When is poor hygiene a health issue for the elder

by Carol Bradley Bursack

An often asked question from adult children and caregiving spouses is "how can I get my parents, or spouse, to bathe and change clothes?" I hear this question so much that one thing is certain - you aren't alone in your dilemma. There are several things to look at with hygiene problems, some of which have to do with the caregiver's expectations.

The fact that many elders don't get around to bathing or changing clothes, common as it is, may not be a health issue. It's certainly a social issue, however, and it's one caregivers are acutely aware of.

Personal hygiene is rather subjective to begin with, so when people ask about getting their elders to be "cleaner," I generally ask about past habits. Many people in the older generation were not raised on a daily shower. Many people from Europe, and other parts of the world, think Americans are a bit nutty over the daily bath. So, keep things in perspective. Was your parent or spouse a daily bather? Or did the person just sort of skip around and take a bath once or twice a week? If this was normal behavior though out a life time, it's not going to improve with age. And, likely, just because bathing takes extra effort, you may see some slippage from the routine of the past. That's probably not a big issue.

However, if your parent or spouse was regular with showers or baths and particular about clothes, and now you find that he or she doesn't get around to bathing and runs around in smelly or obviously dirty clothes, then you should consider a few things:

With hygiene issues, as with so many others, the caregiver can do well with a little self-examination. Are your worried about your elder's (or spouse's) welfare or are you worried about what other people will think? It's perfectly legitimate to want your elders to look nice for their own sake. We are concerned for their dignity. And it's perfectly human to care if others think you are a good caregiver. One of the ways people judge is by how the elder looks. Even nursing homes are judged by those standards.

We certainly don't want our loved ones to look neglected. However, we do have to take a look at ourselves and our motives so we don't put our elders through emotional pain just because we want pats on the back from the ladies at church.

As I mentioned at the beginning, hygiene is subjective. As with so many issues, balance is important. We want our elders to stay clean enough to be healthy. We want them to retain their dignity. We do our best - and that may mean hiring some in-home help for bathing. But don't make hygiene a driving force in your relationship with the elder. There are many more important issues than whether they are looking sharp that day.

Perhaps a quiet day, with some down time for both of you, is more important - at least on occasion. You may even find that if you let the whole issue go for a bit and stop arguing, the elder or spouse will stop resisting. As with so many other things, they have rights. And they don't like to be bossed around. You may find that a more relaxed approach, with slightly lower standards, gets you farther in the long run.