Bath Time Battles

shower

by Joan Blumenfeld, MS, LPC

My client, Betty, could no longer bathe herself.  A mild stroke had left her unsteady on her feet and unable to use her right hand.  Betty also suffered from mild dementia which made it difficult for her to process all the steps needed to shower on her own.  For safety’s sake she had to have an aide assist her with bathing but she loathed the lack of privacy.

So Betty fussed.  She argued and yelled.  She refused to get undressed or enter the bathroom.  Although she eventually submitted to being showered — most of the time, anyway — it was an all-out war that exhausted both Betty and her caregiver.

We never knew exactly why Betty got so agitated over such a seemingly routine matter.  Perhaps it was a general sense that she was losing control over so many aspects of her life.  Perhaps it was the lack or regard for her own privacy.  Maybe she just had an irrational fear of water.

Regardless, Betty had to bathe.  So her aide and I devised a Care Plan that made the showering experience more comfortable and less of a threat.

We revised our own attitudes regarding the necessity of daily bathing.  In many countries bathing once or twice a week is deemed sufficient.  So we cut back the number of times Betty needed to shower to just twice a week, with sponge baths given in-between.  This simple step greatly reduced the opportunity for bathing battles.

Then we changed the way we communicated with Betty about bathing.  Because of her dementia, the success of activities depended on breaking down communications into short, concrete steps.  To elicit her cooperation in the bathing process, clear one-step instructions such as “Take off your shoes” or “Now unbutton your shirt” were more effective than generalized instructions to “get ready for a shower.”

Here are 10 other tips we followed to provide a more relaxed, less confrontational atmosphere for Betty’s shower time:

  1. Go slow. Do not rush her.
  2. Use a hand held shower for better control of the spray.
  3. Use a bath chair to avoid fatigue.
  4. Keep the bathroom warm.
  5. Keep water out of her face.
  6. Let Betty wash as much of herself as she wants to and is able.
  7. Have soap, shampoo, towel and washcloth out and ready to use.
  8. Use a large, soft bath sheet (in her favorite color), for warmth and comfort.
  9. Have her favorite body powder or after bath lotion ready in advance.
  10. When Betty is resistant, approach showering at another time of day.

Final pearl of wisdom:  Bathing can be a battleground for people with dementia.  Be creative and flexible in your approach.  Find more good ideas for easier personal care at www.alz.org.

Joan Blumenfeld, MS, LPC is a Geriatric Care Manager based in Fairfield County, Connecticut. For information visit joanblumenfeld.com. © Joan Blumenfeld 2011.



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