My grandpa is very stubborn and will not take a shower/bathe. I don't know why and he won't tell anyone why. His catheter is constantly coming out and pee goes all over him and couch and carpet. He won't let us clean up that either he just yells at us and it is making it difficult to be around him because he is really starting to smell bad. He goes to doctors visits often but they just act like they don't smell him or something. I'm very confused about what to do. My grandma is to weak to help him shower and I think it might be a little weird to him and me if I tried to help.(if he ever did decide to take one). Please, any advice would be helpful!!
Tell him it makes grandma uncomfortable for him to never bathe and or that dr says he might get infection and bacteria will get in catheter and he might easily end up in hospital...see if that helps, or tell him you see bugs in his hair, and he better shower and wash his hair...
Lastly, threaten if he doesn't do it himself, you will call in a nurse to come in a couple times a week to bathe him. Case closed. Then do it.
I wouldn't put up with it.
You definitely could use some assistance, even if just one or two times a week to get him cleaned up. Also, he may be afraid or unable to get into the shower, for fear of falling, or maybe he is afraid of the water (drowning). There is some issue there that he isn't telling you guys, that maybe an outside person can get out of him. I would also talk to his doctors and tell them that they need to say something to him when he comes in for a visit. It usually is received better by an outside source, than from family. Good luck and definitely get some help...you and your gramma need it.
At the facilities it is so much easier. We are trained, but don't force other peoples loved ones to shower, or do bed baths. It is illegal to use restraints, so we persuade them gently. With the Dementia patients, they are loaded with fear, and need to feel safe and not have their dignity compromised.
This is the technique I use to have someone at one of the facilities to be clean. I will first ensure they have privacy. Then, to make sure they are warm, and tell them every step of the process. If they can help or assist in any way, I let them, and ask for their help. I don't use the word shower, bath, or use terms that are negative. Every little accomplishment, no matter how small, I praise them, since it makes them feel very happy. We all want to feel happy, and safe. When getting them ready for a bed bath or shower, I get every thing ready. (6 washcloths, 4 towels, bath blanket, special body shampoo, and ointment to dress any wounds). In the bathroom I get the hand held shower nozzle, turn it on low to medium, and test the water on my wrist to make sure it isn't too cold, and also to prevent burns. When bringing them in a shower chair, and doing the transfer I ask them, "would you like to freshen up and feel good?" "It's going to feel really good, and you will feel nice and warm and safe." When helping to undress them, whether a bed bath or going to the shower room, I will close the door, draw the privacy curtain, and then tell them, " I need their assistance, and they will be kept warm, and that I will keep them covered to protect their privacy." Next, I will cover them with a sheet or bath blanket, undress one arm, ask them to hold the sheet, undress the next arm and ask them if they can help lean forward to take the shirt off. Even if it is a bed bath, I will ask for their assistance to roll over, while keeping them covered. When taking them to the shower room, I will have them fully covered in 2 bath blankets, one on the back of the chair, to prevent drafts, and one on the front to keep them warm. It also prevents them from feeling exposed, and their private parts from being seen. In the shower room, I will turn on the hand held shower nozzle, and warm up the water so it won't be too cold, or to hot to burn them. I'll test the water on my wrist first, and then ask, "can you test the water, is it too cold, is it good?" They always answer and will say, "too hot, too cold, or nod ok". Then, I never spray directly over their head, I use my hand to gently aerate the water, and when placing soap in their hair, have them hold a washcloth over their eyes. I use one washcloth for the face, one for their eyes, one for under each arm, one for the front of their chest, and front private part, another for their back, and one or a few for their rear end. When rinsing off, I always tell them exactly what I'm doing, and keep the hose down at approximately shoulder height. I will also try to warm them up several times by running warm water on their back, and arms. I also tell them, "you are doing great, thanks for helping, doesn't that feel so good?" If they can help clean their face, I ask them to use the washcloth to clean their face, or give them one to do their arm or chest. Also, it doesn't matter if they clean well, since I will make sure I clean that area. It just makes them feel like someone is asking permission, they feel great about being able to care for themselves, and they feel warm and protected.
