09.18.07
Dementia and Bathing
Bathing is a particular sensitive issue for persons with dementia. Those with dementia become confused easily and often misinterpret what others are doing and saying. In such individuals, often even the smallest thing that is unpleasent such as water in the eyes or ears can make the individual respond with fear or violence.
A guideline for bathing without a battle:
-Focus on the person more than the task.
Try to meet individual preferences and focus on the well-being of the person. Always protect the persons privacy and dignity (such as covering the person with a towel after turning off the water and in transfers)
-Be flexible!
Modify your approach to meet the persons needs. Methods such as singing and talking with the individual while bathing can distract him or her from the fear, anxiety or shame of being bathed by someone else. Be flexible with the procedure divide up tasks such as washing hair and washing the body.
-Use persuasion,not coercion.
Help the person feel in control at bathing time. Give choices and respond to individual requests. Avoid asking “Do you want to take a bath?” when you know that the answer will be “no”. Instead say something like”It’s time for your spa, would you like body wash or a bar of soap? Would you like to wear the green and tan outfit or the blue one?” Use a supportive and calm approach and praise the person often. Ask questions that are not exasperating or that have maybe two or three answers. Sometimes questions with endless possibilities can overwhelm a person with dementia such as “what do you want to wear?” narrow the question down to 2 or 3 possibilities.
-Be prepared!
Gather everything that you will need for bathing before approaching the person. Warm the room (no one has a good expeirence bathing when they are cold and wet). Have towels, washcloths, and clothes ready. Get shower chair and bath mat securely in place.
-Stop.
When a person becomes distressed, stop and assess the situation. It is not “normal” for a person to cry moan, or fight during bathing. Look for underlying reason for the behavior. What can you do to prevent the person from becoming more upset? If you are unable to calm the person you will need to shorten the bath. In such a case wash only what is necessary for good health. If the person becomes too distressed or aggressive you will need to end the bath. Try to end with something pleasant such as offering a cup of coffee or a back rub. This may make it easier when you return. Reproach the person later to finish washing critical areas if necessary.
-Ask for help.
Talking with others about ways to meet the needs of the person gives you an opportunity to find different ways to help make the bath more comfortable.
