Pamela Toto’s 102-year-old client had a problem: She was able to live alone, with help from her son, but getting in and out of her shower, where she had a chair and a handheld nozzle, was too difficult.
So, Toto, an occupational therapist, showed the son how to safely help his mother into her shower chair.
But, Toto says, “they didn’t do it.” She learned why in a talk with the son: “He said, ‘I do everything for my mom, but I just don’t want to see her naked.” Toto helped the pair find a solution: a wrap-around towel robe the woman already had that she could wear on the way into and out of the shower.
It was a good illustration, Toto says, of the challenges, both practical and emotional, that caregivers and care recipients face when someone needs help with showering, using the toilet or other intimate hygiene tasks.
“It’s hard to ask for help in those areas, and it’s also hard for care partners to give help in those areas,” says Toto, who is a professor of occupational therapy at the University of Pittsburgh.
She and other experts say there are ways to make such tasks easier.
Notice changes and think about causes
For some people, the need for hygiene help arrives suddenly, with a stroke, a fall or other crisis. But many older adults gradually become less adept or attentive to personal care, Toto says.
Not every change is a problem, says Heather Young, a nursing professor and dean emerita at the University of California, Davis. “Having a shower every day or every other day is not a necessity,” she says, especially for many older adults who aren’t working up a sweat. Also, she says, “Someone who has always been fastidious about their hygiene is very different from someone who’s always sort of neglected it.”
However, if you notice a change, it’s a good time to start a conversation, says AARP family caregiving expert Amy Goyer. For example, she says, you might say: “I’ve noticed that you aren’t showering as frequently. Is that because you don’t feel safe in the shower? Can we put up some grab bars to make it more comfortable? Is it because it’s cold in there? Because we can put in a heater.”
Sometimes, the challenges are greater. Michele Merfeld Hale, 66, of Columbia, Missouri, cares for her husband Larry, 88, who has vascular dementia and often resists showering. “The sad thing is, he was one of the most hygienic men I ever knew,” she says. “So, it pains me when he doesn’t want to shower.” But Hale has learned that her husband is afraid of falling and dislikes water on his head. So, now she uses no-rinse shampoo and body wash to make the process quicker and more comfortable.