Bathing Challenges that could happen when caring for a person living with Alzheimer’s or other dementia
These suggestions are actual tactics I used in providing care. I found that sometimes I had to adjust my “agenda” of providing a shower when met with resistance. There were times it took having a brief conversation with the person about how they were feeling that day and being “present” with them before we could begin.
Don’t hesitate to put your agenda aside if the struggle is overwhelming and you are becoming angry. It isn’t helpful and will probably make the situation worse for you then and in the future.
I found that by developing a relationship of trust prior to providing personal care with the person worked so much better than when I showed up and we went straight to setting out clothes and starting a shower. If you’ve already met with resistance and now have a battle everytime you bring it up with them you may want to stop and do a “start over”. Give it a month and just be their Friend that month. I talk about this more in my blog about relationships, please read it if you think you might like to give it a try.
When you meet resistance come bath time, consider the many steps it takes and how confused you would be if you saw all the things in the bathroom and didn’t know what to do with them or what to do first? It could also be that everything is white and they truly can’t see it. Consider changing to a colorful toilet seat if they “can’t find it” (their eyesight and range of vision could be affected)and switch to items that have thicker handles that are easier to grasp (hair brush, toothbrush, comb).
I noticed most of my clients didn’t like to get wet or cold, and who does really? I found that when I heated the environment prior to them entering, set out everything we needed within reach and reduced My agenda and made it all about them, I met with success 90% of the time.
If you notice body odors, it could be what is happening with your loved one. It could be that finding the items they need has become to complicated for them and they are embarrassed they can’t remember so they avoid it at all costs. Also consider it is a private event, how would you feel to be nude in front of someone in your family or a stranger? It’s important to do your best to provide them privacy. A good practice is to cover private areas with a hand towel or other item and only expose areas that are being washed. I have stood outside the shower and held a towel across (when clear curtain or doors) in front of me just below their chin so I could still “see” them and also provide privacy. This worked well most of the time.
Taking the above into consideration here are some other things that worked for me:
1) Begin by warming the room, even if it causes you to be un-comfortable; have all items needed close by (towels, shampoo, hair cover) lay out the clean clothes
2) Turn on water to get it warm this will also assist in warming the room; if they use a shower chair place a small towel on it. You will want to run warm water on it just before they sit down (also a good way to assist with back side cleanliness)
3) prepare all items needed so they are close at hand; never leave the person alone
4) approach the person and explain you have their room ready, if they complain saying they don’t need a bath; Don’t Argue! State plainly that you have their shower ready as you are walking to the room, tell them step by step what to do such as: “lets remove your shirt, pants, etc.; “now step into the shower”, “sit on the chair” (remind them you’ve placed a towel on the chair so they aren’t surprised) continue to instruct them every step if necessary. If they continue to resist, you could suggest a small thing like “Your hair looks so nice when you style it the way you do. Can you show me how you do it?” This hopefully motivates them to walk to the bathroom and there you would begin with the hair, let them start with the brush. As they are brushing their hair, you point out that you see a “little something” on their cheek,chin,neck, etc. and maybe they may want to wash that off (you can add “so it doesn’t become crusty” - no one wants to be crusty). When they agree, you simply hand them a wet and warm wash cloth with a small amount of soap mixed in it and hand to them. Do not “do” for them, unless they ask. You will want to hand them the wash cloth and to direct them, point to the area on yourself you want them to wash. At this point you may be able to persuade them to “get the rest of the crusty spots” by getting in the shower or you can help them at the sink by just getting that wash cloth wet, warm and soapy then handing to them to get the “smelly” spots while they are still in their clothes. You do this by lifting the shirt so they can get in the arm pits and offering to wash their backs (usually they are won over by this process). To clean the genitles or private area, I suggest they use the bathroom. I would say “Hey since we are here you want to use the toilet?” While they are seated I offer a warm wet (light soap for ladies or a special cleanser)soapy wash cloth again by saying “Hey while your in that spot you want to get your private area?”. They usually agree. We then go on to removing the dirty clothes to put on clean ones. I would say “Hey since we have these pants off we could put on these?”. Be sure to have the clean clothes nearby and ready to avoid a break in the mood. You may also want to describe the clean clothes such as: “put on these nice pants you picked out” or “these pants that look so good on you”. Basically something that is complimentary and provide a “feel good” experience.
5) encourage them to do as much as possible for themselves be sure to always stay in the room with them. Many accidents happen in the shower/bathroom. Be prepared to pick up any dropped items.
6) avoid “discussing” if they need a bath, this may only lead to an argument or a castatrophic event; continue to give them step by step instructions. Example: “Wet the wash cloth; put the soap on it; now rub all over your body; rinse off with the water; well done”!
7) wash the hair last to prevent them from getting to cold; when drying use the small towel on the head and dry hair; place one towel around their shoulders to keep them warm and use the other to dry their lower body.
8) as you proceed to get them dressed, remember to continue to give step by step instructions. It is helpful as well to have them help you choose what they will wear. This doesn’t have to be a long process. Choose two shirts and present them so they can make a choice. Do the same with pants.
Congratulations you’ve just completed one of the most difficult tasks in caregiving!
I pray this was helpful. I strive to make sure this site is providing helpful information. If you found any part of this difficult or hard to understand please let me know. Your comments are appreciated!
