The issue of elderly who were once reasonably clean adults refusing to take showers and wear fresh clothes is one that is far more common than one realizes. My dad, who worked a large portion of his life as a roofer, is starting to suffer from this common thing as well.
Sometimes the issue is depression. If we have a parent who no longer takes an interest in staying clean or wearing clean clothes, it’s wise to look at depression first. A routine check-up with their family physician is a good idea, especially if low energy is also part of it, or if they just don’t care about anything at all. Depression isn’t always obvious to an observer so it is important to have a physician examine them.
Another factor is control. As people age, they lose more and more control over their lives. But one thing they can generally control is dressing and showers. The more they are nagged, the more they resist. “My daughter is trying to take over everything. Well, she isn’t going to tell me when to shower, that’s for sure. Besides, I’m just fine!”
A third issue is a decreased sense of sight and smell. What your nose picks up as sweat, they don’t even notice. Not on themselves. Not on their mate. Their senses are not as acute as they once were.
A fourth cause is memory. The days go by. They aren’t marked with tons of activities as they were when they were young. If there isn’t something special about Wednesday, well – it could be Tuesday or Thursday. They simply lose track of time and don’t realize how long it’s been since they showered. Also, many of our elders did not bathe or shower every day when they grew up. There was often only 1 day a week that the whole family would bathe, often in the same water. We now take daily bathing for granted, but when our elders were young, a weekly bath was likely the norm. They may have gotten into a more frequent bathing habit in their last decades, but their brain is taking them into the past. Once a week, it’s bath time. Then, they forget what day it is, or even when they last took a bath or changed clothes. Time just slides by.
Fear or discomfort can be another big issue for elders. Fear of slipping in the tub. Discomfort trying to get in and out. More serious is when a person with Alzheimer’s or dementia is in the bathroom and doesn’t understand why there is water running down on them, or believes that the drain may suck them down. They just don’t understand what you are trying to “do to them”.
So what do you do about it?
This is a case where compromise is essential. Third parties can also help. I have an elderly lady who does not remember to bathe or change her clothes, though she will look me in the eye and say she had. And she believes she had.
Some of this was memory. She thought she must have taken a bath somewhere along the line, so she said she did. However, I feel much of it was fear. She was afraid of the shower. She was afraid of getting in the tub. She was confused by it all. Denial was easier.
Elders can be quite modest and often do not feel comfortable having a family member helping her take a bath. Far too intimate. For most families the “solution” is to hire a private home care company to help with the bathing. Sometimes the elder may not fully cooperate, but you need to persevere and continue to try. In my experience, it is very rare that an elder does not eventually accept and appreciate the help. But this process can take time before it is successful. The key is to have a private home care company that can send the same person each time to do the bath.
There are different approaches to take, once you’ve figured out why bathing is such a big deal. If a doctor finds the elder is depressed and antidepressants work, the problem may solve itself. A renewed interest in life may make the person more aware of needing (or wanting) a shower or bath and clean clothes. Energy may increase and that, too, helps.
If you find that you are in a power struggle with the elder refusing to be “bossed around,” a little trickery can come in handy. If the elder has a good friend, it sometimes works to get the friend to give a call and say “Hey, Alice. Shower up and put on your newest outfit. We need to go out and have lunch.” A reason to get cleaned up for someone besides family, coupled by an “I don’t care what you smell or look like if you don’t” attitude by the son or daughter, can sometimes do the trick.
If you can still get them in the shower, but they are afraid of the water (or sitting in the tub), there are many types of shower chairs available. These are wise for anyone who is getting older or who may have arthritis or balance problems, as it decreases the risk of falls. A hand-held shower head helps a lot with the fear factor if the person doesn’t have water pouring down from overhead.
However, if the person is in a demented state and afraid in the bath, then you or another person must move gently. Don’t insist on a shower or bath. Begin with just asking to wipe off a person’s face. Gradually move to under arms and other parts of the body, talking and telling them what you are doing, as you go. Be soothing. If they fight it or say stop, then stop. Try again later. Yu may at least get to a stage where there is an occasional sponge bath.
The thing to remember about cleanliness is that you may have to lower your standards. It’s hard. You know that at one time Mom would have been humiliated if she didn’t smell good, or had stains on her clothes. That part of you, due to kindness, wants to take over and have her look like she’d have wanted to look.
The other part, though, is that she is now in a different mode. Too much nagging is counterproductive. If Mom isn’t as sweet smelling as you’d like, or if Dad has stains on his shirt from lunch – well you all may have to live with it. Constant arguing about cleanliness and clothes can make the person feel belittled, and that won’t help at all. They will not take it as love. They will take it as criticism. So, compromise may be in order. And let’s face it, no one has ever died from body odour or gravy on their shirt.
Outsiders understand better than you think they do. Do your best to help your elders look nice and stay clean. But don’t expect a pristine appearance. It’s often not realistic, and the issue may be more about your own ego than about the elder. Think it through, be honest with yourself, and find a way to live with what you must. It’s once again attitude adjustment time.