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Hospice totally prepared us for everything during my husband's last 6 months of life. They came to tend to him 3 times a week, once from the nurse and twice from the LNA to bathe him in bed. He had a catheter and they occasionally changed that. No IV fluids because that is not good for an actively dying patient. The only respite we could get in Vermont was if he went to a hospital for a week, where he never would have received the care needed that we provided at home. Hospice provided all his supplies (depends, chucks, catheter bags, cleaning syringes, a bedside table) we got our own hoyer lift and wheelchair. I believe he got better care from our hospice than from his primary and hospital stays. We were trained to use the morphine and only used that the last week of life. I'm not a trained nurse but could do everything they did for him. The oncall nurse came out in the middle of the night when he died and we helped prepare the body and said goodbye when the sun came up.

I am elderly and I love myself more than I can say. So, how to do a soapy reminder to shower…

I am sorry for the loss of your mother. I'm responding as an experienced visiting hospice registered nurse, and the author of articles at Compassion Crossing .info that help caregivers and families understand hospice and palliative care. 1. I appreciate that you are doing this series. Still, if I may tweak something you stated, you stated, "They will not recommend a treatment plan," and then referred to your mother about how you were used to the providers telling you what to do next regarding treatment. The order a doctor writes to the hospice agency to make an admission is an evaluation and treatment order ("eval and treat" for short). The evaluation is when the hospice registered nurse comes onsite to determine if the patient is terminal. The hospice medical director is then called to confirm the RN's findings and receive permission to admit the patient. The treatment is hospice, where the plan of care is to provide comfort care through what life remains. Every nursing visit should include a discussion of what to expect next as part of the natural dying process and how to manage symptoms with either medications or non-pharmacological means. 2. Hospice is a federal program, and Medicare regulations do not vary from state to state concerning hospice. I cannot stress this misconception enough because I run into it in various social media forums, where people will state that the rules vary by state; they do not! Again, this is a federal-run program where CMS makes the rules without regard to the source of payment (whether pro-bono to private insurance or state Medicaid to Medicare itself). As part of 2, the family does not have to obtain recertification as this is part of the CMS rules. The hospice agency will arrange for this. If the patient no longer qualifies, they will be discharged for failure to decline. 3. There is an entirely false statement that going onto hospice means you are agreeing to stop all other types of healthcare (stated around the 5:40 mark or shortly after that). A) You could have obtained a 3rd party prescription for the insulin (I know this for an outright fact, being a hospice registered nurse and knowing Medicare regulations), and your insurance (not hospice) would have provided a level of coverage for the insulin just as if your mother was not on hospice. B) When discussing medications provided by (covered by) hospice, these are medications directly related to the terminal illness and specific comfort medications. Just because a given medication is not covered by hospice does not automatically mean it cannot be obtained, given, etc. It just comes down to who is paying/providing the medication. C) Recommendations to stop or change medications are just recommendations. I recommend that they be followed by the patient, power of attorney, or family if no POA is in charge. 4) Medicare requires that hospice staff not be the primary caregiver. Therefore, hospice doesn't come out and give medications, call with medication reminders, or so on. 5) Hospice is a generic word like "hospital." There might be two to dozens of hospice agencies in any geographic area. While all of them must obey CMS rules (see #2-this is not a state-by-state situation), how they apply them can vary by agency (not state, but by agency). Some agencies would have had more frequent visits for your mother. For instance, I've worked for several agencies where cancer patients are seen twice to thrice per week at minimum and during daily visits in the last two weeks. 6) Around the 9:25 mark, hospice is always covered by Medicare, Medicaid, and private insurance. Hospice is a service and not a location. This is another myth -- hospice is not a location. So, when referring to the coverage in this area, you are talking about two (2) separate things. The cost of hospice (a service) and the location (hospital, nursing home, etc.). Insurance covers the hospice service but may or may not cover the location(s) for which the hospice is being provided; the location is often a completely different organization than the hospice provider. 7) Thank you, thank you, thank you for recommending interviewing several hospice agencies! 8) Shortly after 11:35, you talk about coverage for IV fluids. A level of dehydration in the body toward death is not only natural but necessary to prevent lingering through the dying process. IV fluids in the last month or so of life are extremely dangerous in terms of causing immense suffering. Good intentions can cause significant harm, and giving IV fluids to someone whose heart and kidneys are shutting down risks fluid overload, heart failure, and other issues that can hasten death (if they occur) or cause lingering through the active dying phase where families then become tormented asking, "how long will they suffer like this?" I am sorry for the loss of your mother and do appreciate that you are putting out these videos.

Thank you. This is immensely helpful. I would have been completely caught off guard. So sorry for what you had to go through.

This video was SO helpful!! Thank you!!

There are flushable wipes

Thank you so much 👍🙏

Thank you for the information !

So nice to hear you point out the marketing angle on appropriate hygiene. Like adding rinse and repeat on the shampoo instructions when really, once is enough. They really sold extreme hygiene - and are still selling it, hard. I'm 72 and have scheduled myself for once per week, but if i do gardening I always shower when i come in because reasons...

