Grandpa refuses to allow us to help him bathe, but he's smells horribly. What can we do?

Htnevada asked...

My grandfather refuses to bathe. He is 99 and just as stubborn as a teenager. My mom is the POA and their primary caregiver as he and my grandmother still live independently. However, I think he is unable to bathe himself without help. Once in awhile (every month or two) he will allow my grandmother to help him take a shower, but she isn't extremely ambulatory either so it's never quite enough. He cannot control his bowels and therefore sits in dirty pants sometimes for days at a time. He refuses to wear anything like Depends because he says, "They're for old guys." Mind you he's 99, so you can tell he's still quite feisty. My mom can't physically take care of everything and he refuses to let the woman they've hired to help clean him up either. He curses, smacks his cane around, and shakes his fists. Last week a cousin helped my mom try to shower and change him after he fell down. He was good about it for one day and then right back to combative. His anger is so much that he struck my cousin in the face and then struck my mother. He's thankfully not at his full strength, but I also worry about my mom because she's so stressed and tired from taking care of them and having a full time job. My grandpa most likely should be in a adult home or a similar facility, but the family tries to keep him comfortable at home. What can we do? The smell is absolutely awful despite the best efforts of family nearby, and it can't be comfortable to sit in dirty pants. How can we get him to let us help him?

Expert Answer

As Founder and Director of Circles of Care, Ann Cason provides caregiving, consulting, and training services to individuals and public and private organizations involved in eldercare. She is the author of Circles of Care: How to Set Up Quality Home Care for Our Elders.

Thank you for your letter. Your family wants to keep your grandfather comfortable at home-----and are willing to sacrifice their own comfort. As your grandfather nears the end of his life, he wants to hold onto himself by striking out at others. He refuses to bathe and sits in his own waste. It is not personal;he is tense and frightened.

It might be possible to approach your grandfather with a type of horse whispering. Two or three family members might approach him, sit around him and speak softly repeating certain phrases over and over. "We love you, you have had a good life and now you are very old. We want you to stay home. The smell is horrible." See if you can soothe him with sound. When he goes into the bathroom, forget the shower for now, just work on wiping him and washing his bottom with wipes and a warm wash cloth. Talk to him and tell him what you are doing. You just want to clean him and change him, but he does not have to shower. When you take off his soiled underwear, get some disposable pull ups for men. Pull them up,and put on clean trousers. Tell him how good he looks.

Make sure the soiled underwear is properly cleaned. Also,try to find a man to be his personal care attendant. The man should be able to remain calm and gentle if your grandfather tries to hit him or be abusive.

Your family needs some professional intervention. Although they are extremely patient and kind, when he hits his loved ones and sits in his own poop, that is not acceptable. He may need medication to calm him down. If he can't see a doctor, a consultation with a Geriatric Care Manager or a visiting nurse would help. They will come to your house and advise your family about how to manage him at home.