48+ Caregiver tips for elderly hygiene issues and care
Personal hygiene can be a very sticky subject to discuss with elderly parents. I am lucky with my mom, as I do the laundry, I buy all the groceries she needs, and living with her I know if she has showered or not. And to be honest, I usually just say to her “shall I set up the bathroom for you to shower” and she’s off joyfully splashing around in the bathroom. But I know, for a lot of you, it’s not that simple.
So I have put together my 48+ caregiver tips for elderly hygiene and care from ten years of doing this for both of my parents parents. From how to approach the subject with your parents, what to do, and how to support them in doing this.
What causes of poor hygiene ?
Quite simply the cost of bathing and laundry may be too high for seniors who have very little financial resources, and they cut back where they can on their spending.
Not enough time in the day
As a person gets older they move and do things more and more slowly, and in the end they may just feel there isn’t enough time in the day to get it all done. It then becomes a question of priorities and they just may not place bathing at the top.
Catching cold is a real problem for the elderly. I know form when I had to help my father shower he would always catch cold and we used to have to have fan heaters wafting warm air into the bathroom, and get him immediately into a heavy towel bathrobe and off to an extra warm bedroom.
Lack of energy
Fatigue becomes a big problem as well. I have noticed this with my mom. Not only does she not hav enough time in the day, but she complains a lot of simply having no energy to get things done, and also just running out of energy after a few simple things.
So your loved ones may simply not have the energy to go through the whole bathing ritual every day.
As mobility decreases, and stiffness and pain increases, some of our parents can become very much afraid of falling in the bathroom. and this is not without reason as it is the most dangerous room in the house with 80% of all falls occuring there.
This fear can lead to elderly parents bathing and showering far less frequently than they normally would do so.
If you haven’t yet done so, take a look at my article on bathroom safety. It’s crammed with practical tips and suggestions for equipment which can make the bathroom a far safer place – 54 bathroom safety tips for seniors – A helpful guide
Loss of Dignity
If your parent need to have help with their personal hygiene this can lead them to feeling undignified and being very reluctant to wash.
Pain and mobility
With conditions such as arthritis, osteoporosis, and with knee and hip problems pain can be very debilitating, and make washing in a bathtub or shower too painful. In such cases sponge baths may be far simpler and more comfortable.
Elderly parents may suffer from depression, and simply be losing interest in the hobbies and activities, in which they once delighted.
Depression can also be a reaction to medications seniors have been given for age-related illnesses, or they may be scared of growing old, as they see their friends slowly die off around them.
There can be many causes, and if you suspect this, you need to address these concerns to their doctors.
Your love ones may be among the millions of elderly suffering from short term memory loss. This can be remedied, to some degree, by them having a chart with a schedule, on which they record their bathing etc.
Fear of losing control
If you are having to repeatedly address the problems of your parent’s personal hygiene, and they continue to ignore you, they may simply fear that they losing control of their lives.
You must try to support them in what it is they want to do. You may find, that they would prefer a sponge bath. Try to find an alternative way of doing things, and sometimes you have to accept that they may not bathe for a day or two. If it goes on for too long, you may need to bring in their doctor to speak with them.
Sight and hearing
Many elderly parents will suffer, to some extent, from a loss of sight and of hearing, which can make moving around very difficult indeed. The speed at which they move will also cause them to take inordinate amounts of time to complete even the simplest of tasks. This can be a very common reason as to why they are bathing or showering less.
Loss of sense of smell
With age, your loved one’s sense will dull, and as a result your loved one may be completely unaware that they don’t smell quite so fresh, or that their clothes may be a bit off as well. This dulling of the senses, combined with the monotony of one day blending into the next, if their routine is very dull, can explain why they may not realize how many days have passed since the last bathing experience.
You may simply be able to help your parent to keep some kind of schedule, as I suggested before, where they mark down there last bath etc.
If your loved one is suffering from some form of dementia, or other form of cognitive disorder, you will need to proceed very slowly with them.
There will of course come a time when you can no longer handle their care, and the need for professionals who are trained in helping people with dementia will be required.
How often should an elederly person bathe ?
Before you decide that you are going to discuss your parents personal hygiene with them, you should really know a little something about it, and what is considered to be enough bathing, or washing, to avoid health problems developing.
How much bathing is recognized as a minimum ?
Everything I have read about the subject of the frequency of bathing, says that once, or twice a week, is fine for someone who is not incontinent.
