Bathing is a private and personal matter. It is a necessity for people, in general. But, for a person with dementia, it is the most dreadful thing to do. He often refuses, withdraws, or fights when bath or shower time comes. Many professionals and care providers claim that bathing a person with dementia is the most challenging part of their job.
Most often than not, the reluctance to bathe may be associated with some environmental or circumstantial factors, many of which can be controlled. The person might feel like losing his dignity being naked in front of others. He may find the assistance as an intrusion into his privacy. He might be afraid of falling, or of the water itself. The temperature in the room might also be a cause for him to refuse to bathe.
During the earlier stages of the disease, the person may only need a reminder to bathe. But as dementia advances, he needs more assistance. And here is where the problem arises. Having another person telling him what to do or assisting him inside the bathroom makes him feel like being tampered. And so, his initial reaction is to resist the instruction to bathe. He will either claim to have just showered or that he will do it later. But, in many cases, the person with dementia will outright refuse to take a bath. As he is defiant, you can expect him to argue and cry.
Admittedly, trying to convince the person to bathe rarely works. But, as his care provider, you can try various techniques in getting your loved one to the water. You just have to exercise lots of patience. And most important, you should not take his offensive behavior to heart. Always remember that it is the disease that makes him behave the way he does, not the person.
Here are a few tips that might help ease the struggle in bathing a person with dementia.
Determine which kind of bathing he enjoyed in the past.
If he is used to a shower, do not insist on using the tub. And if he used to go down the tub, do not attempt to give him showers. And if he so prefers it, you may allow him a sponge bath at the sink once in awhile.
Suggest bathing at the time of day the person is most cooperative. Determine when he is in good mood or most relaxed Although, there are occasions when you are more successful inviting him to bathe in the afternoon, most persons with dementia cooperate well when their bath is done in the morning. Probably because they are made to change clothes once for the day.
When the person refuses to bathe, do not be too anxious. Wait for a while and try again. Give him a choice before taking him to the bathroom. You may ask him something like, “Do you want to bathe now or in 15 minutes?” Don’t force him to do as you wish. It could be dangerous for both of you.
Once you have established the best time to bathe, make it his routine time for bathing. Otherwise, he might get confused when you change the schedule.
Make the bath area appear familiar, comfortable and non-threatening.
If the person is in a care service facility, try to replicate or change the shower or bathing environment to look and feel like home.
Install grab bars, a handheld shower head, and put non-skid mats on the bathroom floor.
Place a shower or bath chair that can be adjusted to different heights.
Make sure that the room temperature is tolerable for the person. It should not be too cold or too warm for him.
Check the water temperature. He may withdraw if he feels the water is too cool for him.
Or, he may not sense that the water is too hot.
Pad the shower chair and other cold surfaces with a towel.
Prepare the bathroom and all bathing supplies in advance.
Cover or remove the mirrors in the bathroom to dispel his suspicion of a stranger in the room.
Keep the razors and electric dryers out of the person’s reach.
Make sure the temperature in the bathroom is warm and well-lit.
Arrange the soap, shampoo, washcloth, towel, robe, and clean clothes in sequence. These items should be within your reach. If needed, you may consider using a towel warmer and towel blanket to wrap him in after bathing.
Let the person get into the bathtub with only 2 to 3 inches of water in it. Fill it up only after he gets comfortable in it or after he is seated. For his safety and yours, make sure that it’s easy for you to get your loved one out of the tub after his bath.
Undress him gradually. If he uses the toilet before bathing, take the pre-existing opportunity to start undressing him. While he is sitting, remove his clothes that are already partly off first.
Simplify the steps of bathing or showering. Do not rush. Give the person a role in the process, like letting him hold the shampoo bottle or the washcloth. Just be sure the bottle is unbreakable. Use the washcloth to cover his eyes to prevent stinging.
Be gentle in washing the person. Do not scrub if his skin is very sensitive.
Adjust the spray on the shower head so that its pressure is as soft as possible on his skin.
Keep the person’s privacy and dignity in mind.
Use the curtains to let him know you respect his privacy. You may also cover him with a bath towel while undressing. Let him hold a towel in front of his body in and out of the shower if he so prefers it. It would also help if a familiar person of the same gender assists him in bathing.
Dry the person while he is seated. Drying him while he is seated reduces the fear of falling. It’s also safer for you, as well. Do not rub him with the towel. Instead, pat him dry to avoid hurting his sensitive skin. Then, start the dressing process.
Compliment the person on how good he looks and how nice he smells after the bath. You may even offer a reward, like a ride in the car or his favorite food.
If bathing is a constant battle, you don’t have to bathe the person every day. You can give him a sponge bath on the days between bathing.
You may also be interested in towel bathing as another option for giving a bath. Refer to the book Bathing Without a Battle (details in the Recommended Reading section below).