Caring for a family member with any type of dementia, such as Alzheimer’s can be very challenging when that person resists the care, or becomes combative with the caregiver. This is often the case when it comes to bathing time. People with dementia virtually never worry about whether they look or smell good, and they usually always believe they have just recently had a bath–so why on earth should they take another one for you? You may find yourself having to get very creative about how you get them into the bathtub or shower.
As a dementia consultant, I tell my clients that bathing is not required every day, or even every other day. As long as this person is getting a “wash-up” of the critical areas every day, then a full bath is not needed. These critical areas include the face, hands, armpits, peri-area, and for women with large breasts, under the breasts. Twice weekly baths should be sufficient for most people if those critical
areas are kept clean daily. If this loved one is incontinent of bowel and/or bladder, then every time they are toileted, their peri area should be washed thoroughly. The skin is much more prone to breakdown
if it is not kept clean. There are many good products on the market with gentle cleansing properties as well as lotions in them. Always check the skin when you are cleaning them for any areas that appear to
look different which might indicate the beginning of a pressure sore either from sitting or from clothing rubbing. Here are a few tips to help you:
- Adhere to their long-time routine if possible. If they took showers vs. baths or preferred morning vs. evening then try to stick to that if possible;
- Keep the bath area WARM–more warm than you like it–it’s much easier to get their clothes off if they’re not cold;
- Have distractions in the tub/shower area such as a rubber duck so you can ask “Now where did this come from?” Hand it to them and keep up a dialog about it, “Is this yours? I wonder if there was a child in here taking a bath…”
- Don’t get their head wet until the very last minute because once their head is wet, they will feel cold and sometimes feel panicky;
- Hand them a washcloth and allow them to do whatever they can with it–anything in their hands will serve to distract them, so be sure to have several washcloths handy to use; Don’t ask them if they’re ready for a bath–simply prepare the room in advance, lead them in and keep talking about something they’re interested in. Use very simple instructions such as “Take your shirt off now.” “Please take your shoes off.”
- If this is your spouse, take a shower with them;
- Have towels or a cotton robe warmed by the clothes dryer ready to use immediately after getting out of the water–wouldn’t that feel wonderful?
- Put music they enjoy on in the bathing area, and encourage singing along. There have been many, many times when I’ve accomplished the most difficult tasks with elders with dementia simply by getting them singing their favorite songs while gently, slowly, with a smile on my face sang with them.
- Keep up the chatter about topics of interest to them, and ask them questions to keep their mind on that subject. They can only think of one thing at a time and if it’s something pleasant, they won’t mind the bath.
- If they’ve developed a fear of the water in the bathtub, try a gentle seated shower with the spray directed on their feet. Putting bubblebath in the water to “hide” the water may help. Don’t
fill the tub up more than a couple of inches. A good old-fashioned “wash-up” at the sink can keep them just as clean as long as they’re getting their hair done in some other manner.
- Remember–the goal of the talking is to keep their mind off the bathing;
- The more distracting things you can have in the bathroom, the better your chances of keeping them calm. Maybe something like a fake tree in a corner with a big brightly colored parrot in the
branches. Put it where they could see it while in the tub, and talk about what the parrot is doing there.
- Remember–what works well today, may not work at all in a few weeks. Just keep trying different things, but keep that calm, relaxed and smiling attitude at all times.
Best of luck with
the bathing issues!
Copyright © 2010 Cindy Keith, RN, BS, CDP