Showering probs-Anyone with parent/MIL in assisted living

[stmonica2]

My MIL is in assisted living. She has refused showers/bedbaths/general hygiene for 3 months now.
I've offered to help her (even offering to wash her whilst in a bathing suit), offered Manis and pedis if she showers and even told her she could ask for anything if she showers.
Any other ideas?

[VillainV]

Does she have the physical ability to wash herself, and is just refusing? If so, I’d suspect some form of depression.

Does the assisted living place have any resources that could help?

[stmonica2]

Jul 26, 2024 18:21:19 GMT -5 VillainV said:

Does she have the physical ability to wash herself, and is just refusing? If so, I’d suspect some form of depression.

Does the assisted living place have any resources that could help?

She can definitely do it herself.
For the past 3 years we've been working with a psychiatrist and her other doctors. Meds, therapy of various sorts (antidepressants, ketamine, talk therapy, ect, brain scans). Nothing has improved or helped.

Assisted living are at a loss and now asking us to intervene.

I've even offered to go and live with her outside of assisted living. She declined.

[TR]

Does she say why she doesn’t want to?

Do you think she’d be open to using wipes? Just so she could clean the really important parts.

[googled]

What about gifting her a big basket of bath bombs, face masks, fancy soaps, etc.? Maybe if she has it sitting there in front of her, she’ll get curious or get tempted.

[jennistarr1]

Thinking out loud here

Ask her for advice about your (kid, sister, husband) whomever and see if that snaps her into it

[livinitup]

Is it affecting her physical health? Is her skin breaking down, lesions, rash, infections, odor? Does she wash after toileting? Has she had any type of health/ hygiene assessment with results that concern you? Or is this being brought to you as a stand-alone decline of independent living skills? Is she combative when refusing, rude, pleasant but determined, detached? Does she communicate her preferences verbally?

I think you need more information and a more complete assessment with specific ‘problems’ of why the staff are bringing this as a concern for you to solve.

Is your MIL reporting anything that makes her uncomfortable?Things that could be resolved with showers?

What is reasonable to expect if you follow her wishes to continue without showers or without consistent washing?

[minzy]

I would also wonder if she is depressed. I assume by the bedside baths you mean she’s refusing not just the basin with water/wash cloth but also the no-rinse foam cleanser. If it’s not the latter, that stuff is definitely better than nothing. I just pulled two bottles my dad got and the brands are Coloplast and Medline Remedy if that happens to help in any possible way.

Is there someone she defers to? Like my dad might say, “blah blah, I don’t think I’m going to do that,” and if I say, “hey, how about you just go ahead and do that,” he’ll often defer to me and do whatever I say. It’s not me taking away his autonomy (I am clear on that) but him reconsidering because he leans heavily on my judgment. Maybe that person for you guys just says, “hey, we’re going to get you cleaned up today, okay?”

Also maybe try it in parts. Like, do a foot rub or scratch her back or brush her hair and while you’re there ask if you can clean that part.

I’m sorry, this is tough.

[mags]

Is she willing and or able to come to your house to shower? Not a long term solution but while you figure it out.

[wanderingback]

Why does she say she doesn’t want to do hygiene? Does she admit to being depressed?

[basilosaurus]

There may be many reasons she doesn’t want a daily shower. Address those first. Daily isn’t actually necessary. Some tits and bits and dry shampoo can go a long time. Have those avenues been pursued?

[dirtyred]

Jul 26, 2024 19:20:49 GMT -5 googled said:

What about gifting her a big basket of bath bombs, face masks, fancy soaps, etc.? Maybe if she has it sitting there in front of her, she’ll get curious or get tempted.

No bath bombs as there are no tubs in assisted living.

[cjcouple]

Will she shower/bathe at your place? Just an idea. I have no experience ans I'm not sure how far you live.

[mofongo]

Jul 27, 2024 7:11:56 GMT -5 basilosaurus said:

There may be many reasons she doesn’t want a daily shower. Address those first. Daily isn’t actually necessary. Some tits and bits and dry shampoo can go a long time. Have those avenues been pursued?

I think you need to re-read OP.

[stemmie]

NYT had this article a while back that talks about this topic in the context of depression.

www.nytimes.com/2024/04/30/well/mind/hygeine-indifference-mental-health.html?unlocked_article_code=1.-U0.-fJ5.HJkWm5-A2hg9&smid=url-share

(should be a shareable link)

Another thought is that this is very common in dementia. The causes in the cognitively impaired tend to be related to either sensory issues, a fear of falling, believing they're already showered as is their custom, being cold, modesty around someone they don't recognize, mirror misidentification of themselves, refusing care as a way of asserting autonomy (sort of like a 4-year-old). If you can figure that out, sometimes it helps. Teepa Snow, a leading dementia care educator, has a series of free You Tube videos on the topic that might have ideas you could try.

[sent]

Depression has tested my will to shower many times.

Ultimately the fear of being out in public as an unwashed person is what forces me to shower. But perhaps with that external pressure missing in the MIL's life, she's just stopped caring.

