Why do some older people become reluctant to take a shower?

Something that many carers and people who work in aged care might have observed is that older people sometimes become reluctant to bathe or take a shower.

Even those who were once very conscious of their appearance and the way they present themselves to the world can become lax about bathing and even putting on clean clothes.

Why is this so?

There can be a number of reasons that older people might ‘give up’ on their personal hygiene.

  • Sometimes older people, especially those with dementia, may fear taking a shower. The person may be afraid of falling, or they may even think their carer is trying to hurt them. By creating a warm, relaxing atmosphere in the bathroom, carers can try to allay some of this fear. It’s also important in these situations to aim to make showering as safe and easy as possible. Ideally bathe in a walk-in shower, use a sturdy shower chair and a hand-held shower head, make sure there are grab bars in place, and non-slip surfaces on the floor.
  • Older people’s senses can become dull. They may not notice that they are beginning to smell. A gentle hint can help in this situation – although you do risk the person being offended!
  • If the person feels isolated and cut off from their community, or depressed about their life or health, they might give up on caring about how they look or how clean they are. If this is the case, we recommend speaking to a doctor about the possibility of the person having depression, and the options surrounding treatment.
  • Sometimes older people may forget they haven’t showered. If this is the case, you can mark on a calendar when showers should be taken.
  • Modesty or shyness can also make some older people reluctant to take a shower. Older people might feel uncomfortable about undressing in front of another person, especially someone they know. Sometimes hiring an extra person, previously unknown to the older person, who can help with showering can remove some of the embarrassment, especially if the person thinks of them simply as a medical practitioner there to help them.

If the reluctance to shower remains – does it really matter?

If the person you are caring for remains reluctant to take a bath, you may have to resort to just sponging them. Do it gently, speak to them kindly and softly, and explain everything you do. Reassure them.

Sponging generally involves using a warm washcloth to wipe armpits, the groin area, genitals, feet and any skin folds. It can help to older people avoid developing body odor between showering.

If person is reluctant to shower, it might also be useful to examine why you are concerned about their hygiene? Are you worried about the person’s wellbeing, or are you more concerned about society’s judgement?

Showering does help older people avoid skin tears and infections, so it does have health benefits.

And of course, our appearance is one way we can present ourselves to the world. If we take pride in our appearance, it usually follows that we have dignity and self respect.

When an older person lets their appearance slip, it can give the impression they have given up on themselves, and have lost some of their dignity.

It’s understandable we might also be concerned about how others might judge the care we are providing.

But does that matter?

So long as the person you are caring for is hygienic enough that they remain healthy, perhaps it’s okay to let showering slip from time to time.

A general rule of thumb is to shower at least twice a week, but even this isn’t set in stone.

You may even find that if you take the pressure off having regular showers, the older person you are caring for might find it easier to bathe and you can find a more relaxed, harmonious equilibrium for you both.

Please note: the image used to illustrate this article does not represent actual people or events.

Image: Young man, Old man – Tom Hussey photographer.

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  1. It may also be… it can be exhausting to be showered ..as I have had csf for 20 yrs I know that to be true. ..so bed bathing or even just sitting in chair being washed and just uncovering each area bit by bit was appreciated by my clients and moisturizing as I went ( and even chatting!!)made my clients feel human not just a body being washed.

  2. Being queued up on a commode chair or stripped naked by a male PCA are good reasons not to shower. If you want people to shower not surprisingly they ask for privacy and dignity. Roughly handling residents in order to do the job more quickly is another reason why people with Dementia might be fearful of showering. I think this article really fails to address a number of issues with Aged Care.

    1. I don’t know about other countries, but in Scotland we (Social Care Workers/Assistants, Homecarers etc) have to abide by Codes of Practice and the Health and Social Care Standards. In fact, we have to register with the SSSC to be able to work in our field, and prove that we have kept up to date with training to be able to renew. If we are accused of not abiding by the CoP and the HSCS then we can be taken to court and prosecuted.

      The description of showering you have given Gian should not and would not be tolerated in our workplace. We are inspected regularly by the Care Inspectorate (unannounced checks) and patients, their families and staff all have the opportunity to feed back to them anonymously about the standard of care received/given.

