Just Do The Next Indicated Thing
Although it sounds reasonable to us to say, Its time to get ready, its likely too vague for a cognitively impaired person. Instead, focus only on the next indicated thing that needs to happen.
I need you to put on your shoes now, is concrete and specific. Still, depending on where your parent or partner is in the disease process, you may need to back up a step and start with, I need you to sit down now, before moving on to putting on shoes.
Most care partners are anxious at the thought of making it out the door. They worry about their parent or partners reaction to finding out a doctor appointment is on deck. I suggest a simple, Lets go for a ride. What comes after that? Ill give you several ideas in the Do what works section below.
Energy is contagious, so if youre feeling anxious, it will catch. Instead, stay focused only on whatever the next indicated thing isnot the thing after the next thing. Stay present in this moment to keep your own anxiety at bay.
Use The Right Bathing Aids And Products To Maximize Comfort
Specially designed senior bathing aids and products can be a game changer as well. For example, if you can still get a loved one in the shower, but they arent steady on their feet or tire easily, there are many types of shower chairs available. This is a wise choice for anyone who is getting older, because it can significantly decrease the risk of falling in the shower. A hand-held shower head can be useful for bathing a loved one who is afraid of or overwhelmed by water. It allows them to direct the stream only where they want it and when. Grab bars are another must-have for those who are afraid of falling. Simply having extra points of support can help a senior navigate getting into and out of the shower safely and confidently.
Use Their Doctor As A Resource
In some cases, a loved ones doctor can be a powerful ally. For example, a doctor can help determine if depression is a factor and whether antidepressants may lift their spirits and give them more energy, thereby helping to resolve the self-care issue. A renewed interest in life may make a senior more aware of needing to shower/bathe and wear clean clothes. Medical professionals can also rule out other factors that may be affecting their ability and/or willingness to care for themselves and recommend next steps. Keep in mind that our elders often place doctors on a pedestal and may take their official recommendations more seriously than a family members pleading and nagging.
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Hire A Bath Aide To Help
While hiring a personal care aide to come in and help my mother-in-law bathe wasnt totally successful, these bathing visits are a blessing for many families. Most seniors are wholly opposed to the idea at first, but for some, having a stranger assist them is less embarrassing than having a son or daughter do it. Furthermore, in-home caregivers are trained to help people of all physical and cognitive abilities. They know how to knock a shower or bath out quickly, thoroughly and respectfully, all while taking a clients comfort into consideration. Its true that some home care companies are better than others about consistently sending the same bath aides, which is why it is important to do your research before hiring.
Some More Tips & Tools For Getting Your Loved One To Bathe
Give them choices
Rather than instructions, begin a conversation by asking whether theyd like to bathe or shower? Try giving them the option of bathing right away or after having their breakfast or watching their favorite TV program.
Study their reaction
When you take your loved one to the bathroom, fill the tub with 2-3 inches of wateror turn on the showerand wait for their reaction. If they become agitated, drop the idea of bathing them that day. If, however, they seem comfortable, fill in more water after theyve gotten in.
A soothing distraction
Patients suffering from Alzheimers can find bathing threatening. Sometimes, planning a distraction ahead of timesomething as simple as soothing musiccan calm them down.
Respect their privacy
While helping our loved ones bathe, respect their privacy and keep them covered with a towel or robe. Be flexible and understanding. If a parent wants to get into the tub with their clothes on, let them. The goal is to get them involved in the experience. When theyre engaged, they will enjoy bath time.
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Human Environment: Good Communication Skills
Another effective tool for successful bathing is the use of good communication skills, which includes gaining eye contact, speaking clearly and slowly, using familiar terms, repeating and reminding as needed, using effective expressions and gestures, and observing the persons body language for comprehension and comfort. When speaking to the person, say the important words last, as people are more likely to remember the last word. Break up activities into simple steps and give only one or two instructions at a time. For example, say here is the soap, please wash your hands. Then say, here is a washcloth, use the washcloth to wash your arms, as you hand each item to the person. Adapt your instructions based on the functional and cognitive levels of the person, remembering that these levels may fluctuate, so try and keep reasonable expectations for performance. Plan the activity to allow the person to succeed by simplifying the steps to fit her or his remaining abilities.
Sing To Aid Communication
We would help her walk to the wet room, and singing on the way encouraged her.
This would generally be something like Lets go for a shower, a shower, a shower.. to the tune of Theres a hole in my bucket, or left foot, right foot 1 2 3. to the tune of Lou Lou skip to my Lou.