As your parent gets older their skin produces less oils, becomes thinner and tears more easily, so you don’t want to overdo the washing and have them damage their skin.
You may have noticed how easily seniors get bruises on their skin. This is a sign of the skin becoming thinner and more delicate.
If my parent is incontinent how often should they bathe ?
With incontinence the issue is not so much bathing, as it is washing the skin which has gotten wet to avoid infections, and not letting people stay sitting in dirty diapers.
If your parent is incontinent they will need the wiping and washing their private parts, being dried and changing into fresh diapers every time.
For women there is also the added issue of UTI’s which are much more common. Women should be cleaning themselves from front to back, to avoid getting infections, caused by fecal matter getting into the urethra.
Does my parent need special bathing products ?
It’s a good idea to be using very mild soaps without a lot of products that have been added.
You can find soaps for sensitive skin, and also mild soaps for babies.
Does my parent need a complete bath or shower ?
If for any reason your parent doesn’t want to bathe in the bathtub, or take a shower, a sponge bath, or a flannel bath is perfectly adequate. Baths of this kind also permit your parents to wash their private parts themselves, as they will be lying down our reclined, and can’t fall over. You may see that they find this a little less stressful.
How do I talk to my parent about hygiene ?
You are there to give support
I feel the best approach, and this is not my idea but one that I think most professional carers have been taught, is that you must make it abundantly clear to you loved one that you are not trying to interfere, or take control, but rather to support them in maintaining their independence.
Is everything okay ? Don’t ask this straight away
Very often, if you feel that your elderly parent is not being very careful about their personal hygiene, you will be worried that they are somehow not okay. But you need to curb this way of thinking.
Your parent may be perfectly alright, but due to a lack of energy they just have different priorities, as to what needs to be done. Getting the bills paid and posting the mail has taken their energy, and toady there isn’t enough left for taking a shower.
Don’t judge them, they may just be prioritizing what they do with their time – everything takes longer and longer the older you get.
Remember this before you start asking your questions, it isn’t all doom and gloom.
Why is it so delicate a topic ?
Personal hygiene is very much fundamental to maintaining an individual’s independence. Activities such as bathing and washing the laundry, when they become very difficult, or too difficult to do, threaten your elderly loved one’s very independence.
This is why you have to go so slowly, as they may feel very much under threat. The idea for your loved one that they may need help and supervision, and that they may be losing control, can be really difficult for them to face. And pretty darn scary too. You have to go very slowly with your approach to make sure they won’t react badly.
It is also an issue of a person being allowed to maintain their dignity, and to not feel as though they are being found to be dirty.
What do you need me to do for you ?
I would suggest that once you have found that your parent may need help with their hygiene, you find ways of starting the conversation bearing in mind that you are saying to them –
“What do you need me to do for you ?”
This is the best approach to take.
How do I find a way to ask about my parent’s hygiene if I feel they may not like it ?
If you need to take a slightly indirect route, for fear of your loved one over reacting to questions about personal hygiene, I have a few suggestions of how to do this.
The bathroom safety check
I would suggest that you ask to go to the bathroom, and whilst there just take a look around and see if things may be difficult for your parent to navigate.
On returning to talk with your parent, you can say that you are a little worried that the bath, or the shower, may be a bit dangerous for them, and can you perhaps get them some equipment to make it all a bit safer ?
You must emphasize that you are worried about their safety, and not that you think they aren’t washing. If your parent isn’t washing because they are scared of falling in the bathroom, they may tell you now as you have opened the door to that conversation.
You can of course just say to them that you worry about them falling, and you would like to help make it safer, it’s indirect way of approaching asking why they aren’t washing.
If you think that their laundry doesn’t look washed and is smelling, you can always just find a way of offering to help them with that.
You can always ask if the washing machine is working properly, and if they ask why, you can say that there are some light stains on something – there is no need to go overboard.
You can even suggest they try another detergent, go buy something for them, and then offer to do the laundry with them, so you can see the results together.
And, of course, you can just ask them if they have the energy for doing all the household chores, and offer to pick up their laundry and to do it with yours to save them time.
If their washing machines are in the basement you can say that you are worried about them on the stairs, and offer to take it home to do it for them.
You will of course have to work out how you do it, but there are so many ways to do it with tact, and to do it gently.
You should always be asking “What do you need me to do for you ?”
If your parents don’t accept help straight away, and you don’t pester them, they will usually come around. And just say it’s because you worry about them.
