Caregiving and dementia: tips for ‘bath time’

COVID-19 is compelling all of society, including caregivers, to adjust. One of these adjustments may be the need to provide a whole new and unexpected care task- bathing and personal care.  This may be because of a hospital discharge, redeployment of your support worker or even a temporary move of Mom or Dad to your home. These strategies and tips may help make ‘bath time’ a (more) pleasant experience for both of you!

When caring for a parent with dementia, one of the most common challenges is the bath (or shower) time. While some people with dementia do not mind bathing, others will not tolerate it well. I will share some of the bathing episodes I experienced with my Mom as she lived with her dementia.

It’s Saturday…

In the early days of Mom’s dementia, it was easier to have her agree to take a bath. All her life she was a creature of habit and bathed on Saturdays. It was now getting to the point where Mom needed more than one bath a week. So yes, she continued to bathe on Saturdays but now on Wednesdays as well. With her short-term memory and immediate recall affected by the dementia, I was able to get her to bathe on Wednesdays with little or no issues. How? Come Wednesdays I would simply say: “Hey Mom, it’s Saturday, time for your bath.” Easy peasy, bathing done twice a week.

A Spa for Maw

I enjoyed making Mom’s bathroom feel more like a spa than her bathroom. I made sure I had everything ready ahead of time such as shampoo, a chair to sit on when getting dressed and clothes to put on afterwards. To set the tone, I played soft music and lit a scented candle. After the bath, out came the plush towels warmed in the dryer. “Ooooh that feels so good” Mom would coo contentedly as I wrapped the towels around her body.  The “spa” experience ended with a gentle back rub followed by a warm cup tea. The best part of all? A huge hug!

Give Mom some space!

On one occasion, Mom insisted she already HAD her shower. I knew for a FACT that she hadn’t and I made a huge fuss by arguing with her. The more I pushed, the more she dug in her heels. We even started raising our voices with one another. Quickly I realized I was the one who needed to step back and calm down- butting heads only made matters worse. Eventually I gave her some much needed space and re-approached in a gentler manner. With my changed attitude, she became more receptive and cooperative.

If you do reach a stalemate over the bath issue, this may be one situation where you choose to walk away and leave it for another day.

 What’s the heck is Mom trying to tell me? What exactly am I supposed to do?

As Mom’s dementia progressed, she often experienced fear and reluctance to take a bath or shower. I tried to understand where Mom was coming from and see things from her perspective. What was she trying to tell me? Believe me, I tried different and creative ways to help her. And yes, some failed, especially if I was frustrated. Usually, if I tried again at another time and/or with a different approach, there was more success. Here’s what I learned:

  • Did Mom know what I was saying to her? If I used something like “OK Mom, we’re gonna get ready for the day”; she would just look at me in a puzzled way. The expression “get ready for the day” was still familiar to me but not to her. Those words were vague and no longer made any sense. She responded better to concrete words and specific instructions like: “We need to wash your hands and face Mom.”
  • What were Mom’s fears? Fear of bathing may be related to a number of things such as fear of the water (depth, temperature, water pressure), fear of embarrassment, fear of being cold, fear of being naked and without clothes, not knowing the next step in a bathing sequence, too much happening at the same time. For Mom, she was terrified of falling. To ensure she felt safe and secure in the tub, I used a non-slip mat and installed grab bars. Mom also sat on a bath chair, easier for both washing and drying plus lowered her risk of falling.
  • Refuses tub or shower, now what? This is where you go with the flow.
    • Consider a sponge bath at the sink (I washed Mom up while she was sitting on the toilet seat) or a even bed bath in the comfort of her own room.
    • My nurse friend recommended a no-rinse soap and no rinse shampoo, this was a great idea. Using these products shortened both the bathing time and Mom’s anxiety.
    • Focus on one body part at a time throughout the week. Mom would have a foot soak on Monday, I’d wash her hair on Tuesday, back washed on Wednesday at bedtime etc. With cueing and monitoring, Mom was also encouraged to do things for herself–wash her hands and face plus her own private areas to preserve her dignity. Tip: Be consistent. When helping a person bathe, as much as possible, stick to a routine at the same time of day, using the same person and same steps.
    • Yes it may feel awkward at first, but you do what you need to do. Heck, once I even jumped in the shower with Mom and gave her a top to toe wash.

Once the  COVID 19 curve starts to flatten, I do encourage you to contact your local community support services and seek help for bathing and personal care. I know over the long haul I could not do it alone. Interesting though, when it came to an intimate task like bathing, Mom responded better to the home support staff than she did to me. Go figure.

Please share with us your own bath/shower time experiences or tips.

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