My Mom refuses to take a shower and won't allow a CNA to bathe he. How do I deal with this?

My problem is that my mom (82) has slight dementia, and she is convinced she showers daily but she does not. She is mobile and is able to wash, stand and has a chair and handlebar in the shower.

PROBLEM: She is convinced she takes a shower, when I know she does not. Then she screams at me that I make her to look like a filthy person, and asks me "Do you think I don't shower? Are you crazy? Are you telling people..." I try to reassure her that I'm just reminding her and that nobody knows this but me. That's no help. She becomes very angry, yells and screams at me and calls me names.

Otherwise, we get along great, and this is a heart-breaking problem for me. After the big fight, she finally takes the shower. I am exhausted, depressed, and discouraged, and feeling horrible plus my stomach ulcers are acting up.

HISTORY:  She had temporarily moved in with us, while her senior community was being renovated. Since initially I had heard running water in the bathroom, I did not notice that she actually wasn't showering. As I was able to convince her to help her wash her hair about every 1-2 weeks, I made sure she was cleaned thoroughly then each time. She had been complaining of burning on-and-off in the private area, she called her bladder on and off. After multiple doctor visits and negative results for an UTI, we proceeded to go to an Urologist, OB/GYN, another internist, and she was examined in a hospital by a team of nurses, while she needed something else taken care off. (Anemia blood transf); they found nothing wrong. Everyone was baffled. After all the doctor visits and trying different supplements, juices, even anti-fungus vaginal stuff, hormone cream from the OB/GYN- nothing; on and off the same thing, burning in the vaginal area- not bladder, as I discovered. Since I work from home, I'm practically with her 24 hours a day, I began really paying attention to her habits and did my own research.

WHAT I FOUND: Besides her mistakenly thinking she had showered/washed private areas daily, I noticed that she was putting small pieces of toilet paper in her underwear, even though I always made sure she had non-irritating chlorine-free panty liners available (Seventh Generation). She does not have any leakage or incontinence, and it didn't make sense but I also know she's had had the habit of walking around in just her night gown with no underwear and putting in a piece of toilet paper in there. I've seen those pieces fall out many a time. So I embarked on a journey to convince her to wear underwear with a clean liner at all times. It was a battle but finally she does that most of the time. However, she still puts pieces of toilet paper in there occasionally, explaining to me that she was just wiping herself and just left a clean piece just in case. Anyways, I keep reminding her to not do that and, as you can imagine, she hates that.

 I found out that toilet paper can be very harmful if used in this way, even cause cancer. The vaginal walls can be very thin and easily irritated, especially in the old age, as skin becomes very thin. I started buying special toilet paper (bamboo based -non-chlorine bleached) and I make sure she only has that one in her bathroom. Ever since all the precautions, her symptoms are 95% improved but the shower issue remains. When we go out, and she uses the public restroom, the toilet paper is not good and she complains again sometimes, and sure enough usually has a piece of paper. 

Thanks in advance for any feedback. 

we always had a built-in heater in the bathroom

Possible falls are definitely an issue as your mother has already stated it. The bath chair which extends over the tub and allows someone to sit down outside the tub, lift her legs into the tub while safely sitting down, then scoot over closer to the wall and inside the tub is the safest method that I know of.

There's still the issue of falling after the shower, so walkers or wheelchairs need to be close by. If the bath is small, that would be a problem.

There's a secondary issue and that may be the cold. Older people get cold so much easier, and they're exposed more as it takes them longer to get in and out. They shiver, they're uncomfortable, and they develop a resistance to getting in the shower.

This is a tricky issue because you don't want to use a heater in a bathroom. It might be that she just gets in with enough clothing to keep her warm, and the clothing is partly lifted or removed to facilitate bathing.

If you can afford it, a European style rack which heats towels would be a thoughtful touch - you could wrap her up nicely as one part of her body is cleaned, and with another nice big warm towel when she's through, while you're hugging her to keep the towel around her as she warms up. Make it a bonding experience.

Then treat her to something she really enjoys to build on creating good memories of the bath/shower.

Having a schedule, like my Mother does, in the NH, has helped 100%. Everyone is clean and dressed and once they learn the routine, they are fine.

