An elderly person’s refusal to bathe, brush his/her teeth, shave, change clothes, or clean the house can be frustrating and bewildering for caregivers. Understanding the reasons for the person’s hygiene issues and addressing them effectively may take time, patience, and willingness to compromise.

If the older adult does not have Alzheimer’s disease or another form of dementia, hygiene problems can result from a number of factors such as:

  • Symptoms of geriatric depression include sadness, fatigue, changes in appetite and mood, loss of interest in hobbies and activities, among other signs.
  • Memory lapses. The older adult may simply lose track of when he/she last showered or changed clothing, especially when one day seems to run into the next.
  • Decreased sense of smell. The person does not notice his/her body odor.
  • Pain/Discomfort. Physical frailty and medical conditions can make it difficult to get in and out of the bath or shower, or do laundry and other cleaning tasks. The person may feel embarrassed to ask for help, particularly when it comes to personal hygiene.

Common hygiene issues of older adults with dementia are often due to memory impairment or feeling confused and out of control. Caregivers should avoid turning a hygiene issue into a battle of wills. Instead, coming up with different strategies or ways to gently persuade the person to cooperate will be more effective. For example, if the person wants to wear the same dirty clothes over and over, the caregiver can remove and launder the clothing once the person is asleep, or ensure that there are several identical outfits that can be switched out.

Bathing may be more challenging if the person is fearful of water, embarrassed to remove clothing, or feels rushed or forced into the activity. Tips to try include the following:

  • Stick to a consistent routine and make the experience as simple and pleasant as possible. Have the water soap and shampoo ready, ensure that the person is not chilled, and is warm and covered when going into the bathroom.
  • Use distractions. If the person becomes upset while bathing, try distractions such as music, listening to the radio, or telling a story.
  • Try alternatives such as a sponge bath, or handheld shower while the person is seated in a shower chair. If the person refuses a full bath, try products such as dry shampoo and no-rinse soap.

Caregivers may need to relax their own standards if the older adult’s hygiene is not a health issue. Sometimes “less insistence means less resistance.”

We help families in the Austin, Texas, area to help make sure that the older adults in their family have all of their care needs met. If you would like our assistance, please reach out to us at 512-814-3228 or via e-mail at

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