For caregivers of people with dementia, bathing challenges often top the list of things that make their job difficult. The person they’re caring for might not believe that they need a shower or bath –they might think that they just took one. They might be resentful of someone else telling them what to do. They could be uncomfortable getting naked in front of the person caring for them. Or perhaps they’re afraid of water, of the possibility of falling, of being cold, of the sound made by the bathroom fan.
Here are some tips to make bathing more enjoyable for everyone involved.
Unless a person is incontinent it’s unlikely that they need to bathe every day. Twice, or even once a week might be enough. While not perfect, a good-enough solution can be to use non-rinse cleaning products between showers and baths for a person who continues to be resistant.
And if they are incontinent, do they need a full shower or bath, or might it work instead to just wash their private areas, perhaps while they sit on the toilet? Consider installing an after market bidet to help with daily cleaning of private areas. Some bidets even include a warmed, lighted toilet seat, that makes toileting more inviting, and the toilet easier to find at night.
Being naked can make people feel vulnerable. It’s okay to allow someone to wear undergarments in the shower, or bathe with a towel wrapped securely around them.
Think about your own bathing preferences. Are you a person who showers in the morning or just before bed? Do you prefer a bath or a shower? Do you start by washing your hair or do you save that for last? Knowing and respecting a person’s routines can make all the difference in a bathing experience that is successful or a struggle.
When you have a routine that works, stick with it. If there is a white board where you record each day’s activities, it might work to add bathtime to the schedule so the person knows when to expect it.
Make sure the bathroom is warm. A general rule of thumb is that if you’re not sweating while helping the person bathe, the bathroom is probably too cold. Have all of your bathing supplies at the ready so you don’t need to pause the action. Pump containers for shampoo and body wash allow for one-handed access, and a shampoo with built in conditioner means just one rinse.
Be prepared, too, for things to go poorly. Breaking into song, or pausing for a cookie break, or simply cutting the shower short are all options if bathing is simply not working today.
Telling someone that they need to bathe can cause resistance. Instead, you might ask whether now would be a good time to bathe or would a different time be better. Would they prefer a bath or a shower? Are there several shampoos or soaps that they can choose from? You could allow them to smell each and choose their favorite. Would they prefer the blue towel or the brown one? These choices may sound silly, but including the person in decisions about the process can improve the experience for everyone.
Allow the person to be involved in the bathing process itself whenever possible to enhance dignity and promote independence. Can they use the hand-held shower head to rinse their own toes? If given a soapy washcloth, can they wash their own armpits and private areas?
“Guess what Mom – it’s spa time!” might go over better than, “Mom. Let’s get you into the shower.”
One fall in the bath is enough to create resistance for a long, long time. Grab bars are a great idea. So are non-skid mats, and a bath chair, or a stool. Make sure you continue checking the water temperature throughout the shower. And if you are helping with a bath instead of a shower, it could help to have the person sit when there are just a few inches of water in the tub, then continue adding water till the depth is just right.
When bathtime is over, it could be helpful to have the person sit while you pat them dry. Patting is better than rubbing for fragile skin. Have a fresh change of clothes in the bathroom to avoid getting chilled walking from the bathroom to the bedroom, wrapped in just a towel.
If a person is grabby, give them wash cloths or squishy toys to hold, to keep their hands busy. Make sure that you have enough time set aside to ensure that the bath is a positive experience for both of you.
And if you’re starting to feel high anxiety around bathtime or you are afraid that bathing the person you care for is putting theirs, or your own, safety at risk, it may be time to find another solution. Is there someone who can help you? Or, can a professional caregiver come in once or twice a week for bathtime?
Thanks for all you do to help the person you’re caring for be clean and healthy. They are so lucky to have you.
Take good care!