She understood this better than the spoken word.
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How To Inspire A Dementia Patient To Shower
This blog post may be of interest to those struggling to get someone with dementia to shower.
Many in the Alzheimers community will know of Bob DeMarco, who cared for his mother with AD. This July 2017 article is from Bobs website, The Alzheimers Reading Room. Of course the suggestions offered apply to all types of dementia, not just Alzheimers. The full text is copied below.
Theres also an 11-minute podcast, which is basically Bob reading this article. On the YouTube page of the podcast, Bob lists several resources that deepen the content of the podcast/article. Ive copied below those additional resources.
How to Inspire a Dementia Patient to ShowerThe Alzheimers Reading RoomBy Bob DeMarcoJuly 17, 2017
Getting an Alzheimers patient to shower can be difficult. In order to accomplish this mission you will need to learn how to be a guide, how to use bright light, and how to use positive reinforcement.
Thousands of caregivers and dementia professionals have used these techniques and they work.
My mother usually resisted when I asked her to take a shower for years. When she occasionally said something other than NO, I looked to the heavens as if it was a reward.
It took me quite a long time to figure out what to do and how to properly motivate my mom so she would take the shower without resistance.
1. Constant positive reinforcement about the positive effects of being clean.
Put it this way bright light, bright mom.
How To Support A Person With Dementia To Wash Bathe And Shower
Practical tips on topics including aids and equipment, skincare and nails, handwashing and dental care, washing, drying and styling hair, hair removal, and using the toilet.
Supporting a person with washing and dressing
For example, consider installing taps that are easy to use and clearly marked hot and cold. If the person with dementia can more easily find and use taps for themselves, they may be able to continue with tasks without too much help from you.
What Safety Measures Should Be Taken When Bathing Someone With Dementia
Firstly, its important never leave such a care recipient alone in the shower. This top-of-the-list recommendation by the National Institute on Aging highlights one of the greatest difficulties faced by dementia sufferers: a lack of privacy. While it stands to reason that they shouldnt be left alone, the intrusiveness of bath time can often cause an individual to want to avoid bathing altogether.
Another major reason for a dementia sufferer to refuse to bathe is because he/she may be under the impression that bathing isnt necessary. Its important to remember that dementia is a disease of the brain and, oftentimes, sufferers do or say things that appear out of place, unfounded and even silly. Its important to be able to sensitively manage a care recipients thoughts and feelings.
Poor personal hygiene is an incredibly common symptom of Alzheimers disease and other types of dementia, says Carol Bradley Bursack on AgingCare.com, Conditions that cause cognitive impairment are often accompanied by depression, difficult behavioral changes, sensitivity to stimuli and an inability to keep track of time. When these things combine, it can cause a loved one to refuse to bathe or mistakenly think that they have already bathed for days, weeks or months on end.
How Should You Behave
One of the things that people find hardest to adjust to is having to take on the role of carer for someone who in the past was perhaps a parent or partner. Not surprisingly, the dynamic changes when youre having to help with undressing and washing.
The key is to act with dignity and kindness. Think about how you would like to be treated if you were in the same position. You need to combine being efficient at washing with making them feel comfortable. Rushing through the process in an overly brisk manner might seem like the best option, but if the person youre bathing feels hurried, they could become upset. Keep up a light-hearted conversation if that help to keep the tone relaxed, even if its just talk about the weather or directions on how to sit or stand.
If the person youre bathing is self-conscious, think about ways that you can help them to undress or wash so that they dont feel embarrassed. This might involve using a dressing gown or towel to change behind, or covering areas of the body that youre not currently washing so they dont feel exposed.
But What About Preventative Stuff
Finally, it depends on what type of appointment. Begin with the end in mind when it comes to specialty appointments and testing. Im not in any way saying people living with dementia deserve anything less in the way of care than anyone else.
What I am saying is theyre typically more medically fragile , and thats something that deserves consideration. Think carefully about routine mammograms, Pap smears, colonoscopies, and the like.
Strategies For Towel Or Sponge Baths
In a towel or sponge bath, a caregiver uses a basin of soapy water and a towel or sponge to carefully wash the person, who may be sitting or lying down. Usually after the body has been soaped and gently scrubbed, the soap is rinsed or wiped off. A small hair-washing basin can be used to thoroughly rinse hair after shampooing. Using tear-free soaps/shampoos can be more comfortable for the person .
Soaps and shampoos should be carefully rinsed off, as these can dry and irritate the skin if not removed. Because thoroughly rinsing off the soap can be difficult, there are soap and shampoo products that do not require a rinse process. Such soaps and shampoos can be applied, and the excess wiped off without rinsing.