What do I do if my parent is afraid of falling in the bathroom ?
The best way of dealing with the risks involved with bathing, or showering, for an elderly person is to help them eliminate as many as possible.
As I wrote earlier I have an article with different types of safety equipment with the suppliers names that you can look for on the internet. You can read that article if you click here.
Non slip treads and tape
You can get non-slip products which will help reduce the risks of falling.
Non-slip shower and bathmats
You can find lots of non-slip mats, which are also mould and mildew resistant to place in the shower or bathtub.
Remove any obstacles from the floor
Get rid of any rugs with thick curled up edges, and any objects which simply are creating a tripping hazard – clear out all superfluous “stuff”.
One of the best pieces of equipment is the grab bar – bars or rails that you can attach to the walls, which your loved ones can hold onto to stop themselves from falling.
There are vertical clamp-on bars for the sides of bathtubs, floor-to-ceiling poles which can be placed anywhere, bars which stick out horizontally from the wall but than be folded back up close to the wall, and all manner of bars that you can attach in the shower.
Personally, I would stay away from the grab bars which attach by suction, as I have had three different ones come off the wall when I was holding onto them. I just don’t think they are very safe.
I am also going to mention frames which you can place around the toilet here as well. Your loved one may be having trouble getting on and off the toilet, so you can put a frame there that has arms for them to hold onto.
If you are finding it hard to pay for all the home improvements required, I have articles about what durable equipment Medicare, Medicaid, Veterans Benefits and State plans will pay for. In particular I have an article on bathroom safety equipment – Does Medicare pay for bathroom safety equipment ?
Walk in bathtubs
If you can afford one, a walk in bathtub is probably your loved one’s dream solution to bathing and showering. There are no difficult steps, there is a seat (get the design which suits your parents needs), and they can come with a shower unit as well.
The risk of falling is dramatically reduced in a walk in bathtub, and your loved one can really relax to enjoy their washing.
If you can’t afford one check my article “Does Medicare pay for walk in bathtubs ?”, as certain Medicaid programs and waivers will pay for one for people on low incomes, and in rural areas there are rural development grants that will help to pay if it is necessary. All the relevant information is in the article.
For those of us who can’t afford walk in bathtubs, or a new shower, there are a few very helpful types of seats that you can use in the bathtub which make it a lot safer.
Seats with a lift and a swivel seat – these go in the bathtub, and can go up and down into the water. There is a swivwl seat to make getting into the tub easier. Some people may require a little asistance but they make getting into the bathtub much simpler.
Another from of seat is a Sliding Transfer Seat which is half in the tub, and half out of the tub. Your loved one would sit down on the seat outside the tub, and you would help lift their legs as you slide the seat over and above the tub, finally lowering their feet into the water. The difference with this seat is that your parent is sitting above the water and can’t be lowered into it.
Hand held shower head
A hand held shower head for washing and rinsing in the bathtub is a great advantage for those with limited reach.
Walk in showers
You want to avoid showers that have steps, so you may need to have a new walk in shower if your parent has one that they have to step up into.
A shower seat is a great way of cutting down risk of someone falling in the shower. You can get seats which fold down from the wall, benches or chairs.
A little tip here is that if you have a portable commode chair, you can remove the bowl part, and use the seat if it fits in your shower.
Hand held shower head
This makes it much easier for people with limited reach and mobility to wash and rinse themselves in the shower.
You can put up hanging shower caddies and keep everything that is needed in one place where your loved one can get to it all easily without over reaching and loosing their balance.
Non slip tape on grab bars
If your loved one finds a grab bar is a bit to slippery, you can just add some non-slip tape.
Sopa on a rope
If your parent isn’t using a gel soap in the shower, try to get soap on a rope for the, so that if the drop it they don’t have to bend down to pick it up, and risk losing their balance.
Sink Safety Rail
If your parent likes to stand at the sink and wash here, you may want to put in a safety rail for them to hold onto.
My parent wants me to wash them how do I do that ?
Firstly, if you are going to wash your parent, you need to make them feel comfortable about it. Don’t let them know if you are embarrassed, as it will just make things worse.
Remember that you are there to help support them in maintaining their independence in their own home.
I have a long article on how to make bathing easier for your parents, covering all aspects, and which goes into far greater detail here
Don’t take over
Before you actually do a thing, you need to know what your parent is able to do, and what they are not able to do. More importantly, you need to know what they will need you to help them with.
