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

12 answers | Last updated: Dec 05, 2016
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 Answers

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.  

Community Answers

Frena answered...

oh for goodness' sake, this showering daily stuff is way overrated. it's only a product of modern plumbing opportunities, it has little to do with whether most people need an all-over shower. most elders grew up in a one-bath a week culture (which of course may have led directly to the invention of deodorants).

the skin of most elders is too fragile and dry to need daily wash-down by outpouring water. three times a week is great. otherwise, they can do what most cultures have always done, including our own. wash-cloth, soap and water gets the job done without so much stress.

plus, id say EVERYONE with dementia is disturbed by showering. latest research shows that brain wave function seems affected by the beating of water rhythms on the skull.

my suggestions: 1. stop bullying Mom (that's one BIG thing that's upsetting her); 2. get a hand-held shower, beginning from the feet up, talking soothingly to her. "There, Mom, this'll help those aches and pains you were telling me about..." blah blah blah. Keep this to not more than 3 times a week; 3. if you guys can't be nice about it, then hire a bathing aide and i'll bet your Mom does much better that way. (we KNOW how to get your Mom feeling comfortable with us); 4. washcloth and warm water in the bathroom sink and some gentle cueing for Mom the rest of the time.

Big time: be NICE, be KIND, be persuasive, suggesting and bribing NOT bullying. And let go of the moral judgment stuff.

Texlas answered...

I agree with Frena, But We all need help in learning these tricks. I went through this with my mom, Who was always fastidious. Bathing daily was very important to her. Now even her caregiver at Asst. living sometimes has problems. the handheld shower is absolutely essential to comforting bathing. I know that Frena is very experienced, and is a godsend to this website.

The caregiver's voice answered...

Consider this...your 85-year old MIL no longer recognizes any of you.

Would you allow strangers in your home to "move around and possibly take YOUR stuff?"

I don't know about you, but if I were in her shoes, I wouldn't want a stranger to bathe me either!

Take it slow and easy. Each time you visit, take time to RE-visit who you are to her. Share memories. You'll likely be doing the sharing and she'll be tickled with the stories. ("You remember THAT?") You'll find the rest to go so much more easier...but you MUST be patient.

In the end both of you will feel less flustered and even grateful for the time you spent together.

Frena answered...

great suggestions, Caregiver's Voice! the skill that good caregivers have is to relate to people with dementia in such a way that they "feel" familiar to the person. that has a lot to do with how we use relating skills -- a sort of learned openness, i guess.

and often, family members are closed up, frightened, upset and so on -- which their family member picks up. people with dementia have terrrrrific emotional radar and they react to what they pick up.

so family members need to begin to develop an open non-confrontational loving style in the face of dementia. kick back, folks, relax and try it. it really does work.

Marrero.lynn@gmail.c answered...

My mom has dimentia and for a couple years now has been living with my husband and myself. Everything seems to be going smoothly because I also took care of my grandma (who also had alzheimers) but only for one very important thing - SHE just does NOT want to change her "panties"(diapers) most of the time - and also does not want to allow me to wash her up, change her or give her a shower. She is very violent, scratches me, (making black and blues on my arms, biting, spitting, cusing at me, etc). I have tried just about everything! Talking about other things to distract her, explaining what we are doing, etc., but she still resists. I don't know what to do. She has a heart condition and I am concerned that anything I say or do may affect her. I have an aide who comes to the house for help in the care of hygene but she does not allow it either. What can I do?

Frena answered...

hallo lynn, this is just an idea. i have found that where there is kicking and fighting around toilet issues, changing underwear and so on, there may have been a history of sexual abuse as a child. obviously i have no idea about your Mom. but it has been so in others i have known. my suggestions: big on reassurance and taking time; gentle reassure for her to show this is safe, no one will hurt her; ask her if she can help herself get changed; as in "Here, Mom, why don't'll feel so much more comfortable. ask permission for every move you plan to make. "Is it okay if..?" "Do you think you'd feel better if..". This is all puts her in charge and helps safety feelings; the severe reaction is terror, if i'm not mistaken. so slow down a lot and calm yourself too what about a different kind of underwear -- the wraparound kind. then you can unwrap them )with her permission. i have even been known to accidentally spill some cold water on someone's clothing so as to give reason for change. (it's not popular, by gosh, but it works. just don't do it often, okay?)

if you really can't soothe her, persuade her, get her involved, then her fear level is too high to allow this (my guess). then (reluctantly) i'd talk to her doctor about an anti-anxiety medication that is appropriate for someone with dementia (and be sure you read up on the side effects on some of these forums).

good luck and hope this helps. try to help her feel you're a good safe mother for her. tell her you'd never let anyone hurt her and so on. and take things very slowly.

Wowmomma answered...

I feel that you have to take control and just clean around her quietly and gently while you speak to her of times long ago. Just clean one area at a time, slowly and naturally. If she gets in the way, just move on to something, or somewhere else. She might like dusting or rearranging things on a table or shelf while you work. When it is time to bathe, just help her into the bathroom, all the while reassuring her, and talking of things of interest to her. Give her a sponge bath if you think she would prefer that. Make sure there is a seat in the shower and a hand held shower. My mom hates taking showers (or bathing at all) because she gets cold so easily. My mom gets one shower a week, which is not sufficient because she has a bladder leakage problem, but we do the best we can.

A fellow caregiver answered...

For those bladder leakage / groin odor issues ... while the elder is seated on the toilet, use a narrow plastic pitcher or tall plastic cup to thoroughly rinse the groin area with warm water after applying a small amount of mild liquid soap with a gloved hand. Have a small towel ready for quickly wiping the groin area dry. This is something that can be done daily during underwear changes and really reduces the need for frequent whole-body bathing. It is a very quick process and likely to be better tolerated by elders who resist getting into bath tubs and showers... just be sure the rinsing water is comfortably warm and not too hot or cold.

A fellow caregiver answered...

My mother is 92 and has dementia. She hasn't had a shower for over 2 years. BUT we do wash her with a wash cloth, soap and water. In fact, she does most of the washing with directions. A couple times a week we (either one of the caregivers or myself) do a more thorough job. Thankfully Mom has accepted this as an OK way to bathe. She was afraid of the shower and I saw no point in forcing her to take a shower.

A fellow caregiver answered...

I am constantly amazed by the trouble caregivers will go to mollify their charges with dementias. When this began to happen with my Mom, I just told her that either she would let me care for her--including personal care, or I would put her in a nursing home. That "worked" for the 3 years she lived in my home. Eventually, after increasing resistance that resulted in a couple of falls--one that required hospitalization (when I called the EMTs she told them she didn't want to go to the hospital even though she clearly couldn't be put on her feet!)--I found a placement in a nearby nursing home. That was 4 years ago, Mom will be 104 in September & she has adjusted to nursing home living by getting around with the help of a wheelchair. I'd say that it is time for a nursing home placement.

Ms rosie answered...

I read an article about the reason why they don't want to take baths, I followed the recommendation and it has worked like a charm for me. I put take duck tape around the tub, according to the article, their depth perception Is off and so they can't tell the where the tub ends or begins. I outlined the tub with red duck tape, cost me $2.00 and she had taken a bath every since. I only b the her twice a week unless she needs more.