Dementia care strategies for bathing are necessary when a family member refuses to cooperate. Bathing is one of those ADLs that require the most intimacy.
For the person with dementia, getting a bath or shower can be a scary, stressful, even frightening event. The person offering from dementia, in later stages, might misinterpret the act of undressing and the physical touch associated with bathing assistance as an assault.
They may lose the ability to understand even what a bath is and the importance of cleanliness.
Many aging family members may feel uncomfortable with someone helping with such an intimate, private task.They may feel threatened, vulnerable, embarrassed, or simply be reacting to the suddenly cooler environment.
Dementia care strategies to use:
Bathing, as you may have experienced with your family member with dementia, can be the single most stressful and difficult personal care task of all to complete – for both of you.
Follow these tips to help minimize disruptive behaviors during bath time and maximize compliance:
- Make preparations in advance—get wash cloths, towels, and clothing ready and have safety issues addressed beforehand
- Respect his/ her privacy and dignity no matter what their level of comprehension of privacy and dignity is.
- Understand that the elderly do not usually need a shower or bath every day; bathing dries the skin (an especially common condition with older people); why risk confrontation when you don’t have to?
- A daily bath or shower (at least to the appropriate body parts) is necessary if your family member is incontinent on a daily basis
- Bathe the person at a time of day when they are most calm and agreeable
- Be consistent to bathe at the same time of the day
- Give a plausible reason for getting a shower that makes sense to them (i.e., “It’s time to go to work.”)
- Occupy his/her mind when bathing , perhaps by telling a story or singing; ADLs should not be conducted in silence
- When undressing him/her, stand to the side, as opposed to standing in front
- Undress the person slowly
- Approach and follow through with the bath in a calm, nonthreatening way
- Offer frequent praise during the bath/shower (let them feed off your positive emotions)
- Don’t feel or act rushed—if they feel hurried they will be more likely to become agitated
- Be patient and go slowly (however, don’t take too long, as this, also, increases the chance of agitation)
- A sponge or bed bath might be a practical alternative to the more involved (and potentially unnerving) shower or tub bath
- If feasible, promote independence by encouraging them to do as much as possible on their own.
- The best time for a bath or shower is often when your family member is already engaged in a similar activity, such as going to the bathroom
- Know which habits were more successful in the past; is a shower, tub bath, or bed bath most successful? Does they prefer day or night? Are they private or modest? Do they prefer a same sex caregiver, etc.?
- Be alert for signs of being frightened or agitated and work quickly to de-escalate
- Provide for safety (shower chair, non-slip floors, hold onto rails, etc.)
- Verify reasonable water temperature (if too hot or cold for you, it probably is for them as well)
- Utilize the proper number of caregivers; bathing, as with other ADLs, might require more than one caregiver
- Do not shower the face, as this can be frightening and can provoke agitation
- Slowly introduce him/ her into the water, if you are giving a tub bath
- Don’t be confrontational—try again later if he/ she absolutely refuses
If your loved one needs your help with ADLs, you might find it hard not to feel overwhelmed at times. But the experience can be rewarding. Arming yourself with some good principles and ideas can make your job a little easier.