Personal grooming for seniors is challenging for adults with dementia, and for their caregivers. Since many seniors in cognitive decline also experience bouts of incontinence, it is even more important for their caretakers to ensure that they are bathed and cleaned daily. In addition, people with dementia may forget to bathe on their own without reminders or may sometimes lash out at caregivers for reminding them to get clean, making bath time a fight. Or, if they do remember how to bathe themselves, they may not recall why its so important. Seniors living in an assisted living or memory care facility may balk at shower help because of privacy or modesty concerns.Reduce the struggle with your loved one by incorporating some of these caregiver tips into your daily shower or bath routine.Make Showers Part of Their Daily RoutineEstablishing a predictable routine is an important part of treating dementia and helping people with dementia enjoy a better quality of life. Bathing or showering may already be part of this routine, but if you or your loved ones caregivers are having difficulty getting your loved one to participate in bathing, it may be time to change how this activity is presented to them.Reprimanding an older adult for not bathing, scolding them, or shaming them isnt going to get the desired results. Its demeaning, and can often make them more resistant to showering, especially if they dont like their caregiver sometimes, people with dementia may provoke a disliked caregiver on purpose, and refusing to shower is one way they do so.Instead, take a positive approach with the unwilling bather. Schedule one of their favorite activities right after shower time, and offer rewards for getting in without a fight and thoroughly cleaning themselves.Prepare All Bathing Supplies in AdvanceIf your senior has a favorite towel, have that ready to go, hanging on the shower rod or by the tub. Learn what kind of body-cleaning tool, like a loofah, poof, washcloth, or sponge, and have that ready for them, too. Smell is a powerful memory tool, so its important that the scent of whatever bath products and shampoo you use are soothing or brings back pleasant memories. Lavender is a soothing scent, for example.Seniors are more sensitive to water temperature and pressure than people of other ages, so ensure that the temperature and pressure of the water are comfortable. You may need to adjust the settings on your water heater or consider purchasing a showerhead with adjustable pressure and water flow. If the bathroom is colder than your senior would like, consider placing a small bathroom-safe space heater in the room, too. Warm towels straight from the dryer can be a warm, comforting option, as well. Place a couple of extra towels in the dryer before starting the shower so they are ready when you need them.Include your senior in buying shower and bath supplies. The two of you can look online for new, fluffy towels in their favorite color or go to the store to pick up shampoo and body wash. If your senior is able, you can make an adventure out of it, such as going to a smaller soap store and smelling different products or touching the different loofahs until they find something they like. If your loved one is involved in selecting their bathing supplies, they may be more amenable to showering.Work With Your Senior to Preserve as Much Independence and Modesty as PossibleEncourage your loved one to wash as much of themselves as possible and give them as much privacy as possible while doing so without compromising their safety. Shower accessories, like a grip on the floor or a shower chair, can help them bathe with less help from you.If your senior has significant cognitive decline or is mostly unable to bathe themselves, you can still involve them in their shower. Give them a washcloth to hold while you clean them it may make them feel as though they are doing something, reducing the chances that they will strike out while being washed.If you or a caregiver must do most of the cleaning for your senior, consider washing them in sections and covering the rest of their body with a towel while you wash each section. This can preserve their modesty and help keep them warmer.Install an Adjustable ShowerheadA showerhead with adjustable pressure and a detachable nozzle helps caregivers and seniors better bathe themselves. The nozzle provides greater targeted control over where the water goes, and the showerhead and nozzle can be adjusted to produce a bigger or smaller stream. Some showerheads have adjustable pressure, too, which can help lower the pressure to reduce the loud sounds that may upset some people with dementia. An adjustable showerhead also makes bathing in a shower chair easier.Installing an adjustable showerhead may be a better option than adjusting the building water heater for seniors who share a home with others, whether its their family or in an assisted living home. Sometimes, Supplemental Medicare plans to cover certain showering aids for those who otherwise could not bathe independently without them, so look at your loved ones coverage to see if they have a plan like this.Narrate Each Step of the ShowerNarrating each step of the shower adds to the predictability of the process for people with dementia or others who thrive on routine. Talk through the bathing process with your senior, stating what you will do and what they will do. This may spark a memory for some people in cognitive decline. They can participate more and give others more security in knowing what will come next.You may use the shower narration to encourage your senior to do each step themselves and only take over if they are unable or unwilling.ConclusionIf you are concerned about your loved ones ability to shower or bathe on their own, consult a senior living advisor in your area for help finding the right memory care or assisted living facility in helping them keep clean and take care of other personal care tasks and activities of daily living. Assisted Living Locators senior care advocates help families locate a good fit for a loved one who needs a little more help to care for themselves or those who cannot live independently.