      I would like to think that the person writing the article is presuming a certain standard of care combined with decent human dignity and the old adage, “treat others as you’d want to be treated yourself”.

      1. I think Gian (sort of) raises the point I was trying to make.

        If people refuse to shower, after all you have tried, and they are incontinent, and in fact they do not want to be touched by ANYONE – then, what do you do?

        You have to clean them, as skin breakdown will result from the obvious results of bodily waste and they will be at risk of infection and subsequent delirium.

        In some situations we need to be coercive? No?

        1. this is similar to a common occurance I experience with a family member in an aged care facility.
          The relative most times vehemently refuses to shower, slaps , yells ,kicks. But when there is incontinence of faeces it is a risk not to shower/or wash them. What would be your suggestion.

      2. In this day and age, it is wonderful that your country still respects the elderly. I am a caregiver myself and it can be difficult at time and as you say, “treat others as you’d want to be treated yourself” says it best! God Bless you for what you do!

  3. The above are all reasons that older people might not wish to shower but don’t forget that often their generation grew up having weekly baths,so with minimal degree of cognitive impairment it may mean that is what they “remember”
    These days too the cost of hot water can be a problem financially for many.

  4. I am my Mama’s caregiver. She gave me a lot of trouble about showering but now has become use to the routine. She still doesn’t want to be bothered but she knows that once a week, I will come into her room and strip her bed to put clean sheets on. That is the signal that clean sheets need a clean body. I also changed the time for her showers until later in the day and that has made a world of difference.
    I am fortunate to have a large shower so she can get in with my help and we shower together, the warm water feels so good to her,she hates to get out. I have settled on once a week showers and sponging thorough out the week, it works for us. I would recommend to just try different approaches and don’t argue, I made that mistake as a new caregiver.

  5. I find all of this really good information and every one is different. I was not given information when I first showered my mum and I know she was embarrassed but luckily we were able to have a laugh about things.I am now a full time carer for my husband and he is a very good man and very cooperative, however I have seen many of the things you spoke of with other aunties of mine.

  6. Not forgetting the stories and experiences of disguised shower before being gassed during the holocaust that some residents can relate to this history and still live in fear today and living the fear and emotions….

  7. It dries the skin out and then we itch ,don’t use soap,and don’t forget to cream afterwards.

    1. All, I have found a wonderful solution to dry skin that I learned from a man who had dermatitis years ago. One you are finished showering the person that you care for, take a towel and blot their skins–don’t rub the skin with the towel as it dries the skin out.

      Next, I take ‘Johnson and Johnson’s’ lavender baby oil gel and put about a quarter-sized amount on my hand and rub each extremity until it is worked into the skin. The moisture that is leftover from blotting the skin gets sealed under the baby oil.

      My husband’s skin used to look awful and now it is soft and not so leathery looking. It takes several applications before a noticeable difference starts showing up but this baby gel is magic in a bottle! It is great for working calluses off over time too!

      I hope this helps!

  8. My mother is quite strong and vigorous, and her shower is quite safe, but she feels bathing more than once a month is unnecessary. She does not need physical help, so sponge bathing by anyone else is out of the question. Reminding her doesn’t help. She is very concerned with her appearance, but not her hygiene. There is no economic barrier, and she lives by the ocean, so that although she has many containers of lotion, she rarely uses them. Her shower is bright and has plenty of natural light, and she has no negative associations with showering. Honestly, I’m not sure she even remembers to shower once a month. Can we just let it go?

  9. All interesting, and valid, comments BTL – but one thing that surely needs addressing is the person with a dementia who refuses to shower or even to wash. And it does happen that you will find a person (who has a dementia) who simply refuses to bathe in any way. And they are doubly incontinent. What then?

    It is hard cases like this that raise some interesting questions. Do you force them to bathe? If not, why not? Of course you have tried everything else; every strategy known to man has been tried, but still the person refuses. What do you do?

