Hygiene issues with DM

[VoluptuaGoodshag]

She doesn't shower. Ever! Her house is totally adapted to enable her to do so. She lives alone and can manage perfectly adequately but she will not shower, preferring to just wash at the basin.

To my shame I had to have strong words with her recently when she had an accident with her colostomy bag leaking. (I don't want to go into details but it wasn't pleasant and I had to do a major clean up). I basically told her that if she didn't start showering, I wasn't going to take her out anymore. :( She was still refusing to even change her clothes until I pleaded with her to do so. It would have been so easy just to strip off in the 'wet room' shower and get properly clean. I fear these accidents will only get more common and I dread visiting. I hate feeling like that, I feel like a rubbish daughter but I also gag at being near her or taking her anywhere. Isn't that terrible. It needn't be like this if she would just shower and deal with her bag properly. I'm not great at being a nurse but I'm trying to be for her sake but it's really getting me down.

To answer the various questions more clearly:

• yes she has a shower in a wet room, totally geared up for an elderly person as the previous resident was in a wheel chair. It has a fold down seat and grab handles and nothing to trip over
• her wet room, like the whole house, is toasty warm
• I was brought up with a once a week bath so I get she's from a much older generation but seriously, if you and your clothes are covered in shite, a wash at the sink isn't going to have much effect
• she walks with a zimmer around the house but she can take that to the toilet and then use the grab handles to shower
• even when she was in hospital she never showered, preferring the nurses to give her a bed bath
• she says she dotoesn't want to shower in case her hair gets wet (there are ways round this)
• when I told her if she didn't shower I wouldn't take her out she didn't say anything just promised that she would. The following day I couldn't tell if she'd had one or not. She didn't smell but the soap was dry in the shower. I know she's not showered previously because I clean the house and the shower area is always bone dry and dusty

That's all I know. I will quiz her further next time. I honestly couldn't stay longer than necessary as the smell was overpowering. She has no sense of smell.

My mum will only shower when absolutely necessary and moans about it. I nag her into changing her clothes, the longest she's gone in the same clothes day after day is over 40 days.

Some patients with dementia feel like the water hurts them.

Adding in continence issues must make the problem so much harder.

It might be time to get advice on assessing how her extra daily needs can be met.

You really do have to have a shower if you have a colostomy and some incontinence or the risk of infection is really high.
Would she rather have a shower everyday or end up in hospital with sepsis and then probably a nursing home?

I cannot understand why she thinks it’s fine.

This is the puzzling bit that you maybe need to push at. Do you think she gets it? You say that she said nothing when you threatened not to take her out any more... do you think she really understood what you were saying, and why? Would not saying anything be her normal response? I guess I'm wondering if she is able to recognise this as an issue, not just being awkward or independent. Does she still have capacity in this respect?

You also say that she has no sense of smell... is that true? I mean ,does she genuinely not have a sense of smell? If that is the case, then that would explain why she thinks there isn't a problem.

In any case it sounds like a horrible thing for a daughter to have to deal with: I know my mum would be mortified. If she's not able to keep herself clean and this might have serious consequences for her health, wouldn't that trigger a care assessment and care visits being put in place?

@Chocchops72 that’s interesting re capacity. She is slightly deaf and showing signs of forgetfulness. But you don’t need a sense of smell to know that poo smells and if you’re covered in it then you are going to smell too. Might get in touch to get her needs reassessed.

Losing a sense of smell and taste and being a little forgetful were DMIL's first signs of Vascular Dementia.

She was being investigated for her sudden loss of taste and smell, had a brain scan and that revealed the dementia.

Poor hearing can have an affect on cognition too over time.

I think it might be time for her to have a care needs assessment and for you to alert her GP that she might need a review for her memory.