Dementia Care: Bathing Without a Battle

Understanding some common reasons why your aging loved one may be reluctant to bathe — as well as making use of some proven tactics — can help you keep your loved one hygienic and cared for without a fight.

There are a number of reasons why the elderly and those suffering from dementia may avoid bathing. Dementia patients can easily forget how long it’s been since they’ve bathed. And, as their senses weaken, ^[01] they are less able to notice body odor, especially on themselves.

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In addition to practical reasons, your loved one may have emotional reasons for avoiding bathing. Pinpointing your loved one’s specific qualms can help you know which techniques will be most effective at making the process go smoothly.

Fear and discomfort

To many of us who aren’t yet experiencing aging, a refreshing shower is the best way to get ready for a new day. Or, a hot bath can be a good way to relax when a stressful day is over. With this in mind, it may be hard for us to imagine being afraid of bathing.

For seniors, however, bathing can pose some risks. Balance issues and vision trouble make it easy to get disoriented. Wet surfaces can be slippery, and there are a lot of angles and hard surfaces in the bathroom to hit one’s head on.

According to the Cleveland Clinic, aging skin can be more sensitive ^[02] to hot water, high water pressure, and abrasive scrubbing. It’s also tougher for elderly bodies to regulate temperature. Once they’re wet, your family member may get very chilled, making the experience all the more unpleasant.

What you can do:

1. Install safety features. A no-slip shower mat, a few grab bars, and a shower chair can go a long way to helping your loved one feel secure and supported. A hand-held shower head can be helpful for washing and rinsing without your loved one having to maneuver around a slippery shower.
2. Keep the environment warm. You can turn up the heat in the home or put a small space heater in the bathroom. Let the room warm up prior to bath time. You can also place towels on a warmer or over a heat register ahead of time. If neither of those are accessible to you in the bathroom, toss the towels in the dryer, and make sure someone is ready to bring them to you when your loved one has finished bathing.
3. Test the water. The best way to get a good sense of the water temperature is to test it out on the inside of your wrist. Unlike the hands, which get pretty desensitized to temperature, the inside of the wrist is sensitive because of the blood vessels near the surface. This will easily let you know if the water temperature is too hot or too cold. While you’re at it, adjust the water pressure so that it falls in a gentle stream. Pressure that is too high can sting, especially to sensitive skin.
4. Make sure you have what you need. It’s best not to leave your loved one alone when they’re bathing. Not only does it put them at risk of a fall, but the confines of the bathroom may become confusing. Confusion may lead to panic or agitation. Make sure that you have everything you need — towels, a washcloth, soap, etc. — set up and within reach before you start the shower or bath. A shampoo and conditioner two-in-one can help you finish the process in fewer steps.

Boredom and depression

Is your loved one struggling to function in general? Perhaps it’s difficult to get them out of bed and dressed or to convince them to eat or participate in activities. Elderly people are at high risk of depression. This is especially true as their routines become less engaging and tasks grow more challenging. They may also feel that there’s no point in grooming if they have nowhere to be outside of the home.

What you can do:

1. Give them something to look forward to. This can be a lunch with a friend or sibling, a visit from the grandkids, or even an outing to a frozen yogurt shop. It may be difficult to plan an outing if your loved one is housebound, but you can still arrange a small treat as motivation. A healthy, delivered meal can be exciting, and it cuts down on chores — cooking and cleanup. Plus, grooming and generally preparing for something one is looking forward to may help ease depression, and this may make bathing easier. With the right investment and planning, grooming and bathing should become a habit again. It’s important to remember that a treat can also help improve the experience for you as the caregiver. If you both know a nice meal will be waiting for you after bathing, the task may just go by faster.
2. Reframe it. If bathing is seen as a chore, it will feel like a chore — to your loved one as well as to you. Try setting a couple of days a week up as “spa days.” Pick scents that your loved one will like, play soothing music, or incorporate a foot massage or a facial mask. In fact, while you’re at it, you can do a face mask yourself. This way, your loved one doesn’t feel singled out for bathing time, and you get a little self-care in, too. Finish it up with a new shade of nail polish or some nice aftershave.

Embarrassment and lack of control

Needing help is already tough. When you add into the equation that a senior has to be exposed to their son, daughter, or other caregiver, bathing can feel like one of those bad dreams in which we’re naked in public.

What you can do:

Keep them covered. Place a towel over your loved one’s private areas. You can easily bathe behind it without them having to be fully exposed. Make sure you also let your loved one know what you’re doing and check in to make sure they’re ready.

1. Allow them to do as much as they can. Holding on to independence is important as we age. Let your loved one do as much as they can. If they’re still pretty capable but need you there for safety, you can sit in the room and read until they let you know they’re finished or need help. If there isn’t much they’re able to do, give them a washcloth or a loofah to hold. This will help your loved one feel as if they have some control over the task and may keep their hands occupied if they’re inclined to hit.
2. Choose the right person for the task. If you and your loved one are of different sexes, bathing may be even more sensitive. If you can get the help of a family member who is of the same sex, this may help your loved one feel more comfortable. Additionally, choose a family member whom your loved one trusts and has a good relationship with.
3. Choose the right time. If you know that your loved one is prone to sundowning and more easily agitated in the evening, try bathing earlier in the day. If you and your loved one have already had an awful day in which most tasks have been a challenge, try again tomorrow instead. This applies to you as the caregiver as well. If you are feeling especially burnt out and frustrated, it’s okay to wait until you’re in a better headspace or ask someone else to take over. In between baths, a sponge bath and a change of clothes can make a big difference. There are also waterless shampoos and soaps that are designed for those who are hospitalized or otherwise unable to bathe regularly. These may be helpful to have on hand for days when bathing is just not a manageable option.
4. Stick with what’s familiar. If your loved one has taken baths for the past several decades, now is not the time to try to get them accustomed to showers. Try to add safety features to an already familiar bathing routine. You can use shallower water and a low shower chair to make getting up from the bath easier.

It’s likely that it’s more than just one objection that’s making bathing an obstacle for your loved one. A combination of these tips may help streamline the process.

No matter what techniques you find helpful, make sure to be gentle. Blot with a washcloth instead of scrubbing. Do the same with the towel when it’s time to dry off. Use a gentle lotion on sensitive areas that are prone to drying out, such as elbows, hands, legs, and feet. Use gentle tones when bringing up bathing and when giving instructions during the bath.

Talk with a Senior Living Advisor

As your loved one’s dementia progresses, bathing them yourself may become more difficult. If it gets to a point where nothing is working, even with the best of efforts, it may be time to hire a professional home health aide to take over with grooming a few times per week.

If caring for your loved one with dementia becomes unmanageable even with in-home support, it may be time to consider memory care. A Senior Living Advisor at A Place For Mom can help you find a range of resources to suit your loved one’s needs.