If she's physically able to do it, then IDK. It's like this is something she can control and so she is controlling it, consequences be damned.

[bsp36]

When my mil was finishing her cancer treatments I think she had a scare in the shower, she would start texting us before/after her shower. If we did not hear from her in 30 minutes we would plan on heading over there. I also told her to keep her phone on the counter in the bathroom in case she fell. Maybe yours had something similar…but if no flexibility with your offers already that is hard to figure out.

[fn2187]

I would approach it only from the medical standpoint. She could likely end up with an awful infection if this continues. I’d see if a medical expert could discuss that with her and then you can approach her and ask what the best setting would be for her to shower in. Maybe a doctor could “prescribe” the shower to her? I’ve seen dr’s write similar things on a prescription pad. Maybe they could write something like “shower twice weekly to reduce chances of infection and skin care”. Best of luck, that’s tough.

[VillainV]

I’m kind of disappointed that Assisted Living would put this back on you to fix. I guess I could see it if it was like “hey, we wanted to make you aware of this issue, we’re working with her on this, but we’re wondering if you had any ideas or suggestions.” But I’d be pissed if it was more like “well, we’ve tried everything and now it’s your problem to fix.”

It may, however, be indicative that she needs a higher level of care than she’s currently getting.

[stmonica2]

On Monday I can ask her Doctor for some guidance and clarification.

She has told me many times she wants to die.

She won't use wet wipes/waterless wash products.

Her hair is again matted quite bad. Last time her hair matted up (8 months ago) I offered to take her to a nice salon and she refused. Eventually I convinced her to let me do it and after 4.5 hours I got it done but she is now refusing to let me touch it.

I will offer to let her shower at our house and look into that YouTube channel.

There are walk in tubs at assisted living and she's refused those as well. I offered to take her back to the house she still owns and shower her there and she said no.

She is physically fine (and fairly agile for being 85) And is mentally sharp) so I don't see a need for anything more than assisted living but I know she has struggled with her mental health for the past 57 years.

[minzy]

That sounds really challenging. Can you ask the doctor for an occupational therapy consult? They seem to be the ones that help instruct with ADLs like showering.

[mofongo]

I don’t have any advice, but I just wanted to say you sound like an amazing daughter in you:) It sounds like you are treating her with compassion and kindness.

[googled]

Jul 27, 2024 7:18:32 GMT -5 dirtyred said:

Jul 26, 2024 19:20:49 GMT -5 googled said:

What about gifting her a big basket of bath bombs, face masks, fancy soaps, etc.? Maybe if she has it sitting there in front of her, she’ll get curious or get tempted.

No bath bombs as there are no tubs in assisted living.

Oh shoot, didn’t think of that. Maybe shower misters?

Although reading the follow up, this doesn’t sound like something these items could fix if she’s that depressed. 😔

[maudefindlay]

You are being awesome in the face of a difficult situation. I agree this sounds like depression. Also agree that 1 or 2 showers a week would be a good end goal for her age. I wonder too is she dealing with any physical pain that maybe she hasn't shared in conjunction with the depression? Maybe the act of showering is exacerbating something and also maybe the bathroom is too cold for her and a heat lamp and/or warm towels and robe would help. Just another thing to discuss with her and her doctor.

Can you/your spouse/other relatives help to get her out more routinely? Maybe if she had a schedule of a couple outings a week and things she can count on to look forward to it might help and then she might be willing to get into a scheduled shower before the outing. Also, are there hair stylists who come to the assisted living and will she allow them to do her hair weekly? Then she wouldn't have to wash it at all and would just need to do a bird bath or whatever she can work up to.

Hugs to you and your MIL. Breaks my heart to hear about people in this situation.

[stemmie]

stmonica2

Given your updates, I wonder if the next step is a geripsych admission for medication management. The risk he if she doesn't start to comply with hygiene is the risk of being asked to leave.

It sounds like she'd be a great candidate for a hospitality-model assisted living if her depression could be successfully managed. She sounds beyond that level of care at the moment. This must be so hard for you.

[imojoebunny]

Jul 27, 2024 17:01:40 GMT -5 stmonica2 said:

On Monday I can ask her Doctor for some guidance and clarification.

We have had a lot of issues with my FIL falling when showering and using the bathroom.  It is definitely a common issue.  She might be afraid of showering. I had to get tough with my FIL because my spouse and his family are just not up to challenge him.  I bought a shower seat, and told him he had to use it, and had my DH put it in his shower,  rubber mats for the floor, since he was slipping and falling when exiting with just a bath mat.  My grandmother, great grandmother, and aunt all died of Alzheimer’s, and we learned to give a lot of eggs to get the chicken.  My super sharp 90+ FIL is harder to manipulate, but if I hound him about certain, important things, he has come around.  I don’t mind being the bad guy, so my spouse can be the “good” son, with his naggy wife. The doctor might be able to tell him, “you need to shower every day or every other day”. When you check in, pass a note to the doctor through the check in desk about your concerns.