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I know that I am burned out so I'm really just writing this for my own sake. My 91-year old mom with dementia exists on three high calorie Boosts, a small dinner, wine and cigarettes every day. She's happy with that and is maintaining an okay weight.
She is highly resistant to taking care of her personal hygiene, however. She uses toilet paper to catch drips despite having an ample supply of pads. She cries when I coach her to bathe. She smells because she also won't change her panties every day and will wear soiled underwear until I stand in her room and watch her change. When I discuss this with her, her response is, "why do you care?" At this point, I'm about past caring. She's got a tough constitution and has never had a UTI. Maybe I just push her to change her smelly under garments when I can't take the smell anymore. She is not bothered by it.


She's nimble enough for me to wash her hair in the sink but my overall battles with her on cleanliness has left me unmotivated any more to make sure that happens regularly. A shower, even with me assisting her, is a battle. It's been several weeks since she had a thorough sponge bath (which I also help her with.) I've grown tired of the fight. It's tough to see my formerly impeccably groomed mom turn into someone who looked the way she does now.
Except for her hygiene, she does really well. As I said, she's pretty healthy, her spirits are high, and we mostly rub along fine. I love her dearly.


Anyway - I'm writing this out for me more than anything. I appreciate the space.

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This refusing to wash thing. Seems so many affected by it. I assumed it was a mix of dementia & depression. Lack of short term memory to know when the last freshen up/wash was + lack of motivation. I saw both when my Mother was in hospital. Also how tiring it was.

See if this artical helps.

https://www.agingcare.com/articles/elderly-parents-who-wont-shower-or-change-clothes-133877.htm
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The cigs have destroyed her sense of smell, so she's happily oblivious to the funk.

I agree with replacing the underwear with disposables, but also try to find it in you to demand she wash the lady bits regularly, because you shouldn't have to live with that.
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My mom broke her hip about 20 years ago. The hospital showed her how to keep herself clean with witch hazel, cotton pads and a washcloth. She has refused any help in all of that time regarding bathing. She does not have an odor, that I can detect anyway, so I'm assuming she's okay, although I did see her bareback once and it looked awful. Her doctor has also seen her back but never mentioned anything about it, so I assume she's fine in that regard.
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Kaybellor...You have described the problem I have with my wife. Nearly identically. I used to take her in the shower and have her stand and hold the shower chair while I washed all the back side including feet and legs, and her butt which she never gets good and clean. Then she sat in the chair and washed her front side and finally, I shampooed her hair while she held washcloth over her eyes. Sounds simple, doesn't it? It would be except that she starts complaining it is too cold or hot when she steps in the shower and gripes and swears and complains and says it's the last time I'm ever getting her in the shower. She says she can't stand that long (3 minutes)and anything she can think of. I swore I was through after 1 or 2 trips like that, but... she gets to stinking and I threaten and plead and bargain and finally get her back in to bathe and it all starts again! She would wear the same clothes forever if I let her, but she spills her food up her front and in her lap and I make her change... everything. I threaten to burn her panties. I get her clean and all clothes changed and, if I don't watch, she will go get her dirty pants and sweater and put back on!!! I would have a caregiver come and bathe her but they are scarce in our small town and she isn't very agreeable to the idea anyway! I'm caring for an 85-year-old child! Good luck to you!
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For nearly a year my FIL very frequently refuses help in AL. He kept saying he’s independent and no one is taking his independence away. We tried to tell him he will fall in the shower alone. And that will make him lose his independence when he ends up in a wheelchair in a nursing home . So then he stopped showers altogether. Then we refused to take him out anymore , so he went back to doing his own showers alone once in a while . We still refused to take him out until he let the staff help him in the shower. He let them help a couple of times . Then he refused again . Then he intermittently took a shower with or without staff in the room. He does a poor job of washing , and never washed his hair . He won’t sit in the shower chair , he holds onto the bar on the wall . Then he stopped again . He ended up in the hospital with respiratory failure and rehab. After rehab he decided he was totally independent again . Instead of telling him that accepting help will preserve his independence by keeping him out of a wheelchair . We just bluntly told him , that he’s not independent and he needs to sit in the shower chair ( which he needs help with ) and let the staff help him . That lasted a week . He may have accepted help also because visitors from out of state came. So he cleaned up . So we took him out last Saturday but he was starting to stink again, because He’s back to not accepting help again . I give up . We bring him take out food . It took me weeks to get the smell out of DH car 4 months ago , even though I threw out the waterproof seat cover . Not taking him in the car if he’s not showered . I’m assuming at some point he won’t be walking maybe within the year . Then it may be too hard to get him in and out of the car to a wheelchair , I’m not killing my back . DH gets very upset about the lack of washing . His room smelled too .
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Don't feel bad...we all get there. It is hard, and you wonder how they can't see it, but there you are.
There's only so much you can do with a person who is convinced that they're still living the life they used to. As suggested, 'disappear' her panties and be ready for arguments when you try to get her to change them. I taped up a large note in my mom's bathroom at the AL telling her the doctor agrees with her that she should change her briefs twice a day to prevent UTI's. Go figure, it's seemed to work!
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Well if she was always well groomed and proud of her looks, I might try taking pictures of her at her most slovenly,, and showing them to her.
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It’s so sad to see our parents decline. I feel it’s a combination of things, being cold, being fearful of falling, becoming exhausted, and as sad as it is, a general feeling of apathy.

