Bathing

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When a person with Alzheimer's disease (AD) resists help, caregivers may find themselves becoming short tempered and impatient. Maintain realistic goals and remain flexible. Strive for a level of cleanliness that will prevent skin breakdown and offensive odors. Avoid arguments and power struggles. If a problem starts, back off and try again. Instead of trying to convince the diagnosed person, simply ask and assist him/her to begin the first step. For example, "let's take off your shoes now." Use the person's good time of day, and use a family member of whichever sex the person with AD feels more comfortable. One may need to enlist the help of a niece, grandson or in-home attendant. Break down tasks into simple steps, and give instructions for one step at a time. For example: place the washcloth in the person's hand if you want him/her to wash his/her face. It may be necessary to instruct each step of the way with words or gestures. Bubble bath may make the tub more acceptable. Some persons with AD will accept sitting in the tub on a shower chair, and being sponged. A hand held shower nozzle, in the tub, may be less frightening than being immersed in water. It may be necessary to introduce the person to the nozzle gently each time it is used, by spraying it in the tub, then on his hands, and so forth. Never try to force a shower or tub bath at the risk of injury to the diagnosed person or yourself. Use sink, towel and sponge bath rather than struggle. Always check to be sure the water is not too cold nor too hot. Explain gently and assure the person that the temperature is correct. For the tub, maintain a low water level. Be sure there is adequate light, especially for the shower. Hook up a spot light. Be sure you have adequate grab bars available, safety strips in place and inexpensive, indoor-outdoor carpet works well on the floor to avoid slippage. Be sure the bathroom is extra warm. Use of a supplemental heater can provide the needed extra warmth. Be sure that all soap dishes, towel bars, and hand rails are secure to hold the person's pulling power. The promise of rewards may encourage cooperation with bathing (e.g. seeing family, favorite food or an outing). Try distracting the person with conversation or make bathing a game. Try bathing together. Many spouses have found this really works very well. Let the person with AD do as much as possible. Only assist when necessary. If he/she is incapable then you must do it all. Try to be as efficient as possible but do not give the impression of haste or of carelessness. Lift under the armpits. Do not try to stand the person erect by pulling on his/her arms. When the patient is sitting, use your hand and arm as a back rest. The person with AD will feel reassured and more secure if you keep your hand or arm on them. Never request the diagnosed person to stand on one foot while bathing the other. Tighten faucets so that the person with AD cannot manipulate them while bathing. Use soap that is easy to hold in the hand and has a distinctive color, thus making it easy to find in the water. Medical soaps with pleasant scents are readily available. Use gentle washing pressure. Wash one extremity at a time. Some caregivers have found that washing feet first and working upward works well. Use tearless baby shampoo and if necessary camouflage it in another container. If normal hair washing is too difficult, try using dry shampoo. Call in a professional hairdresser or barber for wash and set, manicures, pedicures, leg and hand oil massages. Many professional shops can arrange to provide these services at home. Keep hair styles simple and short. A hand held dryer is many times preferable to the hooded machines found in beauty shops. Use electric shavers for facial and body hair. Remember to apply skin preparation oil or lotion to prevent shower burn. When toweling, lightly massage muscles to stimulate the person's circulation. Remember that your goal is to keep the diagnosed person reasonably neat and clean. Don't become obsessed with the necessity of perfect hygiene. The world won't collapse if baths are missed occasionally or if you can't accomplish every item of the routine every time. When all else fails, bathe the daignosed person and try to ignore protests and anger. Then do something that you both find enjoyable. If you cannot cope with a difficult personal hygiene situation or if the person with AD absolutely will not allow you to care for him/her, then stop. Wait a day or so and try again. Home | Who We Are | Volunteer | Membership | What's New | Calendar of Events | Links | About Alzheimer's | Programs & Services | Search Last updated: September 23, 1997 © 1997, 1998 & 1999 Alzheimer's Association, Northern Virginia Chapter. All rights reserved.