Grandpa won't move out and won't bathe. Help?

A fellow caregiver asked...

My grandmother is 94. She is still very sharp but uses a wheel chair. She can stand and walk a VERY short distance. She takes care of my grandfather who is 89 with Dementia. They currently live 80 miles from me and we rented an apartment across the street from my house so my family can pick assist them. My grandmother and I have two challenges:

  1. He refuses to move. I hope we don't have to say we are going for a ride and then never go back. Any ideas on how to reason with a person who can't make proper decisions?

  2. He now refuses to take a bath. It has been over two months. We do not want to put into a home. We know it is coming but if we can continue to do the basics of feeding, dressing, bathing etc we can handle the situation. What suggestions do you have to again reason with him so he will work with the care giver and take a bath? How would a home handle this situation?

Expert Answer

Kay Paggi, GCM, LPC, CGC, MA, is in private practice as a geriatric care manager and is on the advisory board for the Emeritus Program at Richland College. She has worked with seniors for nearly 20 years as a licensed professional counselor, certified gerontological counselor, and certified geriatric care manager.

First a better understanding of the term 'Dementia' will help you deal with behavioral problems such as refusing to bathe and refusing to move out of the current home. When a person has Dementia, he loses the ability to solve problems and even to recognize that he has a problem. In his reality, he is fine and you are the person making unreasonable demands. What this means to you as a caregiver is that you cannot ask him to make reasonable decisions because he has lost that brain function. If a five-year-old wants to play with his trucks on the highway, you recognize that he is not developmentally ready to realize the consequences of that behavior, and you do not allow it. Your grandfather now is not able to see a problem with not bathing because his brain has been damaged by his disease. You handle the situation in much the same way that you would with a child: lovingly you set limits. 1. People do not die due to a lack of bathing, so your grandfather's refusal to bathe is not life-threatening. However, his body odor may make caring for his personal needs difficult in the short term. In the long run poor hygiene could lead to more serious medical consequences. It is important to find out why he is not bathing. He could be frightened of the water or the room, or it could be a way of defying your grandmother, or any number of other things. If you can find out why, you will be better able to get him to bathe. In the short term, try sponge baths, perhaps in a different room of the house. Consider hiring a male aide to assist with a bath once or twice a month.

You may want to look at the website or read the book Bathing Without a Battle: Person-Directed Care of Individuals with Dementia, by Ann Louise Barrick PhD.

  1. Taking your grandfather for a ride and going in to visit someone in the new apartment is probably the best way of moving him. It is certainly the kindest. Remember he is literally, physically, unable to reason. He cannot understand why you want him to leave his home where he feels secure. It is pointless to explain. His brain cannot follow the logic. Trying to argue and explain will only agitate him and frustrate you. The kindest, most loving way to get him into a safer environment, where he can have care from loving family members, is to not tell him that it is going to happen. Once it is done, you can grieve with him, and agree that it is terrible. Your goal is not to force him into agreeing. Your goal is to provide him with the best care.