Carole Larkin, a geriatric care manager for ThirdAge Services, knows that many caregivers want to “pull their hair out” when giving baths to Alzheimer’s patients. While some people with Alzheimer’s disease don’t mind bathing, it can be a frightening, confusing experience for others. But there are certain strategies caregivers can use to minimize frustration for both patient and caregiver.
“Doctors recommend older adults shower or bathe a minimum of twice a week to reduce the chance of infection, especially urinary tract infections in women,” says Larkin, who trains caregivers in home care companies, nursing homes and memory care communities. “If you can get them to bathe more, kudos to you. If not, be satisfied with twice a week, unless another medical condition demands more frequent bathing.”
Larkin offers these tips to help caregivers overcome the ordeals of bathing:
- Make it seem as if the request is just a routine part of daily life as in, “It’s Tuesday morning. We always take our bath on Tuesday morning. Let’s go get cleaned up, and then I’ll make you a nice breakfast.”
- Follow up on the positive reinforcements so that your loved one gets rewarded for complying. Doing this as part of a regular routine ingrains the behavior you want replicated. It might take some practice, but it can be done. Always praise and compliment them after the bathing is done.
- If there is no other way to get them to bathe, ask their doctor to write on a prescription pad something like: “Mr. So-and-So needs to bathe two times a week for infection control.” Make several copies of the prescription (in case they tear it up). Show the prescription to them and say, “Doctor’s orders.”
- Some people are extremely modest. Be aware that this may be their reason for saying “NO.” Respect their dignity by allowing them to cover up with something while in the shower. Perhaps a towel or a sheet or even a poncho. Just wash under whatever they use to cover up.
Caregivers should involve the patient in the bathing process. Larkin suggests that caregivers have the patient try to wash themselves first, no matter how well they do. That gives them ownership of the task and something they can succeed at.
“If they can do a credible job on their own with just reminders from you to wash here and there, let them do that,” she says. “Even if all they can do is hold a washcloth while you do everything else, let them do that. At least they are participating in the task as much as they can.”
The same goes for hair washing and drying.
“Allow them to do as much as they can, even if you have to go back over what they have done,” she says.
Above all else, caregivers must remember that safety comes first. “There need to be grab bars positioned for them to hold onto, while getting in and while bathing,” she says. “And there need to be appliqués on the shower or tub floor to give them traction under their feet.”
If the patient is unsteady on his or her feet, caregivers should feel free to use a shower chair. Not only can it help calm a fearful patient, the chair gives the caregiver a steady place for the patient to sit while being washed. See some of Larkin’s other ideas and tips about Alzheimer’s caregiving at www.alzheimersreadingroom.com.
The National Institute on Aging (NIA) suggests that advance planning can help make bath time better for both the caregiver and the Alzheimer’s patient:
Plan the bath or shower for the time of day when the person is most calm and agreeable. Be consistent. Try to develop a routine.
- Respect the fact that bathing is scary and uncomfortable for some people with Alzheimer’s. Be gentle and respectful. Be patient and calm.
- Tell the person what you are going to do, step by step, and allow him or her to do as much as possible.
- Prepare in advance. Make sure you have everything you need ready and in the bathroom before beginning. Draw the bath ahead of time.
- Be sensitive to the temperature. Warm up the room beforehand, if necessary, and keep extra towels and a robe nearby. Test the water temperature before beginning the bath or shower.
- Minimize safety risks by using a handheld shower head, shower bench, grab bars and nonskid bath mats. Never leave the person alone in the bath or shower.
- Try a sponge bath. Bathing may not be necessary every day. A sponge bath can be effective between showers or baths.