To want DHs grans carers to shower her??

[quaintlittlevilllages]

DHs granny is living downstairs, we live upstairs, and she has a variety of medical needs including diabetes and can't walk (can briefly stand.) Has 2 carers coming in 4 times a day. The thing is she will not shower only once a week and she is very smelly! Her bedroom is next to the kitchen and so we can smell her when eating / cooking.

I have asked the carers to shower her and they say they can't unless she says she wants one!

I've told her she is a bit whiffie (nicely!) but she just says she doesn't feel up to showering. It means stale Urine and body odour sort of penetrates the whole house.

Help!

[HemanOrSheRa]

I agree with Ici. Are you able to be there when the carers come in? Is she having the same carer/s everyday? I see this alot in my job. Where the older person will say one thing to one person and another thing to someone else. So there will be conversations like:

Carer: Would you like a wash today?
Mrs Q: No thank you.
Carer: Ok.

The next day a different carer come in:

Carer: Shall I help you wash today?
Mrs Q: No thank you, my DIL will do it later.

And so on. I'm not suggesting any neglect on anyones part, btw. It's just something that can happen and a pattern that develops over a period of time.

Has she been told the consequences of not washing/showering regularly, particularly with continence issues? Her skin will start to break down and that is really horrible and painful. Not nice at all.

[Icimoi]

I think it would be reasonable to ask the carers to try a bit harder to coax her to agree to a shower, or at the very least a strip wash. It sounds a bit as if they will only do if if she actually asks, and she isn't going to do that. And you need to back them up by being very frank about the smell and asking her to do it for the sake of everyone else in the house.

[ElderlyKoreanLady]

YABU if you think they should be forcing her to accept intimate care against her will (which is how it comes across.)

If she has previous form for poor hygiene, I doubt there's anything you'll be able to do to change that now. Most people wouldn't allow someone else to perform intimate care if they don't feel the strong urge to be clean.

[shouldnthavesaid]

Can she get a stand aid and a good shower seat? We have a 'steady' at work which is great, I think community hospitals can lend them out - you only need to be able to do a quick stand and can be wheeled directly from bed to shower seat. You can get wonderful shower seats with padding etc.

Senset foam is very good for nasty smells, and it's soothing on the skin as well. Wash wipes aren't bad but they don't keep you as clean as a good bed bath or shower will. A hot towel wash might work for her, but you'd need a washable bed for that really ..

[4seasons]

Loads of brilliant , caring advice has been given by mumsnetters to this post. I am sitting here full of admiration for people who care for their elderly relatives and feeling lucky that I didn't have to do it for too long. Not sure if I would have coped at all well. Nothing useful to add I'm afraid but am I the only person wondering if DH ( who's gran it is ) is also trying to think of ways to cope with the problem ...or indeed doing any of the practical caring ? My limited experience showed me that others often " step back " when you " step forward " because .... " you are doing such a good job , we couldn't do it as well as you ". In other words they are happy to dump on you and get on with their lives . Are there other relatives who could help with gran ? What about her children ? Would she listen to them or allow them to help her wash ?

[hannahwex]

Hi
If she is showering once per week and having strip washes it is probably the carpet/ chair/ cushions that are smelling.

I used to be a district nurse and this is a very difficult subject to broach with an older person

She needs a continence assessment to ensure her pads are adequate and that she doesn't have a urine infection

[LilacWine7]

The carers are right, they can't force her to shower. It's her personal choice.

They should, however, make sure she has a good wash each day (not least to prevent skin problems). When I worked in nursing homes and hospitals I often found residents were reluctant to wash due to feeling cold. But most would accept a bed-bath or thorough wash down with some coaxing. If she has continence issues she definitely needs a good wash down below a few times a day, the carers should be doing this every time they help her on and off the toilet/commode. Stress the importance of it (both to carers and to granny, as not doing this properly can lead to skin breakdown, pressure sores, serious infections etc.) Make sure there are disposable gloves, pads, wipes, bags and skin cleaning-foam accessible at all times, plus a supply of clean knickers next to the toilet. It's also worth checking they're not leaving her in wet knickers or damp clothes. Also check her bedroom carpet for smell, might be worth getting it steam-cleaned if she's had accidents on it.

Would she be more comfortable letting you or DH wash her than the carers? Maybe they're a bit too vigorous or in a hurry? A good way would be to get her to sit on the toilet or commode wrapped in hot towels and wash her bit by bit with flannels, only exposing the part you're washing (fill sink/bowl with hot soapy water and keep changing water so it stays hot and clean). Encourage her to use antiperspirant and make sure her clothes are freshly washed every day. Wash her hair in a bowl if getting to the bathroom tires her. Make sure bathroom is very warm. And try to make washing a pleasant experience rather thanks something she dreads... put her favourite music on, chat to her, give her a foot-massage, buy her some toiletries she likes, make doing her hair and nails part of the experience so it's about pampering rather than just a chore.

Also look into getting the shower adapted. Has she got grab-rails to hold onto in case she feels unsteady? A seat in the shower? Is the seat comfortable? A folded towel on the shower-seat can stop it digging into her skin. You can also get shower-chairs on wheels if it's a wet room, so she can be undressed in bedroom and wheeled into bathroom, staying on same chair while she's showering. This takes away fear of slipping on bathroom floor. Also, is standing a big effort for her, even with help of 2 carers? If so you could look at hiring a stand-aid machine or an ETAC-turner to help her get from chair to wheelchair or commode (ask for an OT review, they will assess her at home and order any equipment she needs to make things easier).

