How do we get my mother-in-law, who has Alzheimer's, to allow us to clean her house or bathe her?

A fellow caregiver asked...

My daughter and her husband live with my mother-in-law (age 85) that has Alzheimer's. She can not be left alone at all anymore because she wanders off often. She does not know who any of us are including my husband who is her only child and often says she is going home even though she is living in her home. I should add my father-in-law died 10 years ago and that is when my mother-in-law began shutting down. The problem we are now having is she will not allow my daughter to clean the house. She gets in the way and will not move no mater how gently we ask her to move. We have tried to get her to sit on the front porch so the cleaning can be done but she seems to know what we are trying to do. Can you help? Also she will not allow us to bathe her. She insists she just took a shower and does not need one. Today I mentioned that she needed her hair washed and she about bit my head off insisting she was fine. We need help.

Expert Answer

Beth Spencer is a social worker in Ann Arbor, Michigan, with more than 25 years of experience with families who have a member with dementia. She is coauthor of Understanding Difficult Behaviors and Moving a Relative with Memory Loss: A Family Caregiver's Guide. Previously, she directed Silver Club, early-stage and adult day programs serving individuals with Alzheimer's disease and related illnesses.

Your mother-in-law's resistance to cleaning may be because this is her home and she resents others taking control of it. Or it may be the disruption in routine, the extra noise and commotion. Two things to try: 1) Give her a task, such as dusting or pushing the vacuum. 2) If she can’t or won’t participate, then the other possibility is to take her away from the house while the cleaning is being done. As you have found, reasoning with her or trying to do it around her do not work.  

With regard to bathing, you need to do some problem-solving and see if you can find out the reasons for her resistance. Bathing is a common problem but a complex one. Generally we recommend that you think about the whole process and ask yourself some questions about the possible causes of her behavior:

  • Are there possible personal causes such as privacy? Dignity? (How would any of us feel being told we need to bathe?)
  • Is the bathroom comfortable? Often people get cold or there is too much waiting around.
  • Many people with dementia do not like water on their faces and heads.  Can you separate hair washing and bathing? Perhaps get her hair washed at a salon?
  • Do you know when and how she bathed before? Try to recreate her old routines as much as possible.  
  • Sometimes bringing in a home health aide from an agency is better than trying to have a family member help. You might investigate this.  
  • Call the Alzheimer’s Association (1.800.272.3900) or library and ask if they have or can get the video, Bathing without a Battle. This is an excellent resource that comes with a comprehensive manual with many suggestions.