing and diagnosis. Do you have power of attorney? If not you need to consult an elder law attorney ASAP about next steps, because you will have to act on her behalf and will need the legal authority to do so. If you end up having to pursue guardianship the courts will order her to have a cognitive assessment. Usually we have to work behind the scenes and use fibs to get things done to keep our loved one safe and cared for. Never argue or present evidence, just say whatever keeps the peace, agree, validate feelings, and work behind the scenes.

Regarding not bathing,  this is a common issue with dementia. In their mind they think they just bathed, or the steps involved in getting the water right, which products to use are just too much. It is important to learn good communication techniques. Modesty, relationship boundaries being crossed, sensory inputs are at play. Someone will have to be with her, directing and assisting or it will never happen. Some find an outside caregiver has better luck, it just depends on the person.  Some find bribing works (lets get washed up and then I have some special ice cream for you etc) or saying let's get washed up before we go to church or the restaurant. A certain time of day may be better. If you fail now try again later.  Let her wear a swim suit, t-shirt, or drape towels and let them get wet, since modesty can be a issue. Keeping a calm soothing tone. She will pick up anxiety and frustration from you so you have to just be even and go with the flow. Be prepared with everything you need ahead of time, making sure you are the uncomfortable one (you should be hot, not her being cold.) Call it a spa day, we're going to spoil ourselves. A girls day in, maybe you bought some special spa stuff. Whisk the clothes away after a shower before she can try to put the dirty ones back on. Replace all underwear in the drawer with Depends.

There are some good resources out there to help you find techniques that may help. Here are a few:

https://www.youtube.com/watch?v=sl3Dc1kERto

https://www.alz.org/help-support/caregiving/daily-care/bathing

https://www.youtube.com/watch?v=iKT9YIVPREE

WDA

Thanks for the responses.

I do have POA but don't want to damage our relationship. The doctor has tested her with paper tests several times and although the scores are below "normal", the won't come out and say what is going on or give a diagnosis other than "diminished mental capacity". I have asked about medications and she (doctor) says there is nothing available for her.

The doctor has written "instructions" after every visit for her to wash, exercise, elevate her feet, etc., including "assisted living" recommendation but she won't do those things on her own and she refuses nurses and assisted living. The doctor says that Mom understands the consequences and we need to wait until "something happens" like a fall - really? I am at my wits' end. 

Mom holds conversations and does a great job masking/hiding what is going on - but I handle all of her finances, bills, etc. due to very bad decision-making around money over the past 5 years. We tried her living with me for 2 years but she and my husband fought every day, and I couldn't take it anymore - so we got her a place of her own. She is in the "independent" section of a larger senior community.

And I'm taking my stinky mom out to dinner tonight (I feel embarrassed by the smell and ashamed of my embarrassment). I have tried the "bribe" method and she will just say "Fine I won't go out to dinner or out of my house ever again" then stay mad for a week.

I think you are right about assisted living or memory care but I just don't think I can get her to go there. She is the type who would just get angry and leave - walking in 30 degree weather! (she did that once when she and my husband got in a fight and I had to follow her slowly in my car)

Every day is groundhog day! Thank you for listening. Any advice is appreciated.

Beauchene105

I'm so sorry you're dealing with this. My advice based on my experience: exercise the POA. That's what it's for--when they can't make their own decisions, and she clearly can't. When my mom could not take care of things anymore, I simply told my mom her safety was at risk and she would need to move to a place where she would be safe. She argued with me, but the roles were reversed and I was now the parent. It is not easy--any of it!!

CatsWithHandsAreTrouble

Does your mom's doctor specializes in geriatrics? Does she have any experience with dementia at all? I think you might need to get a different doctor and/or visit a neurologist and have them check out your mom.

I'm completely flabbergasted that her doctor thinks that just writing notes for her would amount to anything. It's obviously not working.

Do use the POA, the dementia your mom has is already changing your relationship day by day, sometimes hour by hour. She might not be happy but her safety and well being are priority. Good luck, it's a big task. 

One good thing is many people here have gone through this already and they are a wealth of knowledge. Keep reaching out and looking around the forum. You're not alone.

harshedbuzz

WDA-

I am truly sorry for what you are going through.

Dad went through the philty-phase, too. It looked as if a yeti had taken over the couch. Prior to dementia he'd been fastidious-- the man showered 2-3 times a day and camped with not one, but two, dinner jackets. It was hard to reconcile the two. He had anosognosia and was unaware of these changes. He believed he'd showered as was his custom and attempting to prove otherwise only annoyed him. I called him on wearing the same shirt for a week once-- it was covered in splatters from Christmas brunch, and it was New Years. He narrowed his eyes at me all insulted and told me he'd "laundered it". LMAO, I don't think that man ever did a load of laundry in 60 years of marriage but whatever.

A couple of random thoughts-

1. Your mom chose you when she was in a presumably better frame of mind to make decisions should she become unable to. A POA is not a suggestion or permission, it is a responsibility to step in. Will she be livid and act out? Yes. But she'll very likely settle into new routines with more structure and better care.

2. If you think your mom is getting positive human interaction at meals when she shows up in an IL dining room reeking of body odor and decayed skin you are delusional. In most IL/AL facilities, the other residents tend to be wary and exclude those who have just had a cognitive shift and can't keep up with their banter or activities. My aunt got to relive middle school mean-girls at her AL and her grooming was still good. 

3. Care needs drive placement. Full stop. If you mom cannot manage her hygiene ADLs or take care of her skin infections, she needs to be in a place where caregivers will do it for her. I was really worried about this with dad, too. But he saw the MCF as a kind of subacute hospital and accepted care from aides in a way he never did from us or aides at home. The structure and dementia-informed program suited him. Yes, he commented that his neighbors were crazy but he enjoyed some of the parties and musical programing and enjoyed chatting with his caregivers. TLDR; he got much better care in the MCF than my well-intentioned mother could manage at home because he was more cooperative for them.

You needn't worry about her storming off into the frigid night. These places are generally secure in that a keypad is needed to enter or exit. In a good MCF, staff will be trained to help redirect and calm an exit-seeking resident until the behavior passes. Dad was very angry when it dawned on him that he needed to stay in "rehab" (our fiblet), but he settled in about 2 weeks and was delighted when we came to visit.

HB