My husband's Mom with Alzheimers moved in with us a while ago and I realized pretty early on we have some serious differences in our idea of personal cleanliness. Here are some thoughts about why Alzheimer and Dementia patients don't want to wash AND some tips and ideas about how to get them clean!
Mom had fallen and laid on the floor for a couple of days at her condo before she figured out how to call me, so she was tired, scared, and pretty darn dirty at that point!
So of course I said, all bright and cheery, that she should hop into the shower and get cleaned up! Whoa, that was EXACTLY the wrong thing to say… who knew a shower could be controversial?
Over the next day, I kept saying she should get a shower and she said she was fine and didn't need to wash. This should have been my first clue that something was amiss, but I missed it.
Over and over I said, “Mom, you have to take a shower” and over and over she said, “Tara, please don't make me take a shower!”
What the heck was going on?
Why Won't Alzheimers & Dementia Patients Take Showers
So first a little background about me… I take a shower every day! I love showers and have washed myself everyday since I can remember. My shower is filled with pretty smelling soaps and gels… oh and I get away from my 3 kids, 2 dogs, 2 cats and the turtle in there. It is my super special alone place.
Well, come to find out, many people, especially older people, don't have that same feeling about a shower. My friend Tena D who is from South Dakota said they never took showers as children and there was only one bath day…
Saturday night! They would fill the tub, everyone would hop in and out, warming the water occasionally and bam, clean for the week.
Come to think of it, my Mother, who died in her late 50s and who would have been 80 now did weekly bath thing… she never showered.
Doh. No wonder Mom (my Mother In Law) won't take a shower… she may have never showered before in her life.
Even though it would be SO MUCH EASIER, the thought of a shower is super foreign to her!
Reasons Older People Might Not Want To Shower
The way I process anything is write and research it… so I thought that I would check out some reasons old dears might fear a shower!
I sort of already covered this, but in case you are a “skipper”, many older people were not raised with a daily shower, or even showers at all! My Mother In Law is Finnish so her early bathing experience is with a sauna (pronounced SOW-NA). From doing some sauna research, it seems like it was a weekly bathing ritual. Ahhh again with once a week bathing.
So if your world view is that bathing is a weekly thing, done as a “bird bath” with a washcloth and hair washed in the kitchen sink, my daily shower ritual must seem to be NUTSO!
The problem currently is that sometimes she soils herself and so a once a week option is really not on the table…sigh.
Worry About Falling
Another anxiety could be the fear of falling in shower. I KNOW, we have grab bars, can get a chair to sit on and a bagillion other accommodations, but I know for a fact that my Mother In Law is terrified of falling in the shower.
I kind of get this one. Unless the floor is squeaky clean, it is easy for your feet to slip out from underneath you, and she isn't so stable a walker as it is!
Let's call a spade a spade, there is no really good way to protect modesty in the shower. You have to get totally naked all at once and as an Alzheimers patient, there is very little chance you will be left alone to take a shower.
Yes, I know you could put a towel around, avert your eyes or any other of a number of things, but seriously, that person is still naked and exposed.
Don't Know They Are Dirty
Okay, this is going to be a little graphic, but here goes. Mom had poop all down the back of her legs when I cracked and insisted that she HAD TO GET CLEAN!
She was still trying to avoid it, but when I was super blunt and said she had shit down her legs, FINALLY I was able to get a wash cloth with soap to hit her skin… winning! I know that sounds terrible, but I was just so happy that I didn't have to smell her anymore I was almost crying tears of joy.
Can't Remember How Many Days It Has Been Since Showering
When Mom was wearing her Thanksgiving dinner dress three days later (having slept in it day and night), we had to keep reminding her that it had been so many days since the holiday.
One of the hard things about caring for an Alzheimers patient is to join them in the lack of time reference. Suggesting that it has been so many days since Thanksgiving really has no frame of reference when she resets about every 20 minutes.
Tips and Ideas For Getting Them To Take A Shower
All of that is great for understanding, but what the heck can we do about it? How do you get a person with dementia to take a shower?
For some reason understood only to her, Mom is great at her doctor's appointments. She expects to clean up to go and we only have a few times where she really didn't want to go.
If your loved one is good at doctors appointments, schedule them a week apart rather than on the same day or concurrent days.
I know it sounds crazy to spend that much time at the doctors, but for me the “no problem” clean is worth it!
