Family and Caregiver Schizophrenia Discussion Forum

Need Ideas for lack of hygeine

Has anyone successfully gotten their loved one to take care of daily hygiene? Discussing and/or reminding is not working. In fact, the more we talk the dirtier he gets! Please help if you have had any success in this area/

This is a common problem for people with schizophrenia.
My brother has talked about how thoughts and mental images of morbid things can pop up suddenly when trying to do normal things like clipping fingernails or washing hair. I’m not sure, but I think he still has reservations about slicing meat to prepare meals.

These things seem mundane for us. But to someone with a disorder that can sometimes be very disturbing, the morbid thoughts and uncomfortable feelings can be overwhelming.

Don’t expect them to want to talk about it, either. It can be both triggering and embarrassing.

Depending upon what your specific circumstances are, it might be better to demonstrate patience and understanding with hygiene, while focusing more on some other fundamental need that will eventually promote achieving good hygiene.
Specifically for my brother, it was a more regular sleep schedule and lots of independence. It might be different for you and your family, but that’s some of the things that helped my brother focus on his own needs, rather than stress about our expectations.


Things can get tough here. I’ve heard some situations that were really bad. My son is one of those. When they begin to neglect these daily functions, some pretty serious things can begin to happen: tooth decay, loss of teeth, hair infestation, bed bugs, you get my drift. When the negative symptoms have reached these points, the courts can deem them “gravely disabled.” They are not capable of taking care of basic needs (think there’s called ADLs?).

Then we can rustle with the idea of involuntary commitment, but at what cost? I’m not ready to trade in the trust I have with my son quite yet. Soon, his mouth will begin to hurt and he will ask for help. He has already started. We have found a dentist who doesn’t use fluoride and is “holistic”, so the tools are in place when he needs them.

Getting a grip on negative symptoms would be helpful, but the industry has yet to hit the nail on that head. Depression and delusions…sigh.

Pick your battles.

We had this issue last year. Started a non confrontational conversation about what he thinks is appropriate in general and he concluded it is necessary when anyone goes out in public as a courtesy to others. Boy was I relieved he got there on his own, because if I had told him it probably would not have been successful. And we he goes out he does clean up. When we talked about how hot long hair and a beard could be he cut his hair–for his comfort. So I have learned never harp on an idea–just put it out there as a general thought and let it go. Doesn’t always work, but I am less stressed. Recently though he shared the side effects of meds made him super lethargic her told me the thought of cleaning up was too exhausting. I had never considered that before and found it incredibly sad.

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I don’t know how you would describe success…

I am really into dental hygiene because I grew up without much supervision and had lots of dental work to make up for that.

So, I handed my family member a newly wet toothbrush with fresh toothpaste on it once a day when I was brushing my teeth and family member retained choice of brushing teeth or not. Daily tooth brushing is in place since family member is in treatment.

Two dentist appointments each year happen. I have had to sit there with family member and run after them when they left after checking in (which they did at many different types of appointments and places). Again, now that they are in treatment, this is easy.

Clean clothes: I take away dirty socks and underwear when on the floor or somewhere like that. Sometimes that is still not possible. But I always make sure there are clean socks and underwear when I take away the dirty ones.

Showers: Since treatment started, we had a goal of twice a week during summer and once a week during winter. With prompts, this works pretty well. Without prompts, showers are sometimes taken and sometimes not.

Once my family member told me that not taking showers and wearing dirty clothes is “self-defense.”

Also, I have taken my family member to the dentist or doctor when they had not had a shower or changed clothes for a couple weeks or more and my family member did not seem to notice or be self conscious, so I also don’t bring it up if there are higher priorities that might be able to happen. And I realize hygiene might be a higher priority in other families than in mine.

This is an ongoing issue for us. In reality, our son doesn’t maintain his own hygiene. Instead, we do. The only reason he showers, shaves, brushes his teeth, goes to the dentist, etc. is because we tell him it’s not a choice if he is going to live with us, spend time with us, go out in public with us, eat meals with us, etc… We dangle carrots.

