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Bathing
The
brain is extraordinarily complex. It is made up of several
distinct parts, each with its own function. While these
parts are separate, they must work together to complete
the simplest task. As Alzheimer's disease affects each
area of the brain, certain functions or abilities can
be lost. One link in the chain of events may be missing
and the person will need help or a coping mechanism to
complete the task. It is important for caregivers to
remember that changes in a person's behaviour may be
related to the disease process.
Where
to begin
A
dislike of bathing is not uncommon for some people with
Alzheimer's disease. A once peaceful, relaxing activity
may be fraught with tension and fear. Start by exploring
possible reasons for the person's behaviour.
Consider
the person
- Does
the person have the flu or an infection? Is he/she depressed
and therefore losing interest in personal hygiene?
- Is
the person afraid of stepping into the tub due to his/her
inability to judge where the edge is or how deep the
tub is?
- Does
the person have a fear of bathing as a result of a
childhood incident, e.g., near drowning or other unpleasant
experience?
- Is
there a change in routine? Did the person usually take
a shower or a bath, once a week or every day, in the
morning or in the evening?
- Is
the routine of washing forgotten? Does the person remember
what the bathtub is for?
- Is
the person uncomfortable with you assisting?
- Are
you uncomfortable with your role? Your discomfort may
be showing and influencing the person with Alzheimer's disease.
- Does
the person need to wear glasses or a hearing aid to
help with communication? NOTE: If you leave the hearing
aid in, watch the amount of water getting into the
ear. You may need to remove the hearing aid if you
are washing the person's hair. Keep the person busy
with washing and then take out the hearing aid when
it is time to wash their hair. Or, use shampoos that
don't require water as suggested under the heading "What
to try" below.
Consider
the environment
- Is
the temperature of the room and water appropriate?
- Is
there privacy?
- Is
it easy for the person to get in and out of the tub
or shower (e.g., are there hand rails)?
- Are
you rushed?
What
to try
Whether
you discover a specific reason for the person's unease,
you can try to make the activity easier and more pleasant.
Here are some suggestions that might help:
- Make
the bathroom warm and inviting by playing favourite
music and providing adequate lighting.
- Make
bathing a positive experience by praising the person's
accomplishments.
- Pull
the blinds down and close the door to create a sense
of privacy.
- Prepare
the bath ahead of time: lay out the soap, wash cloth,
shampoo, towels and have the water in the tub.
- Use
coloured bubble bath or a coloured bath mat to make
it easier to judge the depth of water (avoid a very
dark coloured mat -- it could give the impression of
a hole).
- Simplify
the task by giving one instruction at a time.
- Allow
the person to do as much of the washing as possible.
- Respect
the need for modesty: allow the person to bathe in
underwear or a bathing suit or wrapped in a towel.
- Separate
hair washing from bath time, if washing hair is part
of the problem. Try shampoos that don't require water.
- Lay
a towel or a strip of coloured tape on the tub to distinguish
the edge.
- Make
sure the person's hands are occupied by providing a
wash cloth.
- If
the person regularly refuses to take a bath, escort
him/her to the bathroom before raising the subject.
- Try
a sponge bath at the sink. This might work if the person
has mobility problems.
- Arrange
to have another individual, with whom the person with
Alzheimer's disease is comfortable, help with bathing.
- Talk
to other caregivers who have faced the same challenge.
For
safety's sake
- Install
a railing in the tub to make getting in and out easier.
- Use
a tub chair and shower hose if getting into the tub
is a problem.
- Use
a non-skid bath mat in the bottom of the tub or shower.
- Avoid
bath oil that makes the tub or shower slippery.
- Assist
the person in and out of the tub.
- Always
supervise bathing.
Day
to day
On
some days these ideas will make bathing easier. On others
you may decide that a sponge bath will be sufficient
or even that no bath is best. It's true most of us like
to bathe or shower often and prefer that the person we
are caring for does as well. It is important to remember
that you are doing the best you can.
In
addition
We
are learning more about Alzheimer's disease and its care
everyday -- much of it from caregivers like yourself
who find solutions to problems and share them with others.
You can call your local
Alzheimer Society to find resources in your community.
You can also exchange ideas by visiting the Forums.
There is information. There is help. You are not alone.
Resources:
- The
Alzheimer Journey, Module 4, Understanding Alzheimer Disease: The link between brain and behaviour,
video and workbook series, the Alzheimer Society of
Canada, 2002.
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