When helping out in other peoples homes, I also check to see if there are grab bars, transfer benches, non-slip strips on the shower or bathtub floor. Always place non-slip shoes on their feet, do they have a shower hand held hose, if not use a clean plastic container for soaping up the washcloth, and one for rinsing. When bring them in, I already have the water warmed up, and will close the door, and close the shades or blinds for privacy, and to keep them warm.
The most important things that the loved one, or the loved one in a facility are dealing with are that they are losing their independence that they had all their life. Their privacy is being compromised. They get cold very easily. It is very unsafe to take a shower or bath, since that is where the most serious falls can occur. They don't want the family member to see them naked, since it is inappropriate from their point of view. They get comfortable and don't think it is necessary to bathe. Their eyesight, sense of smell, and taste aren't as good as what it was years ago. If they are taking any medicine, (Pain, heart, Blood Pressure, Diabetes, etc.), it will affect their judgment and they will not be aware as we are about the situation at hand. If their doctor doesn't address the situation, you may need to have a private consultation with him or her and tell about the complete living conditions. They may need a Eldercare Social Worker, and Eldercare attorney, someone from a licensed agency (Certified Nursing Assistant, Certified Home Health Care Worker), that is licensed with the state to come in a few times a week to help out. Maybe even a housekeeper once a week, once ever other week to keep their living conditions, including their own person hygiene in check. Also, remove trip hazards, and slip hazards. Throw rugs, have to be removed, or place non-slip backing underneath. They are afraid of spending, money, so say it is not a problem, you are treating them, to remove their fear of financial difficulty. The Eldercare Social Worker, can help get costs covered. The social worker will also make sure they are getting proper nutrition by sending in a dietician.
Family is the hardest, and very difficult. This entire thread has given me some great ideas. Whether the family member is competent and doesn't have Dementia, or not, I will definitely get a CNA/CHHA in to help assist me, since it will eliminate the combative loved one's protests. It also has reminded me, that it might be best to get outside help with my loved ones.
They have a cat but I'll tell you, it's not the cat, as my mother is fastidious about cleaning the litter box, etc. It's body odor, plain and simple. My mother will wash herself with a soapy washcloth (face, neck, underarms) and do a pretty good job. My brother, on the other hand, stinks! He gets up everyday and puts on the same clothes unless my 84-year old mother yells at him to put on clean clothes. She still does his laundry. He also does not brush his teeth and his mouth is a cess pool. I'm surprised his teeth have not fallen out by now. He's had plenty of abscesses and infections but then only will go to a dentist when he can't stand the pain anymore. I don't know how a dentist or hygienist will get within 50 feet of him!
I go over there and have to beg him to comb his hair. Good God, doesn't he look in the mirror??? His hair is greasy and all matted down from sleeping at night. Before he goes anywhere, he supposedly "wets down" his hair and combs it. I bought him a brush one time and put it on his dresser and told him to use it! It's disgusting! You can smell him from 5 feet away. My mother is 84 and tired of getting after him all these years he's lived there, so she just stopped saying anything. It's so embarrassing when I have them over. My brother was sick a few months ago (coughing, hacking, etc. for days on end -- of course, would he call his primary care doctor and get in to see him?? -- of course not, he'd rather wait until Sunday or at night after the PC doctor's office is closed) that my mother called me and wanted me to take him to the emergency room. I told him I wouldn't until he took a shower or bath because he stinks! No healthcare worker should have to deal with that. I ran a bath and I (his 55 year old sister) took the hand held shower and "hosed him down" while he was sitting in a tub of soapy water. He screamed like a baby when I squirted water on his face to get it wet so he could use the soapy washcloth to wash his face! "Oooh, ooooh, I got water in his eyes" Good God! It was ridiculous! I'm sorry I sound callous but I've totally had it. My parents were enablers, who told my brother all his life that he was stupid and couldn't do anything, so now he doesn't! My father is now deceased and it's just my mother and brother who live in the house. My only living sister is totally useless. She doesn't help at all and basically doesn't want to know anything or gives a rat's behind.