Something Fun To Do
Mom loves to go out to lunch! YAY! On weeks that we don't have a doctors appointment, often I can get her to go out to eat for lunch. Which means… bathing and clean clothes! Whoo whoo!
I actually like to go out to eat with Mom so this is a win-win situation.
For your loved one this might mean gong to church weekly, a senior daycare or something else that they enjoy doing.
A Family Holiday
The holidays are a great, low stress bathing time (the rest of things are falling apart but Mom likes to dress for dinner!) For example, tomorrow is my big girl's birthday. She is coming home for dinner and cake and the Grandpas are coming too!
This will be an easy day to get mom cleaned up.
I never thought of this one but a reader sent this one in! (if you have a great idea, please send me a message to email@example.com)
I just read your blog…patients who refuse to shower and wanted to add a comment. I finally realized that my husband didn’t want to shower because he admitted to me that he couldn’t remember how to make the shower work! So simple! So then I would get shower started and temp just right for him, THEN take him to shower! submitted by Alma
Establish A Weekly Routine
I read on the Alzheimer Association website they suggest that having a routine for bathing would be a good idea. I agree it would and we do this with our kids. We simple say, “time for your shower” to our kids and they trot right into the bathroom and get clean.
Now, this might work for your loved one, and what makes giving advice about Alzheimers so hard! The way they said this so happy like, I thought that would be great. We would just get into a routine of every other day or every third day and BAM, good to go! This did not work for my Mom at all. She honestly couldn't give a crap about what day it is and that it was “time” for her bird bath or shower.
That said, because Alzheimer and dementia patients live so much in the past, if they grew up with a “Saturday Bath” routine you might be able to get them to wash up every Saturday pretty easily!
Additional Resource :: My Morning Routine As A Caregiver
Have An Authority Figure Step In
This one works sometimes for me! I didn't think it was controversial, so fingers crossed no one yells at me!
I am Mom's primary caregiver. I do her pills and take her to the doctor. I help her wash her hair and her butt and so am more caretaker than authority figure.
My husband on the other hand is pretty hands off. He is great with her doing things that need done, but he isn't nagging her to brush her teeth or fetching her glasses for the 3rd time today.
For this reason he is perfect authority figure. Sometimes when it gets really bad I will tell him to say something and about 2/3 of the time she will clean up within a day! Now, this isn't one I can go to all the time or it will lose it's potency, but when I am desperate, I bring in the big dog!
Get A Home Health Aide In
I am in a Alzheimers group on Facebook and some of the gals there were talking about showers the other day. One of them said that her Dad wouldn't let anyone in the home bathe him, but he would get a shower when the home health aide came in.
A bunch of the other people said that didn't work for them, so like everything this is going to have mixed results depending on whether your loved one responds to the aide you bring in.
One thing that seems to be a major trouble with this plan is that some home health aide companies send different people each time so there is no consistency in who is coming to care for your Alzheimer or Dementia patient. This seems to cause a real problem with agreeing to bathe.
Controversial – Shock them
My first big “fight” about bathing resulted in me yelling, “your legs are covered in shit, we need to wash you”. Sigh.
I know that is not the best way to get your loved ones to comply, but I couldn't take it anymore! And it worked, Mom let me clean off her legs and put on clean clothes.
I am happy that it worked, but I would only use this one in case of emergency. It was shocking to Mom to realize that she was that dirty and then that I had yelled a profanity at her.
I am not proud that I lost my composure, but was glad to have a clean Mom!
Controversial – Trick Them
This is another one that seems a little creepy to type out loud! Only use this depending on your level of guilt about lying!
So you could say that there was a doctors appointment, a family holiday or even an emergency coming up (I KNOW that doesn't make sense, neither does much of what Mom thinks!)
Figure out what makes them shower and then create that situation, even if you have to say that it was “cancelled” afterward.
I KNOW, this sounds really crappy to do to someone you love, but remember, sitting in your own filth is not healthy either so this is definitely “for the greater good”.
Pick Your Bathing Battles
Last but not least has more to do with you than them! Yes, I wish I could pop Mom into the shower each day and snug into clean clothes. It would make me feel better to be clean, but it doesn't feel better to her.
Since tomorrow is family holiday, I know she will be cleaning up… so I have decided not to think about it today! A clean day off!
While your cleanliness level may be higher than your loved one, you can't make every day a battle of cleaning wills. Sometimes have grace and give yourself a day off!