Spousal impoverishment is a concern for older couples when one spouse needs long-term care and applies for Medicaid. If one spouse requires care in a skilled nursing facility and the other remains at home, the spouse at home might face significant financial hardships. The high costs of nursing homes combined with Medicaids strict income and asset requirements risk leaving the community spouse with little income and assets. Medicaids Spousal Impoverishment RulesBefore the federal government enacted spousal impoverishment protections in 1988, many healthy spouses experienced poverty when their partners went on Medicaid. Medicaid has strict income and asset restrictions. Yet nursing home care is expensive, with monthly care fees ranging from $5,000 to $8,000. Many couples didn't meet Medicaids income and asset requirements, but couldn't afford care. Before receiving Medicaid, many families had to spend down their assets, leaving few assets for the spouse at home. Prior to qualifying for Medicaid, many couples paid nursing home fees out-of-pocket. Only when they could no longer pay would government assistance become available. Once all their funds went to long-term care expenses, the spouse living at home had little support. Medicaids 1988 spousal impoverishment provisions responded to these concerns, protecting spouses from loss of money and resources when their partners require long-term care. The spousal impoverishment rules rest on the principle that both spouses have a duty to provide for each other. Although the spouse at home must support the spouse receiving long-term care, the spouse receiving care also has a responsibility to the community spouse. The regulations allow the community spouse to keep a certain proportion of the couples combined resources and income, preventing impoverishment. MMNA and CSRAPer the spousal impoverishment rules, the Minimum Monthly Maintenance Needs Allowance (MMNA) and Community Spouse Resource Allowance (CSRA) permit the healthy spouse to keep a portion of the couples assets and income. The Minimum MMNA applies when one spouse is the primary earner. When the spouse with an income applies for Medicaid, the individual can transfer a portion of the monthly payment to the healthy partner.The CSRA protects some of the couples assets for the community spouse. Generally, to be eligible for Medicaid, a person cannot have more than $2,000 in assets. However, when one spouse applies for Medicaid and the other is healthy, the healthy spouse can keep more than $2,000 in resources. The federal government determines the minimum and maximum Community Spouse Resource Allowance yearly. Some assets, such as the couples home, car, furnishings and appliances, and personal possessions, don't count toward Medicaids assets requirements. Home and Community-Based Services The original spousal impoverishment protections only applied to married couples where a spouse needed nursing home care. In 2014, Section 2404 of the Affordable Care Act extended Medicaids spousal impoverishment protections so that when one spouse applies for home and community-based services, the other can retain some funds to support themselves.

The Social Security Administration provides four types of Social Security benefits: retirement, disability, dependents, and survivor benefits. Survivor benefits are available to the children and spouses of deceased individuals who qualify. If you qualify for retirement or disability benefits, your spouse and children have the right to obtain survivor benefits when you pass away. You also have a right to receive survivor benefits upon your spouses death if your spouse is qualified for Social Security benefits. Requirements for Survivor Benefits For your spouse and children to get survivor benefits upon your death, you and your family must meet specific requirements: You must be qualified for Social Security retirement or disability benefits. Older adults must have worked long enough in many cases, at least 10 years to earn 40 credits. Workers can earn up to four credits each year, depending on their income.However, people who die young may need fewer credits for their spouse and children to acquire survivor benefits. In some cases, spouses and children of workers with at least one-and-a-half credits earned in the three years preceding their death can get survivor benefits.Your children must be under 18 or disabled. (If your children are disabled, they must have become disabled before age 22.)Your spouse can receive survivor benefits at age 60, or 50 if they're disabled. Other Family Members May Be Eligible Stepchildren, grandchildren, adopted children, and dependent parents may be entitled to survivor benefits.Can Same-Sex Spouses Receive Survivor Benefits? Yes. In Obergefell v. Hodges, the United States Supreme Court held that the Constitution gives people the right to marry regardless of sex. Following Obergefell, the Social Security Administration allowed married same-sex spouses to get survivor benefits.  Can Spouses of Self-Employed Individuals Obtain Survivor Benefits?Yes. Self-employed people can contribute to Social Security and become qualified for benefits. If your spouse was self-employed, you might be able to receive survivor benefits. Can Surviving Divorced Spouses Get Survivor Benefits?In certain cases, yes. If your marriage lasted 10 years or more, you could acquire survivor benefits on your ex-spouses work record. Learn more about Survivor Benefits on the Social Security Administrations website.