He gets belligerent if anyone tries to suggest that he might do something he doesn't want to do (in this case, bathe). He hadn't bathed for months at home, despite gentle suggestions. He recently moved into assisted living, so help is there, but he has refused it. Do we just let him be stinky or are there strategies we haven't thought of? (He's 280 pounds and cranky -- we don't expect staff to force him.)
Refusal is communication. It's not just forgetting when they last showered. They cannot do the task anymore.
They may not understand When Last nor plan When Next. They may also lose understanding to Why this is important.
Other common factors are fear of falling & pain/discomfort.
For a larger man, mobility may be harder, maybe it brings on uncomfortable feeling of shortness of breath too.
The only way I know from where you are is a Team Approach. Three staff arrive, aprons on & march him into the bathroom. Make it as easy on him as it can be;
- chair to sit on
- nice warm water
- professional manner to reduce any embaressment
- ensure any pain is managed well
- drying & dressing help (encouraging him to do what he can for himself)
- LOTS of praise when the task is done & he is clean 😇
Tone of voice is so important.
1. Three staff start with a stern 'Matronly' leader.
2. Professional kind approach throughout
3. Lots of praise at the end
Aim for 2 showers a week. Have it written into his care plan/schedule.
I haven't met your Dad, but many others that this approach worked for.
Discuss with the AL Manager. Having three staff is alot but this can be cut done once he accepts the help.
Note: If he is aggressive or there is ANY danger he could cause harm to staff - a medical review may be recommended first. Maybe a pill to calm his mood will be in order.
(That made the difference for my LO - between Refuser & Clean).
"Dad, you really do not smell fresh. Let's get a bath/ shower planned right now. You will feel so much better after a hot shower".
We never had this problem with dad, b/c he had so many of us caring for him. Mom kind of just 'fibbed' a little and it was was easy to know she had not showered, the shower was bone dry and the towels were stiff (and sometimes dusty!)
My hubby is about this size--and he is getting lax with washing (with SOAP) his privates and butt. (He would kill me if he knew I was saying this). He BATHES but doesn't bother to actually scrub well. IDK why. He has some bowel issues and has a lot of diarrhea and doesn't clean well after the fact. I am getting a warm water super-bidet installed this week (fingers crossed!) and hopefully that will help the cleanliness situation. I have thrown away too many pairs of underpants b/c they are irretriveably stained. Hopefully the bidet will help a lot!
I am straight up "Hon, take a quick shower before coming to bed" and he never fights me on it. We have a hand held shower head and THAT is a game changer, too.
I hate to be mean, but I know when he takes these 3-4 hr baths, he simply stands up and gets out of the tub and doesn't always imply SOAP in the regimen. SO all the guck that comes off, just sticks back on him.
Your dad needs a good SHOWER--not bath. Is he at home, I didn't pick up on his location. A NH will not allow a patient to not do at least a minimum of cleaning. Big wet, hospital grade washcloths that are wetted and used to clean and then to re-clean work really well, for the short term, but long term, you gotta get in the shower.
A male aide will probably be more welcome that a female. Or a willing family member. My brothers bathed my dad.
The last 2 times have been crappy underwear in the trash, surgical gloves on the floor, soap residue on the lay flat shower table, cover for the razor on the floor ,,( at least used razors were in bins). Opened briefs and adult wipes packages, toothpaste residue on the shower room floor,
I really feel bad for the hand held shower head.
That being said, so glad I can shower on my own without assistance with the added bonus of knowing the code to the shower room (thanks to the real nice aide).
Hope today is better.