Try contacting the family to see if they may be able to come in and talk to her. I have found that the patients are more responsive when their kids come and talk to them. Also, I know its a long shot, but have you tried asking her "Would you mind helping me out? I really need to get this shower done, I don't want to get fired" Sometimes with difficult patients, this works because it seems more like its a team effort and they're helping you keep your job rather than you taking care of them, they feel less helpless. I had a difficult patient who refused to let me change is depends with BM in it unless I asked this way... let us know how it all turns out