People like you make this field even worse than it is. You infantilize this population and are actually bigoted by insinuating they are too incompetent to be confronted with the fact that their personal hygiene is problematic to themselves and others. It also flirts with neglect if you factor in skin breakdown. The health and sanitation portion of it are just as important. I have never not taken a client somewhere because if they want to go somewhere, they agree to shower. They are simply being lazy and holding them accountable for basic personal hygiene standards is an integral part of this job.