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The skin picking is serious when he loses weight and becomes very thin. The loss of subcutaneous fat in the arms makes the skin very fragile. It actually can become as fragile as wet newspaper and tears very easily. Healing these tears is very difficult. Keep his fingernails cut very short. The Aide can help on this as part of bathing him. The skin damage can lead to blood infections called sepsis which are very dangerous.
As others have suggested, a home health agency can send a person just for bathing. Daughters bathing fathers can sometimes be tricky and he may do better with a "nurse" (as the older generation often views these people) to help.
Lack of cleanliness itself isn't the issue - he won't die from that. It's the combination of issues that concerns me.
I hope that you can find some help.
Carol
What I did with my husband, when he went to bed I would pick up his soiled clothes then put clean ones where he had neatly folded his soiled ones. When he got dressed in the morning I would take the PJ's and wash them.
Fortunately I never had a problem with him not wanting to shower. Later I did have to watch to see how well he was washing when it got to the point where he was not doing a good job I started helping him little by little.
Having someone come in to help your Dad bate is a great idea. Aides that do this have a "knack" at getting people to take a shower or a bath and making it more of a pleasant experience.
A few things you might want to try first.
If your Dad is scared he may slip while in the shower get him a shower chair or a bench. I got a used walker from a thrift store, cost about $2.99 and my husband stood holding the walker while I used the wash cloth and helped shower him. He was stable and there was no fear of him slipping. The shower walker stayed in the shower and when the shower was over he used the regular walker and stood by the sink holding on to the counter while I dried him he combed his hair.
We do have a walk in shower so there was no tub to step over so this might not be an option if you have a tub/shower. If that is the case a shower chair or bench is a better option.
Also the noise in the bathroom while the shower is going is loud, I turn the water off once I get him wet. then I just talk to him and tell him what I am doing. He loves the shower.
I had a PT tell me once that the head and trunk area are vulnerable places so start wetting the feet and legs then go to the side, up the torso then the head and trunk. This seems to work well.
Most people with dementia can't live alone after the early stages. Your profile does indicate that he lives in his own home, right? I'd observe how he is operating in that home, because he may not be able to manage their without daily assistance, depending on the level of the progression, if it is indeed dementia. If it isn't you can help get him treatment, for whatever is causing this cognitive decline.
Sorry, just frustrated.