Thank you so much!!!! The word "community" terrifies me as well 55+ stuff--I like the kids running around my neighborhood, young families living in my old apt building. It keeps me young babysitting for neighbors.

❤thank you. I so needed to hear these words. I'm struggling to find my last living relative a place to live her last 6 months safely and free from pain. She is in hospital right now and they are looking to move her next week. Your words about guilt, relief, mixed emotions really hit home. I feel so guilty that I am physically, mentally, emotionally unable to take care of her. Pray I find a good facility.

I am in my late sixties, I have stopped showering every day since retiring, I am fully healthy, I walk most days, I don’t emit bad smells, I campaigned heavily for my elderly father not being showered any more frequently than every 3 days when round 90. He could even go longer than that. I myself am able to go several days & do so especially in winter. Frequent showering is overrated & unnecessary. Younger bodies have different needs. Let elderly people make their own choices! Of course support them in sensible ways & any ways required. Having a shower or bath regularly is a fitness activity & is useful from that perspective, it’s up the person’s daily activities they participate in, if that is a reason then they should do it, in my opinion.

Very good video. Lots to consider. My Mom hated to bathe and her smell was gone from age and smoking. It was not a good situation! I typically shower and wash my hair twice a week. My friends think that's weird 😂!!

I become disoriented in the shower. On a good day, I can get into the bathtub, but am more comfortable washing at the sink. I lived in the wilderness when I was younger & it's possible to do a thorough job ! There's also the energy factor to consider !

In a care home there's the lack of privacy, no assurance that a shower wont be interrupted by someone wandering in to the room. There might also be a subconcious fear due to association with being cold that puts off elders that have no tolerance of being cold.

Time management is the big obstacle. Something that I would anticipate takes no more than an hour, turns into 3 hours because of whatever they got into. Next thing I know my to do list and the wife's list is way over due. I then get that overwhelming feeling of how did I get so far behind? Only to wake up and experience the same process over and over again. Don't care if you got ur oxygen mask on or off. Just clean up this mess now caregiver before it gets even worst. No rescue helicopter available.

imma get this on my b day

Exhaustion is not behavioral. I have on my right side a damaged knee and an issue with mobility in my right shoulder. It is hard to bend down even on a shower chair to wash that leg. It is also hard to clean my back with the shoulder issue. You are making a lot of excuses that seem to imply elders are "crazy", lazy and don't care. That is not true.

Can opening is a massive operation, thanks for the observations x

This has been a huge help, thanks so much for your insights hope all is well now with your recovery x

I bought a spray hose/nozzle that reaches from sink faucet to toilet with a diverter that acts as a bidet with hot & cold water mix so temp is always comfortable...purchased from Amazon and installed it myself. You may want to stress the importance of cleanliness to avoid a UTI that in the elderly can mimic mental confusion, anger, dementia etc. Often misdiagnosed in the elderly.

Good advice, thanks. I myself don't drive during rush hours, at night or in rain storms. I also limit weekend driving to earlier in the morning. 🙏

The only parts of my body that I wash with soap on a daily basis are the areas between my legs and my derriere. I'm 61.

I used to be an aide and often wondered why seniors dont like to shower! Now Im older, I can see its hard with bad knees, aches and pains etc. Its not for not wanting to stay clean.

SOLD! x2 Best Pxword book for seniors I've seen after hours of research and the only one that I found that had detailed info (this video) This will be a gift to my wife but really all my family. It will be stored in my fireproof safe. Thank you!

Dad has a no slip walk in shower with heated bench. There are 4 grab bars. Where he sits on the bench there is a hand held shower wand with built in grab bar. There is a heater in the bathroom and heated flooring and the shower has it's own light. Still, he refuses to take a shower for 10 days at a time. I have to ask over and over. He's not uncomfortable or afraid. He feels secure. I ASKED HIM. No. He'd rather watch tennis all day.

"Getting " another person to do what you want is selfish. The best way to get anyone to do something is make the action itself desirable to them - and not as a reward. If the action has a high enough value and they need help to do it they, will try to do it without help and only accept help if they understand the difficulty and the risks of doing it without assistance. Love requires recognition and acceptance of the rights of another person and respecting them. When a mentally competent adult refuses to do something they have a reason that is valid to them. If you're not willing to devote the effort that's necessary to understand that reason and address it with supportive and remedial action, but attempt to force or coerce them into agreeing, they will resist more strongly. Objectively, showers are not necessary for hygiene. They are a modern invention for people who are in a hurry. Sectional sponge baths are used in senior care facilities.

My grandmother was in her early nineties when she refused to wash. She’d previously been fastidious about bathing daily. This turned to a daily sponge bath and massage with moisuriser and ice gel linament worked into her sore muscles and joints, which she thoroughly enjoyed . Eventually her dementia progressed and she believed she” had a very very very very good wash this morning”. It made me smile. Fortunately she didn’t get smelly, and was willing, usually, to change into clean clothes and let me brush her hair and clean her dentures. We would chat and laugh so she was pretty compliant with me.

