caregivers caregivingDear Sheila,
My mom has dementia but still likes to go out to eat or have me take her grocery shopping. The problem is that her hygiene has gotten really bad and she doesn’t think there’s a problem. I’m not comfortable taking her out if her clothes are soiled or she has a strong odor, but I don’t want to hurt her feelings either. Is there a solution?
~Sensitive Nose

Dear Sensitive,
My first thought is that it’s great your mom still wants to go out. We know from many different studies that the progress of dementia can be slowed when folks like your mom spend time engaged in stimulating, social activities. So I applaud you for looking for a solution to her hygiene problem. There is rarely just one way to solve a problem, but understanding why your mom’s hygiene has taken a “nose-dive” is a first step. If your mom’s dementia is advanced, she may not be aware of or care about her appearance, but since she still likes to go out, it sounds like her dementia has not reached that stage. One thought is that elderly people are often cold and do not like to undress. Have you tried setting the thermostat up a few degrees, running the water and making the bathroom warm & cozy before inviting her to bathe? Another thought is that your mom may not notice that her clothes are soiled because her eyesight is poor. If your mom is sleeping in her clothes (not unusual at all) you might try setting out her pajamas where she can see them at night. When she removes her clothes you can toss them in the hamper and put out clean clothes for the next day. Another idea is to create an occasion when your mom would want to look nice; a doctor’s appointment, going to church or out to lunch with a friend. She may respond to your gentle coaxing to take a bath, while you remind her of the nice outfits she could wear. You could also try going into the bathroom while she is using the toilet and say something like, “Oh, I brought you a warm washcloth and some clean clothes to put on when you are done.” Then remove her soiled clothing and leave the washcloth and clean clothes in the room. I do want to stress, however, that it is always important to knock on the door and ask permission to come into the room. No matter what the cause of her poor hygiene, making sure that your mom is treated politely and respectfully should be a priority. I am curious though whether your mom is receiving any caregiving services or if you are serving as her primary caregiver? If more often than not you find your mom dressed in soiled clothing she may benefit from having a caregiver with her for a few hours in the morning. Typical caregiver duties include such things as laundry and changing linens. A morning caregiver from a reputable home care agency can do a lot to assure that your mom starts out each day clean and fresh smelling.
~Sheila

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