The bathroom is an especially sensitive topic for older people with dementia. People with dementia are easily confused and often misunderstand what others are doing and saying. In such individuals, often even the smallest thing that is unpleasant, such as water in the eyes or ears, can cause the individual to respond with fear or violence.
A guide to bathing without battle:
Focus on the person rather than the task.
Try to satisfy individual preferences and focus on the well-being of the person. Always protect the privacy and dignity of the person (such as covering the person with a towel after turning off the water and in transfers)
Be flexible!
Modify your approach to meet the person’s needs. Methods such as singing and talking to the individual while bathing can distract them from the fear, anxiety, or embarrassment of being bathed by another person. Be flexible with the procedure by dividing tasks like washing your hair and washing your body.
Use persuasion, not coercion.
Help the person feel in control at bath time. Give options and respond to individual requests. Avoid asking “Do you want to take a bath?” when you know the answer will be “no”. Instead, say something like “It’s time for your spa, would you like a body wash or bar of soap? Would you like to wear the green and tan or the blue suit?” Use a calm and supportive approach and praise the person frequently. Ask questions that are not infuriating or have perhaps two or three answers. Sometimes questions with endless possibilities can overwhelm a person with dementia, such as “what do you want to wear?” Try to reduce the question to 2 or 3 possibilities.
To be prepared!
Gather everything you will need to bathe before approaching the person. Warm the room (no one has a good experience bathing when it is cold and wet). Have towels, washcloths, and clothing ready. If necessary, securely place a shower chair and bath mat in place. All these little preparations can help the person feel comfortable and relaxed.
Stop.
When a person is distressed, stop and assess the situation. It is not “normal” for a person to cry, complain, or fight while bathing. Look for an underlying reason for your behavior. What can you do to keep the person from getting more angry? If you cannot calm the person, you will need to shorten the bath. In such a case, wash only what is necessary for good health. If the person becomes overly distressed or aggressive, the bathroom will need to be interrupted. Try ending with something nice like offering a cup of coffee or a back rub. This can make it easier when you return. Reprimand the person later to finish washing critical areas if necessary.
Ask for help.
Talking to other people about ways to meet the person’s needs gives you an opportunity to find different ways to help make the bathroom more comfortable. Whether it’s talking to your family or other caregivers or medical professionals who have dealt with the person, these conversations can only help give you a clearer understanding of their personal likes and dislikes.
Their loss of privacy, independence, and possibly dignity can be difficult for the individual with dementia to understand. There are many factors to consider when it comes to bathing, which most caregivers would agree is one of the most challenging aspects of dementia and self-care.
For more information on great tips on how to bathe older residents with the disease, see the Alzheimer’s Association page on Dementia Baths. To find a variety of dementia care homes in your area that are registered with the CQC, visit TrustedCare.co.uk