I buy personal wipes that can be flushed down the toilet. I'm 75 and bathing is so very difficult. The worst part is getting my legs up and over the tub edge, then finally out again. From getting out supplies until I towel dry my hair and dress, and back in my wheelchair it takes me over 2 hrs. It is exhausting! Wish I had a walk in shower!

Thank you for doing this video. You have explained everything I needed to know sooner than I did. It will make life so much easier than it has been xxx

Bidets are great for down there hygiene 😳. Double as foot baths too….

Just seeing this video about bathing and seniors. 72 , fell recently injuring knee. I was searching how to safely getting in the tub and saw this. I have never been a shower or bath everyday person. Growing up in the 50s and 60s everyone bathed on Sat before church on Sunday. I grew up in a very hit humid state but still it was no a common practice to bath everyday. Plus I am not fond of being wet as I have always been very thin. I get cold easily. Getting older has posed more issues with fear of falling and it is very tiring. I still have relatively long hair so washing and drying it takes a lit of time. I don't do much but light house keeping, watch tv so don't get dirty. You did say something that hit home. My family doesn't bug me about bathing as I do get in once or twice a week. Sponge off in between but you mentioned losing control. It hit home. I am a control freak and growing old has taken so much. I do feel angry at times. Scared too. I hope caregivers back off their senior parents or spouse and let them keep making personal choices.

I refuse to do "therapeutic lies to anyone my love for GOD means 2 much too me to not tell the truth.

Thank you for great information❤

Yes I got to talk to myself.. have a great one

I'm 77 and have only ever showered/bathed weekly unless I'm dirty, as you say, from gardening or doing a deep house cleaning. However, I do take a washcloth and wash the nasty bits every day, change my underpants and incontinence pad after I wash. I have a step-in shower with hand grip bars and a slip proof floor. I imagine with my knees getting bad I'll need a bench, but so far so good.

Thanks. Broken humerus a week ago today and can verify all you have said. Meeting surgeon tomorrow about a repair. May do the surgery knowing the pain will go back to day 1, but knowing I have made it through week 1 means I know I can do it again if needed. It does get better by the day, you will celebrate the extra inch of movement you have, and sleep gets easier.

I found that using Lumi body wash in the shower helps keep the body oder down much longer.

Come on people bathed in Australia long before the 1960s you Americans must be a dirty lot!

Does it work on teenagers too?

This is BS for idiots! I was both a PT in nursing homes, caregiver for elderly parent and now…Senior, living with my children! NO ONE is going to tell me when to bathe! I KNOW MY SKIN, and it’s changes due to autoimmune diseases! Mind your own business and just provide safety equipment!

I looked after a friend's mother who has dementia and she doesn't even know when she needs to releive herself, or when she's thirsty or hungry. She's like a baby who never learns. All these were shockers for me!

What if they can’t be on their knees!

Growing up in the 1960s, people typically took a bath once a week. The idea of showering daily is ridiculous. It wastes water and body care products, it dries your skin and your hair. Using a basin of water to wash your face, underarms and private parts is much easier to achieve. As a 69yo, I don't have the energy to deal with getting the cat box out of the shower, vacuuming up the cat litter, getting fresh clothing, showering, wiping the water off the shower walls and floor when I'm finished, then dressing and moving the cat box back into the shower. I monitor myself for body odors and wash myself as necessary. I spend most of my days alone at home with my cat. He never objects, so get over it.

I have had a fall, and taking showers is frightening ( fx hip) I have a helper who comes twice a week just to be here as I climb into the shower. Modesty is maintained as well as possible as she prepares the water temp and clean towels . I also have Life Alert as I live alone. Your article q most helpful and thank you for caring.. We are still valuable but for a bit of frailties c age.. Course we're still adorable and talented.

These are not safe, please install real grab bars that are permanently mounted. When you have a real emergency and it needs to support your full weight it will be able to. Don’t gamble with your safety.

THIS WAS A LIFESAVER! My mom scoots herself off her bed onto a mattress that I leave next to her bed then onto the floor. When I’m alone I have had to leave her until I could get help. My mom cannot walk so I modified by using her commode chair on its lowest setting. I was happy that we could get her on her knees then she put one leg forward and pushed herself onto the commode. I was then able to transfer her yo her wheelchair. I cannot thank you both enough for this video.

HOA!!!!! 😨

Very good advice,thank you! I can not stress the importance of having a good financial planner. They offer so many resources for safely growing your wealth (whatever that may be) and many plans for your long-term care. So critical. There are programs for long-term care where if you don't end up using it, your investment is returned, but only a good financial advisor can direct on these programs. I wish to age in place, therefore building my strength and health is very important to me and have a trainer to get me on that path. Please don't live for just today. it's a massive mistake.

Getting past. That's my current stage.