JessieBelle, rather what expected; reason I asked is that's the situation with hub's aunt and uncle's son and dil, which is fine, as far as that goes, but they didn't want to hire anybody else to do it either; they really just seemed to be in denial that it needed to be done, or at least that aunt - wife - couldn't do it for uncle - husband (his mom and dad) - who's the one who really was the one needing it done - she had gotten home health for him and thus gotten an aide to do it that way, as long as they would, which is a whole other issue, then when they quit, was able to get him an aide for it through the VA since he's a veteran, which they did thank me for, almost a year later, when think they did finally begin to realize and believe he did need it and realize she really had gotten to the point she really couldn't do it but they didn't like it at the time and by then that really wasn't/isn't enough, hence the current issue dealing with now; don't remember if that's all you're having done - will go back and look - thanks

Thank God I never had to face that.
Went to the Office on Aging yesterday to try and get help with hubby's high drug costs. spent 2 hours with a very helpful MSW but that is not the point they had all kinds of literature pertinent to caregivin and i wnt through that this morning. one pamphlet was entitled "When your loved one refuses care" Lots of warm fuzzy pictures and Titles like "involve the person in decisions" "Evaluate special needs" Ask the person about concerns over accepting care""Present options"
"Talk about your needs too" "When a person can no longer make decisions for his or her care" "If the person still refuses" "Take care of yourself"
it was all so nice and helpful about talking to professionals and bringing in other family and outside help. They did not mention the real issues like finger painting the bathroom, drying wet clothing, peeing in the wast bin 9if you are lucky), hiding unmentionables in kitchen draws, never washing hands and just the plain stink of it all. They did give the authors name but no indication of her profession or qualifications. Gee whiz granny is going to be terrified if we call in the clergy, Drs or other outside people. I still can't believe it.
Some of the others were "helping an older adult remain independent' "seniors and driving" "Doctor visits" "Checklist for new caregivers' "Stress and the caregiver" "50 things every caregiver should know"
One use full thing was a leaflet entitled "The warm Line" Sounds rather like A/C but you speak to a real person who has been through whatever you are upset about and lets you spill your guts. it is not a crisis hot line just a volunteer with good listening skills who can sugest services if needed. There is the Mobile Crisis Assessment team (MCAT) I wish I had known about them when I was working,that sounds more helpful than calling 911 and having six police cars converge on a house plus the fire dept at 3 am. Anyway that was my excitement for yesterday afternoon. these are services available in New york State. Don't know about other states.

deb, I wouldn't do it because I don't want to touch my parents privately. It is a personal thing that I am sure many people share, particularly if the family is not close. Hiring someone who does is professionally was a much better choice for me.

Jessie, can I just ask why you wouldn't do it? dealing with that with a family situation we have; think maybe they do have an aide but because of other things it's somewhat of an issue

Agree with MaggieMarshall a bird bath 2 or 3 times a week is quiet enough and don't forget to warm the lotion and be generous with it. important to pay attention to the genital area especially with incontinence and skin folds and the feet especially with diabetes.

She can be kept squeaky clean without a shower. If she's afraid, don't try to get her in the tub. Give her that gift of understanding. Don't listen to those who say her skin smells musty. What's that about anyway??

Give her thorough bird baths a few times a week. Pamper her with a pretty talc and generous rub of lotion on her probably dry skin, and call it a day.

There was a home aid that came with Gentiva to help bath my mother-in-law. She tried one time and said she didn't have to do it and never came back. I could really use some help.

My father did not want to bathe. Before I got here, my mother had a walk-in shower put in. That helped a lot, but still he did not want to bathe. He would often go a month or two with nothing but a bath with cloth wipes. This was not healthy for his skin. The skin in the private areas can become very raw and sore if not kept clean. We finally decided he had to take at least one bath a week. My mother saw to it. We turned the heat up in the house, got all the towels ready, got the water running, then she helped him get undressed and on the shower seat. He always felt better after he bathed, so it was its own reward.

The main thing here was that he was not given an option of if he wanted to bathe. I am glad that my mother did it or we would have had to hire someone. One of the limits I established early on was that I would not bathe them. When he became very ill we had a home aid come in twice weekly to bathe him. It was either a wet or dry bath. That was a tremendous help.

It is so tough when they refuse to shower. My mom will do that off and on and it is so frustrating. She too is afraid she will fall so, for her the bath seat helped. One thing I told her that helped motivate her was that if she doesn't stay clean she can get an infection and maybe even end up in the hospital. That made a big difference for my mom anyway.. Also, one of the CNA's that she likes and will take a shower for is tall and seems very strong. I think she likes her and trusts her because of that. We have worked up to once a week shower and shampoo and I'm so thankful for that!

Look for skin fungus under her bra line, and in any folds of the skin. Call her MD and ask him to send a visiting nurse and bath aide. Then wash all clothing and bedding and throw blankets. Very important, don't let it slide.

There is a bath bench that sits half in and half out of the tub and has a handle on the side in the tub. Maybe she could sit outside the tub then slide over so she's in. Do you have a hand held shower nozzle you could use? Also, place a bath mat in bottom of tub and show her it suctions to the tub and won't slip or slide if she steps on it. Maybe try some real pleasant smelling bath gel and let her know she would smell so good if she would use that. If all else fails, place a towel on the toilet seat, have her sit there put warm, soapy water in a basin and give her a bath like that. Could you wash her hair in a sink? That's all I can think of to suggest. Good luck to you.