Bathing (for dementia)

By Family Caregiver Alliance

People with dementia are often resistant to bathing. They will claim they just showered, or that they will do it later, or outright refuse to bathe. Unless someone is incontinent, daily bathing is not necessary. Pick your battles—once or twice a week may be sufficient. Coupling bathing with an activity is sometimes helpful, e.g. going to the doctor or out to lunch or having a bowl of ice cream.
If someone is used to a shower, don’t try to convert him/her to a bath and if used to a bath, don’t start giving showers. A sponge bath during the week at the sink may be sufficient, if supervised by you. Use non-rinse soap products to make the process easier.
Allow person to get into the bathtub with only a little water in it, and fill it up after he/she is comfortable. If using a bathtub, be sure you feel comfortable in getting the person out of the bathtub at the end of the bath.
Fear of bathing may be related to a number of factors such as fear of falling, fear of the water, fear of being cold, loss of dignity in being naked in front of you, or feeling vulnerable in the coldness of a bathroom.
Make sure the bathroom is warm to initiate bathing. Have everything ready ahead of time, such as towels, shampoo, a chair to sit on when dressing, and clothes to put on after bathing. Consider a towel warmer and towel blanket to wrap the person in after bathing.
Use a pre-existing opportunity to start undressing, such as when someone is sitting on the toilet and has clothes partly off anyway. Or in the morning when changing out of sleeping clothes. However, sometimes you will be more successful if you wait until the afternoon when you might not have other things to do and you can approach bathing in a slower, calmer manner.
Install grab bars, non-skid mats, a shower bench, handheld shower head, or bath stool to reassure the person you are bathing, to make your job easier, and to allow for greater safety and independence.
Use shampoo/conditioner combinations so as to only have to rinse the hair once. Liquid soap can make it easier to apply soap and only needs one hand to apply.
Allow your loved one to do as much as possible for himself/herself. This increases dignity and independence. Giving step-by-step instructions can help. Any way you can provide privacy will help.
Adjust the water temperature. Someone with dementia may not sense whether the water is too hot or too cold. Monitor the temperature throughout the bathing process.
If the person you are bathing becomes agitated, have soothing music, sing a song together, or interact in a way so as to distract him/her from the fear. Even offering a favorite cookie can be a distraction.
Adjust shower pressure so it is as soft as possible. People with dementia might feel the “sting” of shower water as a threat.
Dry the person while they are seated so as to reduce fear of falling in the person as well as yourself. Pat dry instead of rubbing to protect delicate skin. From this position, it will be easier to start the dressing process.