I think many people on this forum will identify with your posting. I wish you peace as you continue on with your difficult journey in caregiving.
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I really appreciate all of the feedback. FYI, one thing Mom does not do is smoke indoors. I am fortunate in that my brother is coming later this year to take over Mom's care. In the meantime, I'll soldier on!
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I feel for you. I’m sort of relieved to hear I’m not the only one . DH and I also considering giving up the the shower argument with FIL. He isn’t that bad with his dementia yet , but so stubborn. He is in AL for a year . Doesn’t shower that often . Doesn’t change his incontinence underwear often enough . Have tried everything . They brought a male CNA from memory care over , FIL cursed him out . He doesn’t want his independence taken away . We refuse to bring him to our house anymore or out to a restaurant the last 5 months . He did let them help him shower a couple of weeks ago because he had visitors from out of state coming . So since he showered we took him out , but now he stopped letting them help him again . I’m thinking of giving up , let AL put him in memory care , which he will fight .
Maybe it’s time for you to place your mom since you are thinking of being away chunks of time.
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My MIL had a bath earlier this week. She had her aide there. She fell.

DH said that the bath wore her out so much she slept the rest of the day--and didn't eat or drink.

She was always an immaculate, incredibly clean pulled together woman. Seeing her (DH reports, I actually have not laid eyes on her in 2-1/2 years) becoming 'raddled' looking is probably as hard as anything DH is dealing with.

What used to be a relaxing part of her day is now fraught with drama. Do they force her to bathe and she's sleeping the other 23 hrs of the day, or do they step it down to 'bed baths' and maybe it won't be so exhausting?

Sadly, she never had a shower installed, thought they were trashy and baths were more hygienic. If she had a shower, she could simply sit on a shower stool and the whole thing would take 10 minutes. A bath requires her to lift her legs over the lip of the tub and it now terrifies her to do that--b/c she CAN'T. Also, she's a 2 person assist now and the bathroom is teeny. Not enough room for 3 people.

She's stated she won't bathe anymore.

Luckily, so far, she has not become incontinent, but the Hospice Co. says that's almost inevitable. I cannot, cannot fathom my DH changing his mom's depends.

I'm just a sounding board--but I might suggest that DH install a handheld shower head to the tub faucet and get a shower chair. Much less effort to get in and out of the tub. IDK.
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Throw out all her cloth undies and replace with only disposable briefs. Don't tell her you're doing this... just do it.

No bath = no cigarettes. Make sure you find all her ciggies before you do this. Tell her she can have one as soon as she finishes her bath. Be her ciggie dispenser to get her to comply.

If this doesn't work, hire an aid who is experienced with coaxing a senior to bathe. That's what we did and it worked great.

Your profile says, "My husband and I live with Mom. We are thinking of being away for big chunks of time and need to consider care options for my mother."

I don't know how this will happen for someone who smokes. You may need to hire in-home aids. A smoking 91-yr old with dementia is a fire danger. I wouldn't sleep in a house with this woman.
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(((((((kay))))) bathing seems to be a big problem for many with Alz. Could you get an aide in to bathe and change her undergarments once or twice a week? Sometimes someone else has more success than family. I saw on your profile you are thinking of time away and care options. Maybe it is time for your mother to be placed in a facility so you can recover a life for yourself and your hub.
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Hugs. Battle-picking is a hard skill to acquire but you seem to have got there :)

As she was "formerly impeccably groomed," though... What do you think is stopping or demotivating her now? Pain? Too much like hard work? Disliking cold air on her skin? Having to accept help with it?

When she says "what do you care" the correct response is "I don't. *You* do, and I want to help you."

All the same, you're completely right - what matters is how she's doing, and if she's happy, be happy.
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