    Why is it that if my child, say she is five years old, refuses to bathe then I simply pick her up and put her in the shower – I use force – but if an elderly person with a dementia refuses to bathe I cannot use the same approach and force them to?

    Failure to force my child to bathe will likely result in my being seen as a bad parent, and if this continues and she goes to school dirty and smelling of poo then I am likely to find myself answering to the welfare. I am expected to use force. But if I use force with an elderly person with dementia. Is this wrong? If it is wrong, then why the different standards?

    1. Have you found any other resolutions to your comment? My father is in a facility and refuses to bathe. The staff has told me repeatedly they are not allowed to force him. I understand why but this has been ongoing for a year and a half. Without his concent, there is nothing they can do?!?!

  10. What is this garbage about judging someone for not taking a shower? Has nothing to do with judgement and everything to do with the fact that other people’s fecal matter does not need to be floating around you house, or your kitchen where you eat! It is a health concern for everyone who lives in the home. I was just renting a place to stay and my roommate brought her mom to live with us. Didn’t mind at first. Or helping. But the mom is so overweight she can’t reach her butt to wipe it. It’s been decades she has been this way apparently. This is neglect as well as age. She never moves. I made her though, and now she is off her cane and walker after 2 months. Still, the house smells like a hot diaper now. I can’t use the bathroom without cleaning the toilet first because even if I manage to talk her into a shower, she pops under the water for 2 seconds, leaves poo all over the shower, and gets out smelling just as awful as she did before. Doesn’t see a problem with the brown chunks on the floor or the smell. There is constantly poop on everything every time she gets out of her chair. And yes, she has a shower chair and brushes. I have cleaned poop off the walls in the bathroom, the floors, the carpet. Her pillows in her room have streaks of feces all over them. Her sheets are yellow. She won’t let me wash them. She refuses to wash her hands and with the amount of body waste she leaves everywhere I have to run around behind her wiping down door handles and counters. No one will sit near her or in the spots she sits in. When she walks past I have a hard time not gagging. We have all discussed it many times and it always turns into a discussion about hurting feelings rather than effort or prevention. Or hey, even responsibility. Her daughter does almost nothing and tries to manipulate me into caring for HER mother. She doesn’t clean the poop, I DO. I cannot make a meal in a house covered in poop. I barely eat anymore. I just had to cut it off and let them treat me poorly for it. I have already dealt with the lost of both my own parents and they can’t seem to get that this is not ok with me. I don’t love this woman. I care for her, but this is something your family or a health care professional should be doing. And yes, people need to be taking showers. Not just for themselves, but everyone around them.

  11. Elderly people in general respond well to routine, it has been their life time of habit but the reality is that, (for example, a person living with dementia), if you are in a community environment or living in a nursing home there are others around you that also deserve respect and to stink is unacceptable. There is always more than one factor in every situation, the carer shouldn’t be subjected to the odour, visitors,cleaners etc have the right to work in a clean environment as well.

    Family expectation is something else to deal with, their resident chooses to not wash or change clothes and screams etc if you go near them with a face washer… Clearly they as well will blame the carers etc for neglecting mum or dad and they too will make a scene.
    Hygiene is not optional!

    Respect, all round respect isn’t always easy.

  12. I have been dealing with depression following chronic pain and failed surgeries for over 15 years. I was put on three antidepressants at the same time, it helped with depression but I felt catatonic. I had no emotions. As I’ve gotten older, I’ve noticed that I don’t shower like I used to. My mother is near 90 and has the same problem. I have spoke to her about it and we both have the same opinion. We can’t stand the thought of getting wet. I don’t know why this happened, it has never been an issue before. I wanted someone to know what an elderly person really thinks and feels about it. I think the answer that a person just gets to the point that they don’t care how they look or feel anymore, the depression is so great is probably right. I have a swimming pool and cannot make myself get in it. I have a hot tub and although it would help with the pain, I can’t stand the thought of getting wet.

    1. With me its become I am warm in my clothes and don’t like the temp changes and it is a physical challenge as well to struggle getting dressed again but I am aware of my need and smell to get in there more but two to three times a week now and use to be daily if I skipped any it was only a day here and there.

