Aspergers & Hygiene - advice please

I'm not sure how you would enlist professional help, assuming that he has capacity and is choosing not to bathe or shower.  I have the same problem with my son and we are basically left to try to resolve this within the family.  Of course, if he is developing sores then this could be construed as a risk so it might be worth speaking to his GP and I wouldn't entirely rule this out. 

Keeping it relaxed and neutral might be helpful, as Sunflower suggests.  Also exploring other aspects of his life that might be moving personal hygiene to a low priority.  If he is struggling with something else then hygiene isn't going tos eem very important in comparison.

I am also wondering whether your brother has always been this way or whether there was a time when things were better.  If so maybe the background to this could be explored.  What was happening when things were better or worse and can anything be learnt from these times?

Overall though I would be leery of trying to persuade him to change.  Whilst natural lines of conversation feel OK, I always find that the more I try to persuade the more the other person digs their heels in and defends their position.  I had this with my dad and his hygiene problems - the more we fretted, cajoled, persuaded and even hinted, the more he felt we didn't understand and withdrew still further.  He could feel out frustration and this added to some very negative feelings he was already experiencing.  

So i would urge caution and maybe focus on what he'd like to do and whether he's OK with seeking a diagnosis at this point in his life. 

It never ever occurred to him he'd think he had issues, he was happy to live in his own bubble of dedicating as much of his time as possible to online gaming. He only has a job because he was forced to move out of the home due to stealing, not working or commiting to studying. He refused to do anything.

I'm beginning to wonder if we need professional help as he tries (successfully) to avoid answering/addressing any questions regarding his lack of hygiene...

I've tried asking him but he does this weird thing where he kinda shuts down if he can't/won't asnwer, he'll give no response but looks like he's deep in thought on how to answer resulting in no answer... 

His main priority asides from eating is frustratingly, World of War Craft/Online gaming. if he's not at work or able to play on a computer, he's on a console wherever he is. 

I can fully understand what both Trogluddite and Lonewarrior have said - pretty much mirrors my own experiences

https://www.showerremedy.com/10-things-to-keep-in-mind-when-buying-large-shower-heads/

Have you thought about changing your shower head? A smaller head will mean greater water pressure - so that water hitting you like needles? A larger head may make the process feel more like being in a rain shower rather than water bombed! 

Yes indeed!

agreed with all you said.@Trogluddite.

plus sensory issues, hot cold the subtle variations between air temperature and shower water may as well be to one extreme to the other, the water hitting my head like needles from the shower head burns even when turned right down, any lower it feels ice cold, then as the water flows down my body it seems to flow very cold, water on my face and in my ears feels like I am drowning! I can’t breath if the water flows over my head down my face, even a very wet flannel feels as if I am under water,

 my feet freeze by the time the water reaches them, 

I have to try to equalise the water air temperature, put warm water in the bath for my feet, avoid direct impact from the water jet on my face, 

then once the sensation finally settles as my body adjusts, I turn off the water and start to shiver from cold, I quickly wipe as much water off my skin before turning the shower off, then towel as quickly as possible.

 Now although I describe the very hot very cold variations, they are in fact normal , not extreme only to me. For years I have covered over this issue, often not showering, just make out I have, so flannel wash, wet hair with very wet flannel, 

My feet suffer because of lack of hygiene, plus my work means wearing boots all day long, I have hyper sensitive feet, a tiny grain of grit is like a boulder, a seem across the toe line in socks is so painful, I wear socks inside out, the rough inner fluff hurts my feet, even little lines on socks feel like tramlines,

I put my boots on then gradually my feet become numb, then they lose sensation, that helps get through the day. Cold numb feet all day, as they warm up when home they burn like putting them in an oven.

After showering I itch, I only use non perfumed washing cream., sensitive skin type, shampoo burns my eyes and causes my head to itch so badly.

well Trogluddite pretty much nailed how I feel, the dirt doesn’t bother me, always been a mucky kid and I work with soil all day, I am very healthy, hardly ever sick,,, I like natural body odour, a primeval throw back maybe?

hate strong perfume but can handle gentle scent, most are to strong.

Thank you for trying to help him, he may not want any help, but you  care for him, just care for him not what others may think of him. 

I am often like a pig in ( clover).

I'm a middle aged man with autism (essentially the same kind as Aspergers), and I have to be honest, this is something that I have struggled with on and off for most of my adult life. I'll try to put into words some of the reasons that I have found caring for my hygiene difficult, though any of the suggestions made so far could play a part, as could others not yet mentioned. It is also only fair to say that my own poor self-esteem and biases may make these observations somewhat inaccurate.

