Answer:
Lack of insight is really a challenge with residents! We want to be direct but diplomatic, firm but not offensive, helpful but not overbearing—always a balance, right?
For individuals who have little to no insight, its best to be concrete but diplomatic and not beat around the bush. I would wonder a bit about the cognitive issues of resident, dementia, mental health issues, perhaps? If you notice that hygeine has fallen by the wayside it may be indicative of depression or other mental health issues. Another issue may be rehabilitative too. So, if she has issues with weakness or cant get around, she proably cant give herself a proper shower other than a sink shower.
If the resident becomes offended by your question or suggestion, just keep in mind that you cant take it personally and there will be a risk that they feel hurt.
So for example you can say (speak with that person in private–even if there are several of them)
“Ms Jones, I say this with much care, but I worry about you. I cant get used to the odor that I notice from you. Are you feeling OK? Is your faucet/shower in working order? I know that when I asked you before you indicated that you didn’t notice the odor. But usually, we dont notice our own odors (give example that people ask you what perfume you are wearing and compliment you that smell nice but your dont really nemsotice your owns smell–good or bad). This the same situation. We often dont notice our own odors –good and bad odors! Because its noticeable and others may have already expressed concerns about it. Is there some way we can work on it? I have some extra shower items and body spray items if you want to give these a try”
If she still denies it, and continues to not have insight then you have an issues with passive self neglect. You may need to explain the building policy–eviction process etc. Option for APS to get involved to provide additional services.
If you want to be indirect ” Ms Jones, I need some direction about an concern that I have an I am wondering if I can get your suggestion” If she cannot connect the 2, then you can be more direct
“Ms. Jones, I am concerned about your body odor. Please dont feel offended I say this with much care and love. When some of our residents experience this it brings up a lot of red flags like being sick, having issues with getting around, or they’ve lost someone special and they are depressed and cant bring themselves to shower up and take care of their hygeine. When this happens, we have to address it because it’s a sign that something is going on.”
Good Luck! I had to address this with a patient years ago, and it turned out she had complicated grief and had some aggitating signs of depression. We addressed depression, got her on meds and had enough energy to shower up and wash her hair. She was still offended but now that her depression lifted and was addressed and it was in the context of her depression she understood why it needed to be addressed.
Take care
Joanne
Joanne Cruz,MSW, LMSW, ACT
Clinical & Medical Social Worker
Home Health Partners, Inc (248) 358-1186
Question:
I’m looking for advice on how to talk with clients about personal hygiene that is being neglected to the point of being at risk of eviction, but reports not being aware that it is an issue (she is unaware of the odor of her body and apartment). How do you have this conversation?