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Dementia Bathing - How to Bathe Someone with Dementia

For caregivers and family members, bathing someone with Alzheimer’s or Dementia can be one of the most difficult caregiving tasks. Bathing becomes even more difficult, particularly if the Alzheimers is severe or late-stage. Starting at Stage 5 of Alzheimer’s, peoples may need more help with typical, daily activities. This may lead to substantial confusion and people may have trouble bathing themselves and dressing themselves.

You May Not Have to Bathe Every Day - Cultural Differences Exist for peoples with Alzheimer’s

Surprisingly to some, not everyone is used to bathing everyday. Dermatologists actually say that you don’t have to shower everyday, and in fact, in doing so, you may be doing more harm than good. It’s a well-known fact that we over bathe in this country and bathing everyday may dry out the skin and hair. Our skin also has helpful and useful bacteria and by bathing everyday, we remove this bacteria.

Cultural differences may also contribute to bathing routines. Some people may have grown up bathing everyday, for others, once or twice a week may have been sufficient. Particularly on farms and in the country, some may have grown up learning that water is precious and that bathing everyday is wasteful. It’s important to understand these cultural differences and know that it may not be necessary to bathe the person everyday.

Bathing is crucial. It can help to prevent skin diseases, rashes and muscle pain. Consult with the person’s physician to find the ideal amount of times the person should be bathing.

Bathing People with Alzheimer’s Can be Very Difficult

There is no way around this. It can be difficult. Period. People with late-stage Alzheimer’s may require full care and caring for someone who has lost their independence can be very difficult for both the caregiver and the person. The loss of independence also leads to a loss of privacy which can be challenging for both the caregiver or family member and the person.

First, always prepare properly by making the bathroom safe to start. Bath safety is crucial. Start by removing the lock from the bathroom door. Installing grab bars in the bathroom and shower area are a must. A hand-held shower attachment can be very helpful to allow the person to have a role in the bathing process. A shower chair or stool can be very important as well. Non-slip mats outside of the tub help the person with traction and avoid slipping. A stepping stool is also a great addition to make it easier to get in and out of the tub. Always put away all electronics including hair dryers and electric toothbrushes. A shower curtain and some music can also be helpful to add privacy and set an inviting mood.  

Make sure to use hot water. Not scalding hot but hot enough that the person will be comfortable and warm. Test the water first before you put the person underneath it.

People with Alzheimer’s may be confused about why they are even showering in the first place. This may be lead to screaming and kicking. It’s important to try to decipher why the person is upset - is it because the water is cold and he/she is uncomfortable or perhaps he/she does not understand why bathing is necessary in the first place? It may even be the sound of the water. This is where providing a distraction comes in.  

The dignity of the person is very important and may also be difficult to deal with. Disrobing can be embarrassing for the person. Consider draping a towel across the waste to cover the private parts. Being naked, in the bath or shower, may make them feel uncomfortable, particularly in the presence of someone they do not know or even a family member. It may be easier and even appropriate to let the person get into the bath with his/her clothes on and undress once in the bath.

Coach the person through each step and provide constant encouragement. Tell him/her about how clean he/she is and how good the person smells great. Show the person exactly how to do each step and let the person mimic your actions.

I Already Had a Bath and I am Clean

This is a common response in late-stage Alzheimer’s. The person may think that he/she had a bath already, when in actuality, that bath may have been last week. If you cannot get the person into the bath, try again later. Persistance is key.

It may be important to associate the bath with a fun activity - such as going out for a walk, to a park or to dinner. Consider telling the person that you will be going out to lunch and that is why he/she needs to take a bath.

Sometimes the person can be so resistant to a bath because the Alzheimer’s is so severe that a sponge bath may be a better bet. Always be flexible and react to the situation.

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