One common thing caregivers begin to experience as their loved one with dementia begins to decline is often a refusal to bathe. The person with dementia may have been someone who cared very much about hygiene in the past, but now you might find that they are either forgetting or refusing to bathe themselves, creating some challenging situations. There are a multitude of reasons they may be refusing, and an even larger amount of tactics caregivers can use to help keep their loved one’s hygiene under control.
Why might someone refuse to bathe?
As dementia progresses, the parts of the brain that interpret our senses becomes affected. Someone with dementia might interpret the water pressure on their skin as being painful, or they may have difficulty regulating the water temperature in the shower or bath. People with dementia might also have some fears about bathing. Examples of this could be fear of falling or the fear of being naked and vulnerable in front of someone, particularly if this person has experienced sexual harassment or abuse in their past. People with dementia might forget that they have to bathe, think they already bathed, or have a hard time understanding what it means to bathe or why they need to. It is important to remember that these are only a few reasons someone might have a difficult time with hygiene upkeep. Oftentimes, a caregiver’s solution is directly tied to the reason the person is refusing or forgetting!
What can caregivers do?
The caregiver approach to each challenging situation can have a significant impact on the outcome. How a caregiver approaches the topic of a shower or bath could affect how the person with dementia responds. Instead of saying, “Come on, mom, it’s time to take a shower,” you might try saying something like, “Hey mom, I know you work hard and I’d like to treat you to a spa day. Let’s go pick out some soap you like, I’ve already got the bathroom warmed up for you!” Sometimes the scents in the room can help someone relax or reminisce. For example, try using a soap with lavender, warm vanilla, or any other scent you know that brings your loved one joy or calms them.
You might also consider changing the set-up of the shower to make it more comfortable and safer for your loved one. To start with safety, you might add grab bars in the shower, use a shower chair/bench, or use a waterproof grip tape on the floor of the tub or shower to prevent falls. This alone could help the person with dementia feel more comfortable. Another great tool is a hand-held shower head. This allows the person with dementia to bathe seated and allows for more control over where the water is being sprayed. You can avoid the head and eye area if it causes discomfort and the person with dementia could also feel a sense of control and involvement in their own bathing.
Of course there is never a “tried and true” or “black and white” solution that will work every time. It is most important to know your loved one and how they might react when implementing changes in their hygiene. Remember that the reasons for refusal and the caregiver techniques are vast and wide – much more than can fit in just this article!
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