ok.. My mother in law lives with me and my husband. She's 74 years old, and I think she has alzheimers. Sometimes she's clear in the head, and sometimes not. The only problem I have with her right now is getting her to take a bath. If I could find anyone in Orlando to come over to my house and help her take a bath that would be a big relieve for both me. She weighs almost 300 lbs. I can't lift her, or carry her to the bathroom. She refuses to take a bath. Do I just let her be and not shower? What do I do? She can still walk, but uses a cane or walker. Any suggestions?

This is a tough situation for you, and it could be caused by a combination of factors. She may not realize how much time has passed since she bathed last. When she was young, maybe she bathed once a week instead of every day like we do now. Bathing is a very personal activity and we all have our own way of doing things; she may be resisting your help because your "way" doesn't match "her" way. (She always washed her left arm first, then her right, then her legs, for example.) Bathing ourselves is something we learn as small children and it is integral to our sense of independence. To admit we need help with something so basic makes us feel really helpless. Plus, she probably doesn't want anyone to see her naked. I assume your husband doesn't try to help with this process?

All that being said, you need to help her keep herself clean to prevent rashes, skin breakdown and infection.

Try to avoid getting into a debate about whether a bath is needed. Run the bath and go through the process one step at a time. Tell her, "I got your bath ready for you, just like you asked me to." (she may say she didn't ask for a bath.) You say, "Yes, you told me earlier today you wanted to take a nice bath." Don't tell her she needs a bath, emphasize that she decided she wants a bath. When you get her into the bathroom, say, "OK, here's your towel already laid out for you. Take your top off, and I'll wrap the towel around you. Ok, now take off your underthings. I won't watch. Ok, now I'm going to help you into the bathtub."

Don't ask her if she wants to do something, gently tell her what she's to do next.

You may need to install safety rails, no-stick decals and no-stick bathmats, because you sure don't want her to fall. Do you have only bathtubs, or do you have a shower stall in one bathroom? You may want to consider using a shower seat and a hand-held shower hose instead of a regular sit-in bathtub. The seat is safer than having her get down into the tub, and the controlled flow of water may be less upsetting for her.

Be sure she washes and thouroughly dries in the folds of her flesh and under her breasts as rashes break out easily in those places. Use talcum powder or cornstarch.

You may want to contact a home health agency or geriatric care manager in your area to help with this process. She may be more compliant with a "nurse" in uniform than with a family member. Getting someone like that to come in twice a week will help her establish a routine, and it's all about a good routine.

Since she is still in her right mind most of the time, I strongly recommend you and your husband review her important documents with her: will, durable power of attorney and health care surrogate. Those things need to be taken care of before she loses the competency to do them.

Two other things I recommend: make sure to take time out for yourself and take care of yourself, and get the book "The 36-Hour Day" from the library or bookstore. (By Nancy Mace and Peter Rabins.) It has a wealth of advice on how to handle issues like the ones you and your husband are facing.

Let me know how things progress with you.

Thank you soo much for your Advice, things are getting better for my mother in law. We have good and bad days, but it's more good days now, thanks to your advice. And, we are now getting help from a nurse who comes in twice a week. And again, I really thank you!