Mike and Linda.
Linda had always taken pride in her appearance. During her thirty-plus-year career, she always showed up at the office freshly showered, with her hair styled, and her nails done.
Some years after Linda’s retirement, her husband, Mike, noticed that she wasn’t taking care of her appearance like she always had. He thought it was because she was no longer working with the public and just didn’t have to be as well groomed. A couple of times Mike thought he smelled body odor radiating from her, but he didn’t want to be rude, or embarrass her, so he said nothing, but it became more and more apparent that Linda was neglecting her appearance and her hygiene. One day, Linda’s hair looked dirty, as had become her habit. Mike noticed she had a piece of caramel corn stuck in it. They had enjoyed the caramel corn and a movie the night before. He wanted to say something but just wasn’t sure how to approach the subject, as Linda had been rather forgetful and a little cranky lately. He figured she had something on her mind, and he didn’t want to offend her. When the caramel corn was still there the next day, Mike tried to gently ask her about her recent bathing habits.
“I shower every day,” she snapped, then stomped off in a huff.
Mike stood there speechless, not sure what to do next.
A few months later Linda was diagnosed with a disease that was causing dementia. Mike resolved to learn everything he could about the disease, as well as how to cope with and manage some of the behaviors Linda was exhibiting, including her increasing reluctance to bathe.
You and Your Person.
Perhaps you’ve noticed that the hygiene of the person with dementia you care for is not what it used to be. Maybe their hair is uncombed or dirty or they have a distinctive odor, indicating that they have not been bathing regularly, though when questioned, they insist they just took a bathe.
Or perhaps when you have suggested a shower or tried to assist your person with bathing, they’ve become resistant, argumentative or even downright hostile.
This may be puzzling to you. In the past (pre-disease) your person always bathed regularly, and always took pride in the way he or she looked. In addition, a lack of bathing can not only cause offensive odors, but skin breakdown and discomfort for the person as well.
A decrease of personal hygiene can be caused by your person’s memory loss – they don’t remember when they last bathed. Or they don’t remember what they’re supposed to do. Perhaps they’re embarrassed, fearful, or confused. These feelings could turn to anger and resistance. Sometimes people try to hide an incontinence issue – which can be very embarrassing – by refusing to bathe.
Here are some tips to consider when trying to help your person with bathing:
Provide privacy. When you assist a person with personal care such as showering or bathing, bear in mind this is very personal, intimate and private, and not typically a “shared activity.” Bathroom tasks can trigger feelings of shame, humiliation, vulnerability, and anxiety. Most adults are not accustomed to being undressed in front of a stranger or family member. These are stressful situations, so be sure to close the door, and pull the window shades. You may want to cover the mirrors if they are having difficulty recognizing themselves – they may think someone else is in the room with them. Allow them to wear a t-shirt or underwear into the shower to reduce feeling vulnerable or shy and provide a washcloth or sponge for them to hold.
Make bath time as enjoyable as possible. Choose the best time of day. Try to match their former bathing routine, but also keep in mind the time of day your person is most relaxed. Make sure the room is warm and well lit, especially in the evening hours.
One caregiver turned the bathroom into a “spa” with relaxing music, warm towels and a gentle massage with scented lotion on bath day to help encourage her mother to bathe.
Another woman hired a male caregiver for bathing her father. The clever caregiver helped the man “get ready for the game” and followed up the shower with a pre-recorded baseball game starring the man’s favorite team. The two “fans” wore baseball shirts and enjoyed (root)beer and hot dogs for lunch while cheering for the team.
A husband would sing old songs, love songs, and funny songs to his wife while he quickly but thoroughly helped her bathe. She loved hearing him sing but because he didn’t think he had a good singing voice, he rarely did so. This husband said his solos began one day when once again his wife absolutely refused to bathe, and he was trying to cajole her into the shower. His vocals worked almost all of the time, he reported.
Allow your person to do as much as possible for as long as possible, but be ready to help as needed. As the disease that causes dementia progresses you will need to provide more and more assistance.
Encourage them. Some people with dementia may have a changed sense of hot or cold or may feel a different sensation from water than they used to, so after you’ve tested the temperature, let them feel the water before getting in to it. “Doesn’t that feel nice?” you might ask.
Make it easy. Break down the tasks into small simple steps. Have things prepared and laid out for them in advance.
Be Respectful. Make sure to explain each step as you go. As you are washing one body part keep the other body parts covered. Consider sponge-baths in between shower or bath days. Usually bathing two or three times a week is all that is needed unless there are incontinence issues
Always keep your person’s safety in mind. Use bathroom aids such as a hand-held showerhead. Make sure there is a rubber bath mat and safety bars in the tub. Use a sturdy shower chair to support a person who is unsteady and to prevent falls. Never leave a confused or frail person alone in the tub or shower. Always check the water level and temperature before your person gets in the tub or shower. Make sure there are no puddles on the bathroom floor.
Be flexible. There are ways to make bathing easier and more comfortable — however, each situation is unique, and finding what works is often the result of trial and error. Plan extra time for bathing. Watch for signs of distress or increased resistance. Don’t argue. Slow down or stop the activity if needed.
If you have questions, comments, or have caregiving topics you would like to see on this blog site, please send an e-mail to caregivers@upcap.org.
Until next time, pidä huolta itsestäsi!
Disclaimer: This blog exists to provide general information, not specific professional advice. No content on this site should be used as a substitute for direct medical advice from your physician or other qualified clinician. No products are endorsed on this blog.
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