    2. Isn’t it crazy to think of things which we used to enjoy…that we not cant stand? You said you cant stand the thought of being wet, I bet money when you were a kid you loved it! I used to be a fish, I was always the first one in and last one out of the family pool. or any pool. And I swam under water, getting my hair wet was no problem for me. The idea of going underwater, when out of public, getting my hair wet is on of my biggest pet peeves now! It is a sickening feeling when something you once loved becomes something you dread the very thought of.

  13. I am 49, I have had numerous accidents and damage to my body joints and neuro damage. Sometimes the water can feel like it’s “stinging” me due to nerve damage. I also struggle with depression due to being young and in pain like I’m 80. Some weeks I simply don’t shower nor do I care . And yes, believe people when they tell you a shower can be absolutely exhausting !!!! Anytime I DO shower I have to lay down after. It’s such a catch 22, because once I’m in there, it does feel really good. I just bought a couple of new bath soaps I really love, in hopes that will get me there………bless all the care givers that go through this plus numerous other battles. I liked the point someone brought up about the elders past. Once a week in a big wash barrel was it !! And everyone washed in that same tub on one day. My mom and especially my grandma used to tell me about the depression, and the habits and lifestyle they had to implement. I also find older people will take all the sugar, jam and butter packets from a restaurant. It’s just their mindset, some survived on so little, they were left living in fear and BIG on not wasting anything. I feel for them. For the people I have cared for, I just help them pack it all up with understanding as they tell me the need for it, then later I just clean out the fridge and usually it is not missed. Some things aren’t worth upsetting them for. A nice sponge bath by women for women and men for men, and some lotion and soothing talk about all types of subjects helps. I have found that people like to talk about themselves and their experiences, so I just talk with them about topics they know.
    Hope this helps anyone, and again, bless the caregivers . I live in Florida, we have SO many elderly who’s family visits them once a year (if that) so a caregiver is sometimes the only person they have, and that can be frustrating too.

  14. People forget that showing is a lot of work! I am 70, and find myself delaying .. for HOURS! I can tell I need to shower every 3 days because i can smell the body oil in my hair. But it takes a lot of work. Once I’m in, I’m fine, but the transition seems to be tough. I’ll sit on the toilet lid reading one newspaper after another on my phone, all about delaying I am sure if it. If I am at my sister’s or elsewhere, without my secure flip down teak seat, it REALLY is a lot of work. I don’t think People realise that.

  15. I welcome any and ALL replies. Just please try to be RESPECTFUL when you reply to me. And please PLEASE, PLEASE! No one crucify me for what I am about to say.

    I found this article by mistake. I read it because it pertains to my situation. My father is 68, almost 69. He refuses to shower. I don’t mean just every day. I mean I am lucky if I can get him in there once a month. I am NOT exaggerating. He has ALWAYS been this way. So, I was reading about many of the people and how they hurt or are exhausted after washing themselves etc. Well, for some of you, at age 70 and up, I can understand why that would be true.

    My mother left my father when I was 5, I believe he was in his early 40’s at the time. I didn’t have the best parents when it came to protecting the children. (In general) The divorce was a huge example, but they often threw us kids right into the line of fire. I knew far too much at a very young age. I say this, because that is the reason I knew my mother had an issue about his smelliness-she straight up told me about his lack of hygiene. Hell, she even told my son when I wasn’t around. (Which bothered me) I don’t mean to digress.

    I mention this because this is how I am aware that this lack of personal care and poor hygiene has been an on-going issue and as a result, I am certain he is not going to change his ways anytime soon, if ever. She (mom) said that she would have to tell him to shower, brush his teeth, change his clothes, put on underwear/deodorant etc. If she didn’t tell him, he wouldn’t do it. She grew tired of babysitting a grown-ass man-child she said, and it played a huge role in her leaving him. I know I couldn’t date someone who never brushed their teeth, never wore deodorant, rarely showered etc. It isn’t just because of what society thinks, I have always gone against the grain whenever I felt like it. I am not a sheep, that is for sure.

