My mother and step-dad (E) live in independent living (meals and housekeeping provided). Unbeknowst to us (his doctor just told us), E was diagnosed with dementia in 2016. After having prostrate cancer, E became incontinent -- and was dealing with that fine. After they moved to independent living, E's mental health really deteriorates -- he was always very introverted, but now barely engages at all. He doesn't recognize the grandchild that has just moved to our city.
He has also lost his sense of smell -- so doesn't know when he smells of urine, even if he recognize that he has leaked (which he doesn't always sense). In fact, he almost always smell of urine now. He has also begun to refuse to accept my mother telling him that he smells and should take a shower. He says he won't now that he is dressed, and he will do it tomorrow morning; but by morning, he has forgotten -- and my mother gets up later than him, so can't catch him before he gets dressed.
Even earlier, his son suggests that he needs home care -- but E is physically able to take showers on his own, and wouldn't accept a stranger telling him to shower. While COVID restrictions are on, the dining room is only 1/3 full at any meal -- residents are distanced at the tables, so they aren't close enough to be really bothered by E's urine smell. Now the dining room is full, and the staff (understandably) become concerned for the other residents.
One of the staff -- male, 6'7" (so imposing), and an authority figure in the facility -- has agreed to tell E that he can't eat in the dining room unless he has showered and has clean clothes on (and it costs $5 per meal to have it brought to apartment). We are not sure how to make this a routine once the staff person has told E.
Does anyone have any other ideas on how to help E deal with this incontinence/etc problem?
If they move into Assisted Living, showering with the help of an aide comes along with the rent in most cases. There again, step dad would have to agree to it. If he continues to refuse to bathe in Independent Living, he will be asked to leave at some point b/c the facility will not allow his body odor to infect the rest of the paying residents.
So he'll have a choice: bathe by himself, bathe with the help of a caregiver, or move to Assisted Living or Memory Care NOW (which he'll need to do one of these days anyway when the dementia progresses a bit further) where his showers will be scheduled. He can choose 2 days a week (or even one day, really) that he will bathe and then stick to it. His clothing will have to be clean as well and not smell, and that determination will be made by mom since he's lost his sense of smell. You can buy him some large body wipes to clean up with during the week when a shower is not scheduled. Making sure he wears clean clothing and a fresh disposable undergarment all the time is crucial to keeping the odor in check!
Being cooperative is not something that most dementia patients are fond of being, however. That's the tough part. You can watch some Teepa Snow videos on YouTube on the subject of showering to see what she has to advise on the subject. Pick up a copy of The 36 Hour Day as well which is a wonderful reference guide for dementia in general.
Be sure to start looking down the road at future living arrangements for your step dad; Assisted Living with attached Memory Care is your best bet.
Wishing you the best of luck with a difficult situation.