My mom has not bathed for over a month. She was born during the war and all her life she has been very conservative with her water usage but this is ridiculous. I say "why don't you go and have a bath and you'll feel fresher". We live in South Africa and are in our summer now so it's a bit humid at the moment. She says she'll do it in the morning. She doesn't smell dirty but I'm a bit worried that she'll pick up an infection. Although she has dementia, she still has the ability to look after her hygiene. I don't know if she doesn't realize how long it is since she last bathed but to actually get her to do it causes huge fights. Any suggestions on how I can convince her to bathe without there being an unpleasant exchange?
You stated,
"Although she has dementia, she still has the ability to look after her hygiene. I don't know if she doesn't realize how long it is since she last bathed but to actually get her to do it causes huge fights."
The new, realistic way to think about it is that she no longer has the ability to look after or care about her hygiene. Dementia is a progressive disease, so now she's permanently lost her ability to do this for herself (remember to bath). She may still have the ability to wash herself but now you may need to use "therapeutic fibs" to coax her into bathing, like "We're expecting visitors this afternoon, so we need to freshen up" or whatever you think would work. Appealing to fears about infections and such will probably not work since that's too complex a thought for her to process.
How many times a week bathing was normal for her? Whatever it was, it may need to be fewer now. Also consider giving her sponge baths in between times.
Is her shower senior safe? Is there a shower chair in it? Is it sufficiently lit? Does she remember how to adjust the water temp? These are all things you can no longer assume about her abilities. Sometimes elders develop a fear or dislike of having water pour over their heads or face. Sometimes having a different person to help bath her works better. We hired a neighbor who is a retired NH employee to give my elderly aunt a shower 2x per week. We started with 1x, then moved to 2x and I don't think it'll ever go to 3 because she doesn't need it. For whatever reason she doesn't put up a fight with Shirley.
I wish you success in solving this challenge du jour!
https://www.google.com/search?q=teepa+snow+hand+over+hand+bathing&rlz=1C1CHBD_enUS896US896&oq=&sourceid=chrome&ie=UTF-8
Up above is a Google link to those videos along with other good articles on the subject. Teepa Snow has invented a 'hand over hand' bathing technique which soothes elders suffering with dementia & seems to help lots with the issue.
Tell mom she'll need to have a bath once a week *or twice a week which is plenty at this stage of life* and that you will help her with it. The X through the calendar is a good idea, but you can still expect push-back b/c elders with dementia don't like to bathe, period. If you can make the experience pleasant for her, that would be great. Figure out if she has fears and address them, first and foremost. My mother was afraid of falling, so water shoes eliminated that worry for her.
Good luck!
What jumps out at me is *Dementia & *not bathed for a month.
Even if physically able, other issues sometimes prevent tasks, especially personal care tasks from being done independently.
Some folk forget how to start - if you start them off they can do it. Some forget the steps (sequencing) & need verbal prompts to do it. Many, as suggested, become fearful. Vision & sensory changes mean they can't see the water, or it hurts etc.
CarylorJean, I would suggest playing detective & work out the problem if you can.
Could try the Ask-Say-Do approach. ASK her, if no action, SAY how to get started, if nothing, try later with DO. Don't discuss, just take her hand & lead her into the bathroom & start the process. See if she is willing..? but stop if she resists.
Once you know HOW much help she needs, then you can plan. Is this going to be a task you help her with, say 3x week? Or is getting a local care assistant affordable?
There is no need to explain to Mom she needs help (it is a step for you to accept though) but if you are her full-time caregiver, it is up to you take the necessary action.
(My Mother detested me helping her bathe but got used to & seems to like the aides that help her now).
Now that we acknowledge she isn't independent, we can strategies what works for her.
First, ensure you are working with her geriatric physician to assess her overall skill with activities of daily living (ADL), and are giving proper supplemental vitamins and/or TX medications to address the cognitive decline.
Second, be sure the shower is still safe for her. If she has to step over the side of the tub to get in, she needs help in and out of the tub. She might need a shower chair and a moveable spray nozzle that she can control. An inhome assessment might be useful for you to see how your mom is doing with all of her ADLs
A few simple strategies to try might include:
Ideally, you help her keep a calendar. Put bathing, shampooing hair, laundry, etc, on her calendar.
Schedule a weekly event for her to dress (and shower for) that may be Church, a salon appointment, a lunch out. Gentle reminders to bathe before these events might help.
I use Alexa to set routines for my mom and find she will respond to what the Alexa says to do easier than me nagging her.
Finally, if it is an issue for you to assist your mom, hire someone to come in to ensure she is clean. Skin can breakdown very quickly in the elderly and if she is not showering she might not be seeing cuts or ulcers that can become dangerous.
Do a search on this forum for bath issues. It is a common problem with dementia and there are lots of good ideas about getting baths done.
I’m having a behavioral specialist PSW come in next week. Do I think she’ll be able to wave her magic wand and make my MIL cooperate? Hells bells, no. But I’ll keep an open mind and try whatever she tells me to. If I hear anything worthwhile, I’ll pass it onto you.
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