During the bath, be patient and reassuring. Try to maintain the persons modesty by covering the parts of the body that are not being washed. For example, if you are washing one arm, cover the rest of the body with a bath blanket, towel, sheet, or robe.
Additionally, towel or sponge baths can be broken up into smaller components that may be more manageable for the care recipient or caregiver. For example, the arms and upper body may be washed one day. The following day, the lower body, legs and feet can be washed. And on another day, the hair can be shampooed. The caregiver should try to be flexible about what the care recipient is able or willing to do that day.
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Your Parent May Simply Be Exhausted
I read on one forum, that for one elderly gentleman a bath was the equivalent, for him, in shear physical effort, as a full gym workout had been for him in his younger days.
And I know that my mom is very often saying she is exhausted before she even starts the day.
If your loved one is predominantly sedentary, and really is not getting much exercise, it is very likely that they have poorer circulation than if they were more active, and will have less energy than someone who is still maintaining a greater degree of physical activity.
Establish A Weekly Routine
I read on the Alzheimer Association website they suggest that having a routine for bathing would be a good idea. I agree it would and we do this with our kids. We simple say, time for your shower to our kids and they trot right into the bathroom and get clean.
Now, this might work for your loved one, and what makes giving advice about Alzheimers so hard! The way they said this so happy like, I thought that would be great. We would just get into a routine of every other day or every third day and BAM, good to go! This did not work for my Mom at all. She honestly couldn’t give a crap about what day it is and that it was time for her bird bath or shower.
That said, because Alzheimer and dementia patients; live so much in the past, if they grew up with a Saturday Bath routine you might be able to get them to wash up every Saturday pretty easily!
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Wet Rooms Makes Life Easier
I cant recommend a wet room enough. It doesnt have to be huge. Ours was the size of a small downstairs loo.
It avoids issues of stepping into showers or climbing into baths. Any accidents can just be washed away with the shower head.
There are no worries about getting water everywhere, and there is no need for a bath mat, which can be disturbing for some people with dementia.
A heated non-slip floor is cozy and helps the less sure footed, and, when the time comes, a shower commode can still be taken in.
Related TinT Resource:
Bathing Dressing And Grooming: Alzheimer’s Caregiving Tips
At some point, people with Alzheimers disease will need help bathing, combing their hair, brushing their teeth, and getting dressed. Because these are private activities, people may not want help. They may feel embarrassed about being naked in front of caregivers. They also may feel angry about not being able to care for themselves. These suggestions may help with everyday care.
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Fear Of Falling In The Bathroom
Fear of falling can be another reason that your loved one is seemingly reluctant to bathe, especially if they are less sure of their footing and their balance when stepping into, and out of tubs and showers.
I have written a long article, full of practical ideas, tips and products, which will greatly improve your loved ones safety in the bathroom, and cut down on the risk of falling. You can find my article here.
Here are a few of those tips which you can use to convince your loved one to bathe.
Why Do Alzheimers Patients Stop Bathing
It can help you as a caregiver to understand the feelings and experiences of someone with Alzheimers. Many people who have it will stop bathing themselves completely. Why does this happen? Alzheimers and other dementias can cause people to find bathing disagreeable. This is because of some of the experiences they are going through, such as:
- A loss of remembrance on the purpose of bathing
- Sensitivity to water and air temperature when undressed
- Sensitivity to water pressure
Also, the person can have trouble with depending on someone else, a lack of privacy and having enough patience to get through the bathing process.
When does this happen? Its common for people to bathe less during stage 5 of dementia. During stage 6, they tend to stop bathing when they no longer understand the need.;
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Managing Resistance To Undressing
Here are some strategies to try if the person resists undressing for the bath or shower. First, try giving the person a reason to take off their clothes. For example, tell the person that it is laundry day and the clothes need to be washed or cleaned. You can also try scheduling the bath or shower for when the person has to change clothes anyway, such as in the morning when pajamas need to be removed. Try cueing the undressing, or gently assist with starting the undressing process. The person may get it and continue by himself, as sometimes the body remembers what the brain does not. You can also have the person undress in small steps while bathing. For example, keep the shirt on while washing the legs and cover the lower body when removing trousers or washing the upper body. You may also need to consider letting the person enter the bath or shower while still dressed. The person will likely disrobe when the clothes become wet and uncomfortable. Overall, try to limit the amount of time the person needs to be undressed.