Refusing to shower (hygiene question)

My mom was diagnosed with FTD in early 2014 and ALS in late 2015. She lives in an assisted living facility. A couple weeks ago, I was able to get her qualified for hospice care. With hospice, a nurse comes twice a week (home health was only every other week) and a CNA comes three times a week to help mom shower and fix her hair.

Last week, mom was compliant with the CNA and took her showers all three days. Mom does pretty much everything herself and the CNA is just there to wash the hard to reach places, make sure she doesn't fall, etc.

Today I get a call from the CNA saying mom was refusing to shower and that she also refused on Monday. I had her put mom on the phone and reminded her how good it feels to be clean and how showering helps keep her healthy. For a split second I heard silence and then the CNA got back on the phone and said mom was trying to hang up on me! I suggested the CNA get a trusted member of the facility staff to try to coax her into the shower. I got a call back from the staffer saying mom still refused and kept saying, "6-ish." I'm assuming 6-ish means when I get off of work and visit her this evening. Vent alert -- really? I have a CNA going three days a week and you want me to sit there while you shower after I've worked all day at my job, before I go home to tend to my kids? -- sorry for the outburst.

Anyway, with Hippa, the nurse, CNA, and other healthcare visitors can't sign in like a regular visitor. Because mom rarely speaks, I have no clue who comes and goes from mom's apartment. I was thinking of getting a white board for the visitors to sign so I know who comes when. What do y'all think about me putting check boxes on the board to prompt mom to shower when the CNA is there? If that doesn't work, I may have to stop visiting with mom until she becomes more compliant.

These diseases really suck. You can't even reason with the patient to help them see the advantages of doing something so basic as showering! And I know my real mom (Pre-FTD) would NEVER want me to have the burden of being her nurse/sole-caregiver.

Please let me know if y'all have any thoughts on the white board or any other ideas about getting mom to shower! Thanks!

Jack I'm sorry to hear this, it's very difficult.

I had an exercise book that was our communication book.

Everyone who came here for any reason - home help, OT even a doctor would put a note in the book about their time there. I also put my own notes in the book. I could let them know if something was happening, if he had a bad night or anything I was concerned about and wanted them to watch a bit. It meant that everyone coming in had to start by checking the book, then filling it out on leaving.

As we had trouble with getting enough calories into Chris I then started a little chart at the back of the book where we would all note every feed he did take (peg).

Something like this could help you, as it keeps a full history that is invaluable, compared to a white board that will be rubbed out. New staff found it useful to look back at the previous couple of weeks as well. You could put a shower chart in the back like I had for feeds?

You are right - you can't reason with FTD. That executive function robs them of the ability to go through a discussion without emotion and devise and then comply with strategies.

I hope you find a strategy that works for your situation - we often have to really think laterally!