Alternatively she can choose to be washed on the bed or in her armchair. The carers can put plastic sheets and towels down if this is what she prefers.

Good luck!

[TheBobbinIsWound]

I had this recently with a relative. I bathed them. She has dementia and hates anything outside her routine so I had her impression of the Churchill dog saying "no no no no no no no" as is her mantra but when asked if she would have let her children refuse to wash she said that she would have forced them. I did NOT force her, I was gentle, firm and encouraging. I also had a reward for after (tea and cake)

Elderly people feel the cold very acutely. I used this as my guide. I ensured that the room was warm. There were heaps of towels and I wrapped a towel around her shoulders and got her safe and comfortable before helping her to remove her footwear. The first time, she washed with the towel around her shoulders until she was relaxed

I talked with her constantly (think loud parenting - well done, you're doing brilliantly, that's it, are you nice and warm, fabulous,)

I encouraged her in and stayed touching her throughout. Reassuring and being a presence.

DH's carers cannot force her to wash. You cannot force her to wash.
If she is fully "with it" you can have a brutally honest conversation with her about it. Give reasons. Listen to her but ensure that the TV, radio etc is off and that she listens to you.

Give a reward. Are there grandchildren/great grandchildren that can visit but might be avoiding because she smells?

If she is not fully "with it" then treat her like your child. Be gentle, firm but fair. Charts and stickers and warnings when something is coming can help.

How's her skin? Dry? Does she have any sores? Any reason you can find for her needing to shower?/avoiding?

Do not force her. You'll only do it once.

You have some unmumsnetty hugs from me. I know how hard it can be xxx

[Flossyfloof]

You can get all over cleansing wipes, for the whole body.
It is not good for her to be dirty as others have said and it could become a medical issue, I don't know if that would override anything? I know that elderly people get fed up of being bossed around and pulled aroundm it us a really difficult issue to resolve. Especially if she was like it before it is only likely to get worse unless you can find a different way if tackling it.
Scented candle, whole body wipes, clean the carpet ( shake and vac if not practical to clean carpet)

[SoupDragon]

Do you think they should force her to do stuff against her will?

It's difficult, but they simply can't make her.

[Spartans]

yabu you may want the carers to shower her, but they can't unless she wants to.

The problem is with granny. The carers can't do anything.

Will she allow you or dh to shower her?

[BettyCatKitten]

I've worked as a home carer for the elderly and not wanting showers/baths was very common.
As a carer you have to observe the wishes of your clients, a fundamental principal of your role.
I know that is not at all helpful to you.
Have you tried to shower her yourself? When my dad was in hospital he would only allow me or my mum to shower him, even though staff were performing other personal care tasks for him.

[HemanOrSheRa]

Gah! I meant to add, maybe it might be better coming from someone else? Can you get GP/District Nurse to speak to her? Your surgery should have a Community Nurse for Older People. They are excellent. They will do a continence assessment, as I mentioned. It's not good for the integrity of her skin regardless of the smell.

[quaintlittlevilllages]

She won't have a strip wash - there's a walk in shower. She just won't wash. To be honest she is a bit famous for this from what DH has said but obviously it's more noticeable now she's in a nightie and in one place mostly.

[TheHouseOnBellSt]

Herman is right actually. What is the smell of? Wee? Or BO? If BO then some wipes might help for her armpits...then talcum and deodarant.

[flanjabelle]

Could she be a bit depressed do you think? How is her general demeanour at the moment? I wonder if this is part of a bigger picture.

[HemanOrSheRa]

They can't make her shower if she doesn't want to. But if she's showering once a week and having a daily stripwash she shouldn't be smelling like that, as OddBoots says.

Does she have continence issues and wear pads? Has she had a continence assessment? Is she wearing clean clothes everyday? Or rewearing clothes that she may have urinated on/in?

I know the smell you mean. It sort of gets into everything, even carpets and curtains. So you may need to get carpets shampooed to get rid of the smell.

[TheHouseOnBellSt]

Aren't they even strip washing her? I agree that you might just have to get a bit firm with her...it's not good for her skin to be dirty bless her. Maybe she doesn't like the cold? Can you get a plug in heater to make things extra warm and insist on daily strip washes?

[quaintlittlevilllages]

Oh she has got one (a seat) and I don't think she's embarrassed as they put her on the commode, wipe her bottom and so on. Sheets are changed and I don't want to sound horrible but the smell is definitely coming from her.

[OddBoots]

The carers are right that they can't make her have a shower, it is her body, she is allowed to decide. That said, my grandma didn't have a shower or bath for ages in her last years but the carers gave her strip washes that kept her clean, she didn't smell. Is her clothing and bedding etc being washed enough?

[flanjabelle]

Can you get a little seat to go in the shower? Could she be worrying about slipping or falling? Do you think she is embarrassed about being washed by strangers? Could you help her into the shower, sit her down on a stool and Then give her some privacy?

I would have another conversation and be less gentle if I am honest. I would explain that she is really starting to smell and it is unpleasant for others. Have a conversation about what she would need to feel comfortable about having a shower.

At the same time get sheets and bits washed so the smell isn't coming from bedding or clothes. Is she changing her clothes daily?