Question 

My mother is 85 years old and has some early dementia.  She moved in with me about six months ago, and it has been working out fairly well. 

The one thing that my mother does not do is bathe regularly.  There is a walk-in shower connected to her room, so access is not an issue.  While it may or may not be required to bathe daily, she does not always smell great.   She also will wear the same outfit for days or weeks if I let her.   

I think she should bathe and change her clothing each day.  I ask her daily to take a shower.  She ignores the request.  If I ask her why she does not take a shower, she says that she is just fine the way she is.  Sometimes she will say, “Why don’t you take a shower”.  Of course that does not make sense, because I already have. 

I am wondering what techniques or tricks there might be to use with my mother to keep her clean and smelling nice like she used to. 

Answer 

Caring for someone who no longer cares for themselves is always a challenge.  What was once a routine part of getting ready for the day is forgotten. 

For some individuals with dementia, the steps that are required to bathe may no longer be remembered, and they will rely on you to step them through the process.  The same is true with dressing.  If the clothing they took off last night is sitting there, they are likely to simply put it on, and it may not always be in the correct order.  If you can, scoop up the clothing each evening and dump in in the hamper or down the laundry chute, if you have one.  Select the new clothing, but do not lay it out until it is shower time.  Put out her robe instead. 

Start by selecting the same time each day for the process of bathing to occur.  It will be easier for her to follow the routine if there is one.  Set up the bathroom with a towel, wash cloth, and fresh clothing laid out for her.   Have her toothbrush out with the toothpaste. It is the least intimidating if everything is set up and ready to go.   

Having a walk-in shower is great.  Swap out the shower head for a handheld head if it is not already.  Add a grab bar if there isn’t one.  I also recommend a shower bench as she may feel more secure sitting.   

Announce each morning that you will set up her shower for 9 a.m., or whatever time you or she selects.  Go in a minute or two prior to the time to set up the bathroom.   Get everything ready and start the shower to the desired temperature.  Make it simple and straightforward.  Call her and state that the shower is running.  People of her generation usually avoid wasting water, so you have created a sense of urgency and need.  Do this calmly and with purpose, as you do with mealtime.   

If your mother needs help with the shower, be patient and thoughtful, letting her participate to her ability.  Try not to rush her or show impatience. 

If she can handle shower alternating with sink bath days, you could also do that.  I do recommend starting with a shower each day though.   Alternating techniques can be confusing for a brain that is already struggling with remembering the steps to a process.  You can always change it at a later date. 

You can see what I am suggesting is that you simply direct what is happening.  You can give your mother choices of time, attire, soaps, or other minor unimportant bathing routines.  Avoid negotiating on bath/no bath.  You will always come out a loser in that situation.   

When it comes to clothing, simply go with fresh clothing each morning, even if she has six pairs of pants that look identical.  Make sure the clothing is easy on and off so that the clothing itself is not the barrier.   

What you are experiencing with your mother is quite common for an elderly person with dementia issues.  Being calmly directive is usually the most successful approach to take.