"My daughter just refuses to take a bath now. . .it's such a struggle to keep her clean. She was always very meticulous about how she looked before and now it's a fight to get her in the tub."
Assisting a person with dementia in taking a bath or shower can often be the most challenging task of a caregiver's week. Bathing can be a frightening, complicated and overwhelming task for many people in the middle and late stages of Alzheimer's disease.
There are a number of reasons why this activity can be so stressful. One is the vulnerability the person with dementia may feel when another person takes his or her clothes off. Another is the sudden change in temperature that takes place when the person enters the bath water or shower. Perhaps the person feels out of control and misunderstands the purpose of bathing. Perhaps, when a caregiver says, "It's time for you to take a shower," the person with dementia may think that he or she has already taken one.
In addition, the person with dementia may resist or deny needing any help. One key principle to follow in caring for people with dementia is to try meet the person at his or her level of reality. Experienced caregivers know that trying to force someone with dementiab into rational, here-and-now reality often causes confusion and agitation. How can bathing be accomplished with the greatest success for both the person with the disease and the caregiver?
Here are some strategies:
* Try to follow as many of the person's old routines as possible (morning vs evening: bath vs shower)
* Simplify tasks and try to do one step at a time. (e.g. run water, towels ready, undress, etc.)
* Allow as much independence as possible. Remember to respect the patient's privacy and sense of dignity.
* Try to be as calm and gentle as possible. Try not to rush or force the person through the task. Talk them through, if needed.
* Adjust your expectations. A bath may not be necessary every day, though it is important to keep the person clean. If the person is incontinent, it will be especially important to keep the genital and buttocks area clean to promote good health.
* Be flexible and creative. A spongebath can serve the same purpose as a bath or shower, but may be more acceptable to the person, because they can remain partially covered.
* Work toward a safe and inviting environment - be sure the room is warm, that the water is a comfortable temperature, and that the tub is equipped with a non-slick surface and a grab bar. Have all necessary items already in place so you do not have to leave the person unattended. Do not leave hair dryers or razors within reach of a confused person.
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