Successful Aging: Getting a sense when hygiene issues have deeper causes

Q My parents are in their 80s and lack good personal hygiene. My mother has been diagnosed with early onset of Alzheimer’s disease. Even before my mother became ill, she resisted bathing. Both my parents do not shower enough, and they wear the same clothes daily, some with stains. I have tried to make suggestions to no avail. Is this normal in old age? Given that I live 3,000 miles away from parents, how can I be effective?

– Y.E.

A Dear Y.E.:

The situation you describe happens frequently, although it is not an expectation of typical aging. To find a solution, it might be useful to step back and look at the bigger picture to understand what’s going on, particularly if their habits have changed.

Here are some possible reasons:

• Fear and discomfort. An older adult may be fearful of falling when getting in and out of a tub or shower. Additionally feeling chilled may be a disincentive to bathing.

• Depression. If your father in particular had good personal hygiene and now doesn’t take an interest in personal cleanliness or wearing clean clothes, consider depression as a possible cause. Other behaviors that may indicate depression is withdrawal, not caring about anything and having little energy.

•Decreased sense of sight and smell. We know vision and sense of smell change with age. As a result stains on clothing may not be seen and the odor of perspiration may go unnoticed.

• Memory. It’s easy to lose track of time if there are few activities; days can just run into one another. One can ask, “Did I shower yesterday or was it the day before?”

• Alzheimer’s disease. While taking a shower, those with Alzheimer’s disease or other forms of dementia may not understand why water is running on them or believe they make be sucked into the drain. Fear prevails. The Alzheimer’s Association is a good resource to help with challenges of bathing and personal hygiene.

• Generation norm. Older adults were not necessarily raised taking a daily shower. If your loved one is used to bathing two or three times a week, that pattern is unlikely to change. Many from Europe and other parts of the world think we Americans are a bit extreme in the daily shower/bath routine.

• Control. With advanced age, it’s easy to feel a loss of control. If older adults feel nagged with advice, they may resent and ignore suggestions, feeling that someone is taking over their lives.

• A sign of health problems. Resistance to personal hygiene may be a sign of health problems. Decreased strength may prevent an older person from turning on a faucet or pressing down for sprays. Joint pain may be an obstacle to opening plastic shampoo bottles, combing one’s hair or clipping one’s finger or toe nails. A cavity or infection can prevent good dental hygiene. Other actions required for personal hygiene may cause pain.

Note your mother’s resistance may be different from you father’s. In this case, go to the Alzheimer’s Association web site at www.alz.org and locate an office near you.

Also see http://www.alzheimersblog.org/2014/02/14/difficult-behaviors-bathing-personal-hygiene/ for some tips.

Consider a visit with your folks and sit down with them for a chat. The conversation might go something like this:

“Mom and Dad, this has been a great visit, so thank you. I want to talk to you about a very personal subject and that’s about your personal hygiene. You likely are unaware of this, but you have a bit of body odor which is not pleasant for those around you. Also, since I am here I’ve noticed you haven’t changed your clothing and many of your shirts, blouses and trousers are stained. Have you been aware of that? What are your thoughts?

“You know keeping up your appearance will likely make you feel good. Dad, you always did that when you had your dental practice and Mom you did the same when you were an accountant assistant. Clearly you are in charge, and I am here to help. You know I love you both.”

Y.E., Thank you for your good question. Hope this gives you a start. Understanding the reasons for resistance will lead you to possible solutions. Good luck.

Send emails to Helen Dennis at helendenn@aol.com, or go to www.facebook.com/SuccessfulAgingCommunity.