    I didn’t want to live with my father. Mostly because he is living with his brother, and his brother, my uncle, is a greedy, selfish bastard and I don’t want my son growing up around that behavior. Long story long, I got stuck here for now. So while I am here, I do my best to pick up after him. He is a very sloppy person, and like this article said, it’s almost as though he has given up on himself. I would like him to meet someone. That will never happen as long as he has let himself go the way he has.

    What is the absolute worst however, is because he has accidents, the runs, etc. and we all share a toilet-so if he is not showering, washing or anything-where do you think that shit and piss winds up? On the damn toilet I use! I have cracked, dry, pastey-white hands from all the bleaching, spraying, sanitizing, cleaning of the toilet seat, base and bathroom that I do daily. It’s unavoidable. Without fail, every day there is poop on the toilet. I have asked him to clean it. He refuses. He blames my teenage son! (Who is innocent in all of this!) It’s never dad’s fault. When my son is out of town, and dad is caught red handed, he still refuses to clean it and simply just walks away when it happens and I try to tell him or show him nicely. (I’ve tried mean, nice, crying, pleading, begging, demanding, ultimatum-ing etc…nothing works with this man.) If I refuse to clean his mess, and simply leave it there for dad to clean, (In order to make him clean up after himself,) we have this sort of stand-off and he STILL refuses to clean it. To retaliate, when he has to use the bathroom again, and I have not cleaned it, then he will just go to the bathroom in the BACKYARD OR IN A JAR until I clean the toilet again.

    I clean the toilet at least every time I use it. I am a female, I don’t want that nastiness inside my body. Right now is about to start week four of him not showering. At all. He smells so badly, it is offensive to everyone around. It’s not only embarrassing, it’s non-hygienic, offensive, uncomfortable and unsanitary for everyone else too! He just doesn’t care and the more I push it, the more he seems to shit on the toilet intentionally and the longer he goes without showering. We have a MASSIVE SHOWER/TUB with easy access. There is no reason for him to not use it. I clean it constantly, it is immaculate. The skin on my hands pays the price for all the cleaning I do. I am just fed up-I have been looking for somewhere to move to, because in the beginning I mentioned I am not supposed to be living here, I was tricked into it, lied to and manipulated into being here. Until I find somewhere I can move to-I am up shit’s creek…without a paddle. (only cleaning spray….lots and lots of cleaning spray.)

    Like I said, I welcome any and all suggestions. Please be nice, and helpful. Yes I know the truth hurts, but what I mean is, don’t be rude or offensive when speaking about anyone in my family or to me in the thread. I really am out of options until I can move. So what the hell do I do???

    1. Dear Hopeless,
      You are never hopeless. You sound like a very smart, capable adult. I don’t understand how someone like you can be “tricked” into living anywhere. There are always options. Reach out to a social worker; pastor, friend, family member, ask for help. There are always shelters, or government subsidized apartments. Make your move a top priority, make it happen. There are no excuses to justify your living conditions, so stop making them. You are smarter than that. Your letter proves that. My advice is this: buy some protective gloves for your hands today. Problem #1 solved. Next, get out of the situation you are in immediately. Take your son with you. Between the two of you, you should be able to earn enough to make better arrangements. Problem #2 solved. Your mother had the courage to get out, follow her example. Good luck to you. I have faith in you, you can do it.

  16. My husband hasn’t showered in over 4years and has now stopped washing up ,brushing teeth and shaving.I have tried everything and he won’t bathe,what can I do

  17. Hi I care for my aunt , who is 84 and has altzheimers /dementia. She refuses every attempt at a shower . I cannot get her to shower easily , especially her private areas because of trauma earlier in her life – she will not sponge bath either !
    She tries to fake me out too!
    Telling me “I had a shower already” which is her telling the care woman shes going to but doesn’t actually shower and of course doesn’t let her assist .
    Im the only one whos been able to shower her in 4 years! It was easier when she lived at my moms house . Honestly, I am frustrated. Any advice welcomed

  18. I have an 86 yr old female who puts her hand down her pants and flips her fat to wash her hands that there are germs that you cant see that im picking on her that im hurting her feelings


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