It’s sad that this is where we are, but I think this illness damages a part of the brain that allows self-awareness and an understanding of social norms. We didn’t cause it and we can’t fix it.

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Thank you for your help. This is so hard for others to understand. I wonder if my son has a reason for poor hygiene that he is unwilling to share.

You are so right. Some people in an attempt to be helpful have suggested that I if I set up a place for him to live on his own without assistance he would do better. They don’t understand what is obvious to those of us who live with it on a day to day basis.

When I am around when my son showers, I can hear him responding to voices. I think for him, it gets worse in the shower. He won’t take baths.

If my daughter doesn’t respond to me for showers then she will usually respond to her brother. We do mention her need for a shower as soon as it is apparent and every day after, we even use a little bit of detailed information like crotch rot or other nasty things that make better want to shower. Her brother treats her like always and says childhood brotherly things like, “talk to me after your shower” or jokes with her until she goes into the shower. Gravely disabled does get a call to have her picked up.

My son alternates between total lack of hygiene to baths 2 or 3 times a day because they relax him.

Sometimes, he’ll soak for hours - but never use soap, and put the same dirty clothes back on.

Right now, he’s doing pretty good. He’ll shower a few times a week, almost always within 24 hours of going to the doctor, and he keeps his clothes fairly clean.

A few years ago, he decided his hair was thinning, so he started shaving his head. Even if he doesn’t shower, he shaves that head with plenty of shaving cream at least every other day. It’s given him a cleaner, neater appearance.

We’re working on the dental hygiene.He hadn’t been to the dentist in years, but we started going once every two months about a year and a half ago. He has 3 small cavities left plus a crown - but he had to have a root canal, lots of fillings, and 2 extractions. The dentist is a faculty member at the nearby dental school and he calmly talks to him about brushing. I think it’s helping some.

But - sometimes, I’d just tell him that it was time for a shower, and fresh clothes - and remind him to actually use soap, not just get in the shower long enough to get wet and get out. Discussing it didn’t help, arguing about it certainly didn’t help. I’d just remind him he was grown and everyone grown starts to stink if they don’t shower for long enough. It worked for us.

I suffer from Schizoaffective Disorder and for me the only thing that has helped me in this area of my disorder is using Seroquel… I don’t really LIKE to use Seroquel because it keeps me knocked out all day, usually, unless I stimulate myself with massive amounts of Caffeine along with the use of this medicine but if it works, it works. This ISN’T going to work for everyone because due to our brain chemistries it’s not one size fits all with this disease/ disorder (which points to me that it is actually MULTIPLE disorders being labelled “schizophrenia” due to the similarity in symptoms but different underlying root causes). I will also mention I don’t actually know if it was the Seroquel I was using or the Cymbalta but I have doubts on the fact that it was the Cymbalta because it seemed to not be helping me the last time I took it and was making my depression worse.

I hope everyone gets this situation figured out… I know it can be hard to deal with being around someone with bad hygiene but the person themselves are probably suffering themselves thinking about how nasty they are and not being able to fix it due to whatever the issue is (I think my own issue is anxiety). Just keep at it and one day I’m hoping we can see a cure to all of this.


My family member just went at least ten days – maybe two weeks? – without a shower, then decided to take one today.

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YAY! No victory is too small to celebrate. Unfortunately mine has gone about 6 weeks. This is the longest so far. He has started brushing his teeth daily again though. And since dental work is so expensive and not covered for adults by medicaid in this state, I am very grateful.

I googled how long it takes to form a habit and came up with the answer of 66 days. If only he’d keep brushing his teeth for that long! He does very well with routine. Really does not like change.


I use and I got this for my son as well - both and an electric, cordless toothbrush and water pick. Easy to use in the shower.

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