Bathing can be one of the activities of daily living that is most affected by dementia. There are many steps in the process of bathing which can seem very difficult for the person with dementia. Additionally, it is likely the person doesn’t remember the reason for bathing and it seems like an unnecessary intrusion into their day.
Resistance to bathing often escalates when someone tries to help. Getting undressed in front of another person is challenging for most people. So imagine what it’s like for someone who doesn’t understand what’s going on. Fortunately, there are things you can do to make the process easier.
Preparing the Space
First, prepare the bathroom in advance. Make sure it’s warm enough. If your loved one is taking a bath, fill the tub beforehand, using only two to three inches of water. Use familiar soaps and shampoos and have your loved one smell them as they get ready to bathe. Use some nice-smelling bubble bath and play some soft music. Make the bathroom familiar to them with a favorite bathrobe, towels or a picture they always had hanging in their bathroom. These can make a bath seem like a treat instead of a chore and can trigger the memory of needing to bathe.
Make sure the room is as safe as possible, with no slippery floors. Use nonskid mats in the tub or shower and make sure any rugs have nonskid backing. Once the bathroom is ready, let your loved one know in a soft, gentle voice. If your loved one does best when given choices, try this approach: “Would you like to take a bath or shower?” “Would you like to bathe now or in 15 minutes?”
When getting ready for their bath, let your loved one do as much as possible on their own. This will increase their feelings of independence and comfort and trigger their long-term memories. In the early stages of dementia, a simple reminder to bathe may be all that’s needed. As the disease progresses, however, you may need to verbally cue them through each step. Eventually, you may have to help them undress. When helping the person undress, wrap a towel around them for both privacy and warmth. If the resistance to removing clothing becomes extreme, allow the person to keep their clothes on. Once in the tub or shower, the heaviness may cause them to remove clothing on their own.
Taking the Plunge
Once in the bath, again, let the person do as much as they can on their own. Coach them one step at a time: Put your feet in the tub. Sit down. Take the soap. Wash your arm. Help them by providing tactile clues such as touching the body part they should wash. If they are unable to wash themselves, give them a role, such as holding a washcloth or shampoo bottle. Be gentle, as their skin might be sensitive. Check all areas of the body for redness, sores and rashes. If you notice any of these things, seek immediate health care attention.
After the bath, have them sit down and place a towel or robe over their shoulders while you use another towel to dry them off. Pat the skin dry as opposed to rubbing. Give them a word of encouragement for having successfully completed a task. Saying “Now doesn’t that feel better?” will reinforce the idea that bathing is a pleasant activity.
Finally, try to set a regular schedule for bathing, so it becomes part of your loved one’s routine. If they become used to bathing at a certain time every day, they will become less resistant to it.