What is the best way to clean the private areas when bathing an elderly person?

The sense of humor thing is HUGE in our household. We're like a sorority house ... Edna (my lady) has lost many of her 'filters': almost everything carries double entendres. EVeRyThing turns into a sex thing.

Caveat: this is NOT going to fit into a lot of people's comfort levels ..

Mind you, I don't get naked around her, but .. (we all share the same TINY bath; I can barely maneuver the wheelchair into the sink .. we even removed the door and use a curtain for privacy) .. I flip up my skirts and plop down on the toilet and do my thing, if we happen to be headed that way: it's a way of sharing her vulnerability. When she sits to do HER job, she generally has a fair amount of gas to pass, and we all joke, "Edna!! Geeeeez .. they're gonna hear that down the street!" and she roars in laughter. (Which is a really great thing on so many levels, not to mention it makes her pee more! yay!!)

We all have gotten to the point where going potty is just one more thing to do. Who knew I'd be sitting around the dinner table talking about how that or this food was going to effect her poop?

As for bathing more often than once a week .. As long a you keep the areas that fold clean (neck, tummy fold, all the pelvic area, armpits, elbows, knees and toes), ask yourself this: how dirty is she really getting? Does she sweat? Adjust accordingly. I like to encourage as much self care as possible and balance it with giving care: she loves, loves, loves having her back washed and scrubbed and lotioned. I mean, really? Who wouldn't right? "There .. scratch that itch? Please??"

There are quite a few brands of 'baby wipes'. A word to the wise. Just because they say they're scent-free or hypoallergenic doesn't mean they don't smell and are easy on the perineal area. I'm fairly sensitive to scents and additives and I always test them myself, first. Ugh. Most of them sting ... a lot. So, while I use them, I always rinse them first and then apply my own perineal cleanser (which doesn't need rinsing). Even better, I prefer to use one of my dozens of washcloths (one use, then toss in the laundry/diaper pail, except for that first swipe). I completely avoid toilet paper with her ... so that there's no paper dust left behind; I've yet to find a TP that doesn't leave traces behind .. and wet is just kinder on skin that's constantly exposed to urine.

Welcome to the wonderful world of caregiving! *barely avoids sounding sarcastic* .. It really does have its rewards .. and struggles. Blessings on your path.

You're so right......ya gotta have a sense of humor!

With the heat in Az. and my mom wearing incontinent briefs, she sometimes gets a rash on her bum. I use Desitin lotion/ointment and within a day it's cleared up. Another thing, sometimes I get it from the heat, a rash under my breasts. I was told it is a form of athletes foot. In other words, a fungus. I use athletes foot cream/lotion and apply it under my breasts and by the next morning, it's totally gone. That type of rash burns and is totally uncomfortable. I started using the same wipes I bought my mom and so far this summer I haven't had any rashes. But then again I shower more than once a week.
I help my mom when I visit to change the incontinent brief and wipe her with the wipe. She doesn't urinate in them it's mainly just a precaution. She sweats a lot with them on so at least twice a day, in the AM and evening, I make sure they're changed and she wipes off with the wipes.

I've gotten her to laugh by calling her breasts, "The girls." I always tell her we have to wipe under the girls and put on a clean bra. Last week, her girls fell out of her bra. She told me, "The girls." I asked her if they fell out of the bra and she laughed and said, "Yes." We laughed and fixed the problem. Without a sense of humor, I'd cry. It makes an uncomfortable situation a little easier to handle. Out of a comfort thing my mom wants me to shower her and not the caregivers. It's my pleasure to help make her as comfortable as possible. I do have it easier than most of you. My mom is in a memory care facility. I see her 3 days a week and alternate every other week with four days a week. I am there between 4-5 hours each day. I also call her or she calls me in the evening to say good night and for me to try to explain when I'll see her again. If I could, I would have her live with me but my medical issues won't allow for that.

TO CLARIFY: When I have washed private areas, and I have washed hundreds upon hundreds, I only utter that joke once the job is done, not in reference to one particular body part.

Whew! That was going to bother me all night if I didn't make myself more clear. I don't know what is with me tonight.

It IS awkward in the beginning. Then you get used to it. Make sure Auntie is comfortable. She's naked and may feel very vulnerable. Maybe a well-placed hand towel during the bath. Don't let her see that you're feeling awkward. It's no big deal....we all do it. We all have our private parts and we all wash them. If you're at ease, Auntie will be at ease. And there's nothing wrong in saying, if appropriate, "I know this is uncomfortable for you and I'm sorry." Then make a joke. MY favorite joke when it came to washing private areas was: "There now! Clean enough to eat off of!" But only use this joke depending upon her sense of humor. I'm a nurse and I use that line all the time and it never fails to amuse and break the ice.

how do you come up with a monthly care giver cost? What are care givers asking for their care. We are in the process of taking my 92y/o mother in since her stroke. and we know this is a 24/7 job but I just can't place her in a home.