I try to limit my exposure to them because it's like banging my head against the wall. I can see my mother "slowing down" more and more over the last 5 years since my father died. She does not have dementia and neither does my brother. My brother is just clueless. The smell in the house is awful (body odor) and I placed one of those Glade automatic air fresheners in their house -- the kind that sprays a spritz of air freshener every 30 minutes round the clock. Well, it doesn't help. They would need 10 of those things! I've even gone over there and check it and the can is empty inside it. I didn't say anything, I just replaced it with a new can. Still doesn't make a dent in the smell. After I leave the house, I can smell my hands (which were freshly washed before I stepped into their house) and the smell of body odor permiates my hands. It's mind boggling!
There is nothing I can do to get my brother to bathe and/or shower on a daily basis. I've told him he smells and to "please" take a shower or bath but it just goes in one ear and out the other. I give up. Again, I just try to limit my exposure to them (it's sad, really). When I am able, I go over there and give my mother a shower (yes, she has a shower chair). It's usually a 4-hour affair when I do it because she has me doing all sorts of stuff over there that my brother could do, but he doesn't (he's passive aggressive). He gets a nice pension check every month but I found out he doesn't give my mother a dime. SHE won't take any money from him because "he has expenses" (what, I don't know, because his car is paid for). He gets $1,000 more a month than my mother annuity (from my deceased father's pension), yet she tells me "he doesn't get a lot of money". What a crock of crap! I keep telling her he has NO expenses and he has a ton of money in the bank (how do I know? Because I set up his bank accounts for him!) but she makes excuses for him. Enabling. He says "she won't take any money" from him and that's probably true but he should INSIST ANYWAY THAT SHE TAKE IT!!!!!
Ugh....I've got to stop typing now, my blood pressure is climbing. But back to the bathing issue, lizony, unfortunately, unless you can convince him to have a home health care worker come in and give him one, or you insist on doing it yourself, you're in a losing battle. If they live in that environment, they are not going to smell the odor or themselves! It's just is what it is, sorry to say. Good luck to you.
P.S. I've also realized that the generation of my parents and in-laws (over 80-ish) did not take daily baths or showers. Bath "day" was usually once a week and that's the way it was back then. Also, elderly people (not my brother) tend to lose their sense of smell -- I think that's why they "bathe" themselves in perfume. I know if I get on an elevator with an elderly person who's done this, I get an instant headache from the perfume overload.
Someone who can't manage his catheter care and refuses to maintain minimum hygiene standards is someone who needs help. If your grandmother can't physically do it, it's time to bring in help or move your grandfather to an AL or SNF.
1. Have you seen his home situation for yourself recently or are you taking a relative's word for it? My dad's girlfriend told me he peed all over the house when in reality, he just got the bathroom around the toilet messy because his urine stream split and he won't sit down to pee. Unpleasant but cleanable, yes. All over the house, no.
2. Who puts the catheter back in? If things are as gross as you say, he's lucky not to have gotten an infection from that. If he does the catheter himself, he's just lucky. If a trained nurse or aide replaces the catheter, they could be cleaning that area really well without worrying about the surrounding gunk. You or your parents should ask about that.
If he is admitted to a hospital for any reason, make sure the hospital social worker knows about the state of the house. They can send him to a nursing facially instead of back home if he can't take care of himself. He probably won't thank you for that bit of interference, but it will get him cleaned up and you can visit in a sanitary place where you can focus on him and not the smell and pee everywhere.
But, you will have to decide. Will you take legal measures to get him out of his home or allow him to just slip away?
kdub24hourcare
Good luck with this tough issue,
Carol