Helpful Hints for Handling Refusals: Bathing

Many family caregivers encounter issues with bathing. The first issue is frequency. Many older adults came from a time period where they sponged off most days and had a full immersed bath once or twice a week. Also, frequent bathing can dry out older skin and cause itching. Unless there is an incontinence problem, if bathing is a battle it may be better to wash at the sink and invoke the reality of the “Saturday night bath.”

Make sure the bathroom is warm and not drafty. Have all of the supplies and towels in reach. Again, have the person with dementia perform as much of the washing as she or he can. Some couples shower together. I’ve even had some daughters shower with mom and sons with dads. Do whatever works. Some of my families have had good success with turning the shower/bath into a “spa” experience, especially with women. They use scented candles, extra fluffy towels, music, and special soaps. Just make sure if you go this route, you don’t create a fire or fall hazard with slippery oils.

For situations where your family member needs more help, a shower chair or bar may be necessary to prevent falls. Start by spraying the feet and working up towards the neck. Save washing the hair for last, or save hair washing for the hair salon. It may be helpful to let the person hold and control the shower wand; this is an example where hand-over-hand may prevent the water from going all over the place but allow the person with dementia to feel in control.

Sometimes, covering the person with towels and removing a towel at a time, washing that body part, then putting the towel back, may reduce care resistance for 2 reasons: modesty and warmth. I’ve given many showers in my time and while I may be sweating profusely, the person I was showering was shivering.

As mentioned in previous blogs, allow the person with dementia to complete as much of the bath/shower as possible. For people with dementia who do not want help, you may want to offer to “wash your back” or “help with the feet.” Think about it. I would feel OK about someone helping me to wash my back or wash my feet, and I would accept that help. No way would I want someone trying to wash more intimate areas, that would freak me out!! If your loved one needs that level of help, and they are refusing it, you can use the hand-over-hand technique mentioned in some of the other blogs.

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