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COPING STRATEGIES
PROBLEMS WITH BATHING
A dislike of bathing is not uncommon at some point in the course of Alzheimer's Disease. There may be days when bathing is not a problem and others when it is a major challenge. Here are some suggestions for those challenging days.
There may be specific physiological, psychological or environmental causes that help to explain the difficulties (these are explored elsewhere). Whether you figure out a specific reason for the problem or not, there are changes you can try to make the process easier and more pleasant.
Establish a routine
- choose a time of day when the person is most relaxed and responsive or that fits in with the person's bathing routine prior to illness
- prepare the bath ahead of time and lay out the soap, wash cloth, shampoo and towels.
- separate hair washing from bath time if washing hair is part of the problem.
Create a pleasant and safe environment
- make sure that the bathroom is comfortably warm
- make sure that the bathroom has good lighting
- create a sense of privacy by closing the door and blinds or curtains
- check the water level; some people can only tolerate shallow water
- colour the water with bubble bath to make it easier to judge the depth of water.
- if using a non-slip rubber mat avoid a very dark coloured mat which could give the
impression of a hole
- place a towel or a strip of coloured tape on the bathtub to distinguish the edge
- try playing some favourite soothing music
- always supervise bathing and assist the person in and out of the tub
- install a railing to make getting in and out of the tub easier
- use a tub chair and shower hose if getting into the tub is a problem
- avoid bath oil that makes the tub or shower slippery.
Use all your communication skills to try to make bathing a positive experience
- use a calm matter-of-fact tone and simply announce that the bath is ready; avoid getting involved in debates about the necessity of taking a bath
- let the person feel the water; sometimes gently pouring some of the water over the person's hands can reassure them that it is not too hot
- simplify the task by giving one instruction at a time and gently talking the person through each step, using visual cues like handing the person the soap
- respect the need for modesty; if necessary, allow the person to bathe in underwear or wrapped in a towel
- allow the individual to do as much of the bathing as is possible.
Use tricks and distraction where necessary and effective
- try marking a chart or calendar to indicate when baths are taken; this can be used to show the person that it has been a number of days since the last bath
- try having the doctor write bathing instructions on a prescription pad or official paper
- offer a reward like favourite food or an outing; having something to look forward to can shift the focus from the immediate task
- if the the routine response to a bath is an automatic refusal, take the person into the bathroom before saying it is time for a bath
- if you are doing the washing of the body, make sure the person's hands are occupied by giving them a wash cloth.
Look after yourself
- encourage baths rather than showers if a person can get in and out of the tub; they are safer and easier for the carer to manage
- try not to get nervous or frustrated if the person objects to taking a bath; sometimes it may be best to wait and try another time
- accept that it may not be necessary to have a full bath every day; sponge baths may suffice sometimes
- arrange to have another person with whom the person feels comfortable, to help with bathing; agencies like Blue Nurses and St Lukes may prove helpful
- talk to other caregivers who have faced the same challenge.
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