Firstly, I have very poor executive functioning, which is quite common for autistic people, and also a core symptom of ADHD. That's the brain function which we use to direct our attention, make plans, and carry out those plans. Because of this, there are times when I simply do not notice how poor my hygiene has become, especially if it has lapsed over a long time period. Even when I become aware of it, I can intend to clean myself, yet very easily get distracted by the smallest of things before I get around to doing it. Once I have forgotten, the intention won't return to my mind unless I'm prompted again. I can be so disorganised that even on a day where I have little else to do, I never seem to find the time to clean myself or get my laundry done; there are so many compulsions and things to procrastinate about occupying my mind. Frankly, I do absolutely disgust myself sometimes; but only for the fraction of a second before some other impulse or anxiety comes to mind. Noticing the evidence of my own senses will only happen if my attention is explicitly directed towards it. Dressing is often done "on auto-pilot" such that I'm barely aware of what clothes I'm even putting on or the state of them. It does not take long before neglecting myself in this way becomes established as my normal routine - a rut that I'm unable to climb out of without external help.

Secondly, there is the problem of depression, to which autistic people can be very prone. I get so that I simply don't care myself, and I don't care what anyone else thinks. For an autistic person, this is particularly problematic - when my social impairments mean that people will probably reject me anyway regardless of what I look or smell like, why should I bother? Once I have spent one day unclean and smelly, and have survived it, what does it matter if I do the same thing tomorrow, and the day after that? The feeling of being clean, which I do enjoy when I make the effort, can even seem like a luxury that I don't deserve to experience; I feel sub-human, so treat myself as such. I've spent a lot of time on autism forums over the last few years, and this kind of nihilism is, sadly, very common; life sometimes just seems utterly purposeless, and I'm going to die lonely at the end of it whatever I smell like. 

Thirdly, there is a sensory component. I simply detest the strong smells of most cleaning products, and cannot abide artificial scents. Quite frankly, I find the smell of BO, even other people's, more comfortable than most toiletries, even those which claim to be unscented.

I think that you should try to talk to your brother about it, as recommended previously. However, do not be surprised if he responds with rationalisations for his behaviour, however defensive and irrational they may seem to you. Both autistic and depressed people are good at using their systematising minds to rationalise (or at least feel within themselves that they are), and if I were feeling defensive, I could give you some very good arguments why modern attitudes to hygiene are mostly social conventions that marketing people have brainwashed us into believing, or showing that most "hygiene" products are actually cosmetics. I'm saying that for the sake of an example, of course, but it is typical of the kind of thinking that I have employed when challenged or trying to make myself feel more comfortable with my lifestyle.

Besides trying to get your brother assessed for autism or some other chronic condition, I think it would be wise to seek help for depression if you can, as what you describe sounds very much like me during a depressive episode; assuming that he is autistic, this may not, on it's own, be sufficient to explain his behaviour.

It is wonderful to see how much effort you are making on your brother's behalf; I know what a difference that can make, as I could not have improved my life without external support. Best wishes to you and to him.

Is this anything to do with comfort & fear of change? Going from filth to sparkly clean is a huge step change and the process, the soap smells and the tingly dry skin afterwards may be too overwhelming.

I have eczema so as my skin dries & contracts after a shower or bath, my hands feel like I stuffed them into stinging nettles and my body is so overloading that I could (do) scratch myself until I bleed. If I could avoid the whole process, I would.

You sound like you genuinely care (e.g. you've gone out of your way to look for advice), so speak to him and convey it in a way which makes it clear it's coming from a good place. 

On another note, early 30's and possibly autistic, sounds like me (diagnosed at 34). It aggravates me that people have eluded help for so long. Not right.

The reasons may be far from obvious so I agree with qwerty it's a good idea to discuss it with your brother. Sometimes people find it embarrassing to ask about this kind of thing but it's often the best way to understand what's going on.

Years ago I worked with a woman whose personal care deteriorated dramatically. When I asked her about this she said it was because of the lighting in her bathroom. The psychiatrist had assumed it was a deterioration in her mental health and wanted to give her a higher dose of anti-psychotic medication. Environmental factors are often underestimated. 

If you can be really neutral, unemotional and non-judgmental when you ask about this it may help. My sister came to clean my house when it got in a state after the birth of my first child. I felt very ashamed and I was acutely conscious of her reaction to my mess. In some ways it would have been easier if it had been someone I knew less well helping me to sort things out.

I guess a common reason could be that taking a shower would mean having to take time off doing other things? 

Another possible reason is that he doesn't like the sensation of water/soap.

Have you tried talking to him to try to find out why he doesn't regularly shower? Maybe together you could try to figure out the cause and find a solution.