Understanding Why Older Adults Struggle with Hygiene: Compassionate Approaches to Support

It’s a common concern that older individuals, particularly those facing health challenges, might appear unkempt or have hygiene issues. While some of this could stem from ageist stereotypes, it’s important to recognize that there may be valid reasons behind the lack of personal care. If you’re noticing hygiene concerns with an elderly loved one, it’s crucial to understand the root causes and approach the situation with empathy and understanding.

This isn’t about one-off instances where your loved one may have had a tough day. Instead, it refers to an ongoing issue of self-neglect that could be impacting their health and well-being. Here are some potential reasons why your elderly loved one might be neglecting hygiene, along with ways to help.

Start with a Compassionate Conversation

It’s important to approach the situation without judgment. The goal should be to understand what’s behind their hygiene struggles and find a way to support them. Open a conversation gently, focusing on their overall well-being and daily challenges. Rather than focusing solely on hygiene, talk about their general mood, health, or activities. Establishing comfort and trust will help you better understand their situation.

1. Depression and Mental Health Concerns

Depression is a common condition that can affect people of any age, and older adults are no exception. When someone is severely depressed, even simple tasks like bathing can feel overwhelming. They may not have the energy or motivation to take care of themselves, and they may lose track of time, neglecting their hygiene without realizing it. If you suspect depression is the issue, it’s important to encourage them to see a doctor or mental health professional for proper care.

2. Loss of Control Over Daily Life

As people age, they may feel that they are losing control over many aspects of their lives. In an attempt to regain some sense of control, they might resist things like bathing, something they once did independently. Reassure them that their independence matters and encourage them by highlighting other areas where they are still in control. A non-judgmental approach, focusing on empowerment rather than resistance, can help make a difference.

3. Boredom or Lack of Motivation

Sometimes, a lack of engagement or activities can lead older adults to lose the desire to maintain personal hygiene. If they feel there’s nothing to look forward to or no one to interact with, taking a shower or bath may not seem necessary. To help, suggest doing something fun or going on a short outing together. Activities like a drive, lunch, or shopping can offer a new focus and encourage your loved one to freshen up before they go out.

4. Diminished Sense of Smell

Older adults often experience a reduced sense of smell, which can make them unaware of their body odor. Without this sensory cue, they may not recognize the need for regular bathing. You can gently encourage them by suggesting activities that might prompt them to freshen up, such as going out for a walk or a trip to get ice cream.

5. Don’t Worry About Daily Showers

Unless an elderly person has been very active or sweaty, they may not need a shower every single day. Their skin might be more fragile and dry, and bathing too frequently can exacerbate these issues. Instead of pushing for daily baths, focus on washing essential areas like the underarms and groin in between full showers. This can often be more beneficial to their health.

6. Fear and Pain During Bathing

Older adults might experience dizziness or pain when bathing, making the process seem frightening. This could be caused by medications, inner ear issues, or joint pain. If these issues are present, it’s important to consult with a doctor about any necessary adjustments to medications. You could also consider adding aids like grab bars, shower chairs, or a hand-held showerhead to make bathing safer and easier for them.

7. Physical Discomfort

Some older adults struggle with feeling cold easily or have less energy and stamina. Others may no longer have the same range of motion or balance, making the process of bathing exhausting or difficult. If they require assistance, this could lead to feelings of embarrassment or a loss of dignity. Offering to accompany them to the doctor to discuss ways to ease discomfort could be a helpful step.

8. Cognitive Decline

For individuals with dementia or other cognitive impairments, personal care can become a significant challenge. Changes in behavior can make bathing more difficult, and some individuals may resist the process altogether. To help, create a comfortable and calming environment for the shower, such as keeping the room warm and speaking to them gently. Remember, it’s okay to skip a shower now and then as long as essential areas are cleaned. In cases of incontinence, it’s especially important to maintain hygiene in these areas.

9. Incontinence and the Stigma Around Protective Products

Some older adults may resist wearing incontinence pads due to the stigma associated with them, equating them with being “babyish.” This can be a delicate subject, and scolding will likely only result in defiance. Instead, approach the issue calmly and normalize the use of incontinence products, reminding them that many people, regardless of age, face similar challenges. The key is to use high-quality protection and continue living confidently.

Be Compassionate and Patient

Above all, approach this issue with compassion, kindness, and patience. Older adults are often facing multiple challenges, and their reluctance to keep up with hygiene may be a symptom of larger struggles. Rather than scolding or criticizing, offer your support and find ways to encourage their self-care. By using these gentle strategies, you can make a positive difference in their daily lives and well-being.

Bursack, C. B. (2025, February 5). An older adult skips bathing? Maybe there's a good reason. Minding Our Elders. https://mindingoureldersblog.com/2025/02/05/an-older-adult-skips-bathing-maybe-theres-a-good-reason/