By asking them what they need from you, they will see that you are supporting them, which is really important for things to go off smoothly.
Give your parents as much privacy whilst washing as possible. You may be able to leave the room as they wash certain areas of their body, and they may want to have certain parts covered when you are there. Let them take the lead on this and guide you. You just need to keep asking what they want you to do.
Make a schedule
A schedule is a great way to start the bathing process. Your parent will know when to expect you, and will not feel as though you are interfering, as this is the time they agreed to do this.
To do this you need to get your parent to give you the times that they want to bathe which fit with your schedule. Again, it is all about supporting them, and not taking over, which will just lead to them feeling frustrated.
Remember don’t go crazy with the schedule, it’s okay for an elderly person to bathe just once or twice a week only. Try to be flexible if they don’t want a complete bath, or shower each time, and would rather have a sponge bath.
Set out the bathroom and bedroom
Have the whole set up ready before you are going to bathe your parents, since you don’t want to be wandering around finding stuff while they get cold. And you don’t want your parents over reaching to pick up things they need, so place stuff close to them.
You may also want to heat up the bathroom considerably, as the elderly catch cold very easily. I always used to heat the room up for my father, who got cold really quickly.
I would have a towel on the bed and take your parent through their to do most of their drying off there. You can have them wear a towel robe through to the bedroom.
Heating up the bedroom is also a good idea so that they don’t get cold when drying and dressing – this can take your loved ones quite a while.
Take the bathing or showering slowly
Only do what your parent asks you to do, and if they are able I would let them wash their private parts.
Talk and move slowly throughout, as they may not hear things correctly, or be able to move fast enough to keep up with you, and this can be frustrating for them, and also can cause accidents.
Keep all areas dry
Don’t let the floor get wet while you are washing your parent. You have to keep an eye out, and to dry things up as you go along so that you avoid either of you slipping.
And even if you are not washing your parent all the time, don’t move out of arms reach, unless they ask you to, just so you can help them quickly if you need to.
Have some kind of towel or cloth on hand to cover up with
You should always have something for your parents to cover themselves with when bathing. They may lose their nerve at some point and get shy, or they may get a bit cold, so have something extra to hand when you set up the bathroom.
What about my parent’s feet ? What can I do ?
Don’t forget mom and dad’s feet, especially if they have mobility problems, or arthritis.
If you aren’t helping your parent’s bathe, you still may need to do their feet especially if you know they have problems with bending and reaching.
You don’t need a bathtub or a shower to do feet
If you are only washing your parent’s feet, you can just use a bowl of warm water.
As with bathing, you will want to have them check the water temperature, after you have, to make sure they are happy with that.
If they have arthritis, you will want to wash them slowly because you can really hurt them if their joints are very swollen – you will find it easier with some kind of cloth, but it may catch on toes, and cause them to get pulled on which can be painful.
Drying the toes
Go even more slowly here, as you will not have the water as a lubricant, and the towel may bunch up and hurt your parent’s toes.
If your parent has very swollen joints, you may just want to dab the feet with a towel, and then dry from a distance with a hair dryer set to cold air – always test this first so you don’t burn their delicate skin.
As you are already washing your parents feet, you may want to also take the time to moisturize them.
There are all sorts of foot creams out there.
There are abrasive ones if you wish to remove dead skin which is getting a bit thick.
If your parent is developing a cracked heal, you can do what I do for my mom which works well, which is to apply the moisturizer and then to put plastic wrap around the feet over night.
You can use vaseline if you just want to keep the moisture in their foot, as it seals the skin. And I would use plastic wrap to stop the grease getting everywhere.
Pedicures for fun
If your parent enjoys being spoilt and having a pedicure, you could go have one together. You can turn it into a fun time out together, which makes it much more enjoyable for your parents, and they get to socialize a little as well.
How about the teeth ?
I would suggest that you take your parent for regular check ups with their dentist, and they will tell you if you need to help.
Unless your parent has severe problems with their hands, or with dementia they should be able to brush their own teeth. If they aren’t able to, you will just have to slowly and gently brush their teeth for them, or guide them through it.
Take everything slowly, and make it clear that you are supporting your parents in maintaining their independence and it should all go well.
I hope this has been of help to you.
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I’m Gareth and I’m the owner of Looking After Mom and Dad.com
I have been a caregiver for over 10 yrs and share all my tips here.
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