My husband and I just got involved in his Aunt's and cousins life again about a month ago. She is in the early stages of Dementia and his cousin that has Schizophrenia. But, three weeks ago we had to step into full-time caregiving when we found out the caregiver was taking advantage of them and we could not hire a caregiver because the house is in light hoarding condition. We are in an aggressive process of cleaning up......I have not had a chance to introduce myself in the newbie section. But, Thanks everyone for the good advice. I am on a fast track of learning how to care give properly. This site is best, awesome resource with everyones experiences and support. Again...THANKS.

If she is in the right state of mind, I am trying to give her more than 1 bath per week. As for the depends, that is a whole other subject. They were leaking and I found that she was stuffing towels down into them and throwing the saturated towels in the bath tub. So, I bought her some thick female liners to stick in the depends to help with the leaking. I try to make sure she changes the depends but sometimes it can be a struggle with her. The first time that I gave her a bath, she wanted to put the previously worn depends back on. Even though, there was no saturation in them, there is still sweat & bacteria. So, I was concerned but I did not want to argue with her so I did the ol' switcheroo while she was not looking and replaced them with new ones! Although, I was able to do the switcheroo on the depends. I argued with her over wearing her previously soil, urine smelling shorts. And, finally gave in because we were going nowhere. After that, I dug around in the piles of junk and found several pairs of shorts and took them home and washed them 3 times. Now, I bring several clean options of clothes from my house and she has been putting on the clean clothes! Thank God....literally!!!

I have been using wipes for in/between. And, she smiles from ear-to-ear when I lather her up with lotion. She says she feels like a million bucks!! This is the times that it really makes me happy to see her happy!!! Maybe her cleanliness will get better when my husband I get the hoarding mess under control and the whole house remodel because she'll feel more comfortable in a safe and clean environment. Wish that I could snap my fingers and it would all be clean and remodeled, tomorrow. But until then, my husband and I are on a fast train of cleaning!!!!

Once a week is fine if you do a thorough shower. But like Yogi said, it's very important to use the wipes in between showers. Otherwise, she will break out with rashes - heat rashes where her skin has folds (sitting down- it would be the area above her stomach but below her breasts), in the areas where her undies (Depends and bras) are in contact with her skin. Rashes become itchy. She scratches, it spreads and bleeds.

If she's going to be washed only once a week, then it's important that her Depends are changed often. You don't want to her to have rashes. Use creams to protect her skin from the urine/feces. But once she breaks out in rashes, I would temporarily increase her showering until it goes away.

My mom has Alz and lives in a memory care facility. She won't let them bathe her so I do it. I only do it once a week, a shower, because she can't get into a tub. I let her wash everything she can and help with what she can't. In between the days she doesn't get a shower, I use non-alcohol, fragrance free wipes. It helps out and she can wipe herself when she feels the need. But once a week, she gets a good cleaning. Also, I put lotion on her arms and legs every other day to keep her skin soft. Blessings

A couple of months ago I googled. " How often should I bathe my elderly mother".
THAT got me HERE and it was the best thing that happened since I've been Mom's caregiver. I SOOOOOO appreciate this site and all it's great information, but mostly I appreciate knowing that there are so many going thru my same situation. It makes me feel SANE!

Thanks for making light of the situation LadeeC. I felt like a pervert asking the question. I was able to finally give my Aunt a bath earlier this week. Since we are working on her leg strength, I encouraged her to lift her legs over the side of the tub to get in the bath and then I help to lower her down in the tub. I used your techniques to get her clean. I ended up cleaning her private areas but also encouraged independence in helping me clean other areas of her body. Seeing that I am new at caregiving, I guess that it will get more comfortable the more baths that I give her.
My mom thinks that she needs a bath 3-4 times a week. I argued with my mom over this point! That is just my mom's opinion and she has never had to caregive for an elderly woman with Dementia. I refuse to argue with an elderly woman that has Dementia over the fact that she needs more baths during the week. It is going to get us nowhere but just stressed out! Besides the urine smell from her shorts from leaky depends, I think that she smells fine. And, I am going to just try and get her to take a bath an min. of once every 7-10 days. On the other days that she does not want to bathe, I am looking into getting the "no-rinse body wash" and "no-rinse shampoo" and change her into clean clothes! ;-)

Oh, lawdy, join the club. It's really something you just kind of get used to. A few things we do to make it a little more, um .. enjoyable:

.. make the cloth really warm and very wet and just lay it on her mound until it starts to cool a bit (it's very soothing, and makes it a nice intro to the next steps)
.. then squeeze the water out over the area and let it dribble down (besides feeling good, it tends to encourage more urinating .. we always wanna clear as much as possible)
.. if she's at all capable, give her a shot, in her hand, of some of the perineal cleanser and have her wash herself. Matter of fact, if she can perform ANY of the cleaning, let her, with your watchful eye catching what's she missed. It helps encourage a bit of independence and is less invasive of her private parts.

These can be done on the toilet or on the bed (make sure you have a waterproof pad under her, of course)

Let us know how it goes!