Tips On ... Bathing

by Edyth Ann Knox
More About Edyth Ann…

Safely bathing an individual affected by Alzheimer’s Disease can be a challenging task and a source of frustration for a caregiver who is concerned about maintaining her loved one’s dignity and hygiene. What complicates matters is that the individual with dementia may find bathing a frightening and uncomfortable process. Remember: no one ever died from not getting a bath. Here are some tips to giving your loved one a bath while avoiding as fuss as much as possible

1) A shower is generally easier and safer than a bath: Giving a person a shower instead of trying to lower them into and lift them out of a bathtub full of water is generally easier to manage. It is also considerably safer. Getting a wet person out of a slippery tub puts both of you at risk for injury.

2) Hand-held shower head: Equipping the shower with a hand held shower head can help to ease your loved one’s fear and prevent some of the struggle. The water coming down from a regular shower head on a person’s head can set them up for a panicked response. Most hand-held shower heads also have an on and off switch so you can have to water running only when you want. Be sure to get one that you can have some control on the flow of water coming from it as slowing the water down when washing the hair and other more sensitive areas is advisable.

3) Have a shower chair: Sitting your loved one down on a shower chair can help make them feel more secure and helps you to wash them more effectively. The chair helps to stabilize the person being washed and gives both of you something to hold onto.

4) Rails in the shower: Having strong and secure handrails in the shower that both of you can hold onto while maneuvering in the shower area. The rails also give the caregiver something solid to hold onto while washing.

5 Anti-skid decals and mats on the floor of the shower: Small rubber anti-skid decorations can be used as a substitute for the rubber mat. The mat covers a larger area but is generally raised and can be a tripping point.

6) Prepare the bathing area ahead of time: It really helps to have everything all set up for a bath ahead of time. That way once you can quickly move your loved one into the area without having to pause to get things ready. It is a good idea to make the bathroom warmer and test the water temperature ahead of time.

7) Respect your loved one’s privacy: Sitting nude in the shower with someone makes a person feel vulnerable and perhaps violated, even when they are a close family member. This is even true when the caregiver is a loved spouse of many years. Wrapping a towel around your loved one or even leaving their underwear on can help make them feel less violated. You may give your loved one a washcloth and verbally direct her to wash her more private areas. Don’t get preoccupied with getting it done "perfectly." There should be enough water flow that the areas were sufficiently washed even without a thorough scrubbing. Stay in direct sight while washing the individual.

8) Keep the stimulation to a minimum: Bathrooms are generally small areas with a lot of things going on: running water, echoes, soapy wash cloths, differences in temperature, and strange people. Mirrors make it look as if there is a whole crowd in the room just watching them in the nude. Covering the mirror on the medicine cabinet may reduce the feeling of "being watched." Keeping the sink and toilet free of objects may also help. Avoid slippery throw rugs and mats.

9) Make bathing as pleasant as possible: Aromatic soaps and lotions can be pleasing and calming. Try soap-free products such as St. Ives body wash and lotion or Aveeno’s body wash product. Both products were soap-free and clean the skin without drying it our. Place some fragrant oil or lotion in a sink of warm water and rub on them after the shower. Relaxing music and somewhat dimmed lighting can reduce the harshness of the bathroom. Shampooing hair is often a special challenge. Try to shampoo with a small amount of the product and keep the water pressure low, being careful not to get water in the person’s face. A no-rinse shampoo can remove one step and still do a satisfactory job.

10) When all else fails: Sometimes no matter how much you try or what you do, bath time is a total disaster. Don’t feel that this is a failure on your part! Most dementia caregivers experience difficulty with bathing at some time in the disease. Picking your fights is important and insisting on a shower is not needed. The stage the Loved One is in will change and you will be able to get them into a shower in a different stage. Sponge bathing can do as well as a shower. Try giving a sponge bath in a different room. Many times the bed room is a better place for the Loved One. Let them do most of what they can do with a sponge bath and then you just help with the areas they can not do. Not taking a shower will not kill them. You mainly want to keep the private areas clean, wash the face, hands and feet. Don't make bathing into a struggle. Get what you can and try again another day or time.

Additional Resources

- Reflections on Reflections: Bathing and Alzheimer’s Disease
- Bathing and Grooming Skill Builder

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