Avoid battles over bathtime
Bathing is a constant struggle for many caregivers of seniors with Alzheimer’s disease, dementia, or other cognitive impairments.
It’s important to keep your older adult’s body clean to prevent skin infections, reduce the risk of urinary tract infections, and avoid unpleasant body odor.
But trying to get them to take a bath or shower often results in arguments, hostility, crying, or screaming. That ruins everyone’s day and skyrockets your stress level.
So what can you do when someone with dementia refuses to shower?
Here are 8 tips from DailyCaring to help you overcome their resistance to bathing. Experiment to find out which of these works best for your older adult.
8 tips to get someone with dementia to shower or bathe
1. Establish a daily routine
Even if older adults don’t need to bathe every day, it’s often easier to establish a regular daily routine that includes bathing at the same time every day.
That way there’s no question about when or why it’s happening – it’s just part of the normal flow of their day, like eating or sleeping.
A predictable daily routine reduces their overall stress and anxiety and makes it more likely that they’ll bathe without resistance.
2. Use positive reinforcement and don’t argue
Don’t try to argue with your older adult about how many days it’s been since their last shower, how stinky they are, or why good hygiene is important.
Logic and reason don’t work. Instead, keep sentences short and simple and focus on the positive, fun activities that come after the bath.
For example, when the bathroom is warm enough, go over to your older adult, make eye contact, and smile. Extend your hand so they’ll take it, get up, and let you escort them as they walk (toward the bathroom).
After they’ve started walking, say something like “Let’s go shower now and then we’ll have a yummy snack (cookies, juice, etc.) and do something fun.”
As you walk, keep the conversation focused on the snack or fun activity to avoid discussing or arguing about the shower. “Those chocolate chip cookies are your favorite, aren’t they? And we can put together that puzzle with the beautiful birds.”
If you consistently take this type of approach, taking a shower becomes associated with positive things like their favorite snack or activity.
If they refuse to bathe and start to argue, drop the subject and move on to something pleasant. This avoids a fight that will create negative feelings that often linger. Wait and try again in a little while.
3. Say “we” not “you”
During the entire bathing experience, it’s helpful to use a calm, soothing tone and say “we” instead of “you.”
This gives the feeling that you’re doing this relaxing activity together, they’re not going through it alone, and scary things won’t be done to them.
4. Make the bathroom warm and comfortable
Older adults feel cold much more easily than someone younger. Seniors often don’t like to bathe because all they remember is being cold and shivering.
Making the bathing experience pleasant and comfortable will reduce objections before and during the shower.
5-10 minutes before they enter the bathroom, turn on a space heater to make the bathroom nice and warm. If you get hot and sweaty, that’s probably a good temperature.
Lay a towel on the chair or toilet seat where they sit to take off their clothes so it won’t feel cold and hard.
You might even want to play soft, soothing music to create a serene, spa-like atmosphere.
5. Reduce effort and help them feel safe and relaxed
Using a shower bench or chair significantly reduces the effort needed to take a shower since they won’t need to stand and balance while soaping and rinsing.
A shower transfer bench allows them to slide into the tub or shower area while staying safely seated the whole time. Some benches (like this one) even have rails that allow you to slide the seat from outside to inside, eliminating the need to scoot.
A shower chair would require them to step into the shower or bath before they can sit down.
6. Use a hand-held shower head to reduce fear
The overhead spray of a shower can be terrifying to a person with dementia.
Some experts think this happens because they can’t see the water that’s hitting them and it feels like something invisible is attacking their head.
To solve this problem, install a hand-held shower head instead of a regular one so you can control when and where the water touches them.
Before turning on the water, get them seated in the shower chair. Then, with the shower head at feet-level and pointing away from them, turn on the water and adjust the temperature.
When the water is warm, say “Let’s put our hands (or feet) in the water now” and slowly start spraying water on those body parts to give them time to adjust to the feeling and let you know if the temperature is right for them.
If the loud sound of the water bothers them, don’t turn the taps on all the way so the spray won’t be as strong.
Or, minimize the time the water is on by using a simple shut-off valve so you can easily turn the water on and off while soaping up.
7. Make sure there are no surprises or guesswork needed
Bathing takes so many steps, it’s no wonder that it’s overwhelming for a person with Alzheimer’s or dementia.
But even if your older adult doesn’t know what to do next, they’ll likely still remember how to do it.
At every step, let them know what’s going to happen and coach them through it so they can do as much as possible on their own.
Give them some time to do things on their own, but be ready to provide gentle assistance when needed.
This gives them control and improves self-confidence. Plus, if they know what’s going to happen at every step, they won’t be as scared or anxious.
For example, you could say “Let’s rub the soap on your arm now. That’s great. Now we’ll rinse the soap away with the water.”
8. Use extra towels for comfort and warmth
While showering, some people might like to use a towel to cover body parts that aren’t currently being washed. (The towel will get wet and that’s ok.)
Help them stay comfortable by keeping the wet towel warm with occasional sprays of water.
After bathing, immediately wrap them in two large, dry towels (front and back) to keep them from getting chilled.
This can be done while they’re still sitting on the shower chair. Getting them mostly dry before moving them out of the tub also helps to keep them warm.