Dementia Care Strategies for Bathing

Bathing can be a difficult and stressful task for those with dementia. Learn tips and strategies for making the process easier, including respecting privacy and dignity, understanding daily needs, and promoting independence.

Dementia Care Strategies for Bathing
Bathing dementia patients

Dementia care strategies for bathing are necessary. When a family member refuses to cooperate. Bathing is one of those ADLs that require the most intimacy.

For the person with dementia, getting a bath or shower. Can be a scary, stressful and even frightening event.  In later stages of dementia, they may misinterpret the act of undressing and the physical touch associated with bathing help... as an assault.

They may lose the ability to understand even what a bath is and the importance of cleanliness.

Many aging family members ... may feel uncomfortable with someone helping... with such an intimate and private task. . They may feel threatened, vulnerable, embarrassed. Or simply be reacting to the cooler environment.

How often should dementia patients Shower? 

Dementia care strategies to use:

Bathing can be the single most stressful and difficult personal care task of all to complete. For both of you.

Follow these tips to help cut disruptive behaviors and maximize compliance during bathing process:

  • Make preparations in advance. Get washcloths, towels, and clothing ready and have safety issues addressed beforehand
  • Respect his/ her privacy and dignity. No matter what their level of comprehension of privacy and dignity is.
  • Understand that the elderly do not need a bath or shower everyday. Bathing dries the skin (an especially common condition with older people. Why risk confrontation when you don’t have to?
  • A daily bath or shower (at least to the appropriate body parts) is necessary. If your family member is incontinent on a daily basis, that may entail using soap and water to clean. A sponge bath may be in order if your family member is uncooperative.  Remember, aging skin is dry. Twice a week shower or bath  would be  sufficient.  If this is not possible, wash intimate parts when they toilet. Help them wash their face and hands by offering a warm washcloth, or a basin of water to soak their hands an feet when they are sitting down.
  • Bathe the person at a time of day when they are most calm and agreeable
  • Be consistent to bathe at the same time of the day
  • Give a plausible reason for getting a shower that makes sense to them (i.e., “It’s time to go to work.”)
  • Occupy his/her mind when bathing. Perhaps by telling a story or singing; ADLs should not be conducted in silence
  • When undressing him/her, stand to the side, as opposed to standing in front
  • Undress the person slowly
  • Approach and follow through with the bath in a calm, nonthreatening way
  • Offer frequent praise during the bath/shower. Let them feed off your positive emotions.
  • Don’t feel or act rushed—if they feel hurried they  will be more likely to become agitated
  • Be patient and go slowly (don’t take too long, as this, also, increases the chance of agitation)
  • A sponge or bed bath might be a practical alternative. The more involved shower or tub bath may cause unwanted behaviors.
  • If feasible, promote independence by encouraging them to do as much as possible on their own.
  • The best time for a bath or shower is often when your family member is already engaged in a similar activity. Such as going to the bathroom
  • Know which habits were more successful in the past; is a shower, tub bath, or bed bath most successful? Does they prefer day or night?  Are they private or modest? Do they prefer a same sex caregiver, etc.?
  • Be alert for signs of being frightened or agitated and work quickly to de-escalate
  • Provide for safety (shower chair, non-slip floors, hold onto rails, etc.)
  • Verify reasonable water temperature (if too hot or cold for you, it probably is for them as well)
  • Utilize the proper number of caregiver. Bathing, as with other ADLs, might need more than one caregiver
  • Do not shower the face, as this can be frightening and can provoke agitation Use a hand held shower head to rinse hair easily. Be willing to use dry shampoo to do a person's hair of they are fearful of water.
  • Slowly introduce him/ her into the water, if you are giving a tub bath
  • Don't be confrontational—try again later if he/ she absolutely refuses
Your hands tell me a story
Sometimes a sponge bath has to suffice

If your loved one needs your help with ADLs, you might find it hard not to feel overwhelmed at times. But the experience can be rewarding. Arming yourself with some good principles and ideas can make your job a little easier.

Bathing a person with dementia can be challenging. Chose your battles wisely. If they continue to refuse a bath or shower, you will have to accept that a sponge bath, done in bits and pieces, throughout the day may have to suffice for a while.

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