Try: Possible causes physiological or medical problems o depression or other physical illness can cause a loss of interest in physical hygiene o damage in the region of the hypothalamus can change the sense of perception of hot and cold water temperature o low vision may make it difficult for the older adult to see the bathtub or shower environmental causes o poor lighting o lack of privacy o room temperature is too cold o water is too deep o water is too hot or cold; other causes o fear of falling o fear of water or of being hurt by it o disruption in daily routine or schedule o unfamiliar caregivers o the task involved in taking a bath is too overwhelming o the purpose of taking a bath forgotten o the humiliation of being reminded to take a bath o agitated from an upsetting situation such as an argument with caregiver o feeling of being rushed by caregiver o feeling embarrassed and vulnerable about being naked or having another person in the bathroom o fatigue o fear of hair washing which is no longer understood o person kept waiting too long while caregiver prepares bath o fear of soap washcloth south of running water etc coping strategies ; evaluate the best time of day to bathing be consistent and routine try asking the older adult when he she would like to take a bath e g ‘would you like to take a bath or shower " or "would you like to take a bath now or before going to bed " of course the option depends on the mobility of the individual a sponge bath might actually be the best option try using a bath chart or calendar to indicate when baths were last taken you might point to the chart to show the older adult that it is time to take a bath try a reward system such as favorite food or activity to encourage the older adult to bathe; make sure the bathroom is warm enough and inviting let the older adult touch the water before getting into the tub try pulling down the blinds or close curtains and doors to create a feeling of privacy; provide adequate lighting in bathroom especially during evening hours; try bathing instructions written by a doctor on a prescription pad e g bath 2 to 3 times daily; prepare bath ahead of time check the water level and temperature some older adults will tolerate only one inch of water in the tub; lay out soap washcloth towel and clean clothes in sequence so that the person with dementia won’t have to wait; use a quiet calm matter-of-fact approach e g ‘mother your bathwater is ready; avoid getting into lengthy discussions about whether a bath is needed simplify the task of bathing by instructing the older adult one step at a time what to do to get ready for the bath; if the older adult becomes agitated or frustrated or you become agitated or frustrated it may be helpful to try again later; try separating hair washing from bathing some people with dementia associate bathing with having their hair washed and become terribly upset because water being poured over their head frightens them try taking the older adult to a salon to have their hair washed while in a chair or was hair in the kitchen sink try dry shampoo if necessary web address; to avoid rashes or infection be sure that all parts of the body are cleansed including genitals this is a good time too to check for decubitus ulcers or pressure sores as well as red areas or other sores if any are found call the physician also check fingernails and toenails and trim them if necessary after the bath shower; try giving the older adult a washcloth to hold onto for distraction while bathing; try placing a towel around the shoulders of the older adult held securely with a clothespin if he she is embarrassed about being undressed; try playing soft music in the background to create a calming and relaxing atmosphere persistent body odor might want to include this another fact sheet since it deals with internal bacterias or infection making the bathroom and older adult safe ; try adjusting the temperature on the water heater so that the water is not scalding between 120 and 130 degrees f the older adult may have an altered sense of hot and cold adjust the water to his her comfort; do not every leave the older adult alone in the tub or shower; remove the locks from the bathroom door; use plastic instead of glass containers in the bathtub; make sure hairdryers electric razors and other electrical appliances are out of reach; use non-slip bathmats on the floor on the outside of the bathtub so the floors remain dry; try using a rubber mat or non-skid decals on the bottom of the tub or shower; try draining the bathtub if the older adult has a fear of falling; try using a hand-held spray attachment on a flexible hose can convert the tub into a shower; adjustable safety benches or bath chairs which have holes in the seat so water can drain can be used in both the tub and shower see assistive devices websites other considerations ; if a person is absolutely refusing a bath or any kind and lack of hygiene is intolerable consult a physician; in the later stages of dementia when total assistance with personal care may be necessary meticulous and careful attention to hygiene is important in preventing skin breakdown this becomes a major challenge for caregivers coping with urinary and bowel incontinence; bathing is a very personal and private activity many people have never completely undressed in front of anyone else and this can be an uncomfortable and vulnerable experience also when a caregiver offers to help someone who is confused it is a strong statement that the person is no longer able to do for him herself this loss of independence can be terribly difficult for people with dementing illnesses it is important to recognize that these feelings may be contributing to some of the resistance to bathing
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Categories: Cognitive Intellectual, Emotional Psychological, Maintenance, Medical Physical, Mobility, Needs Much Assistance
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*This information is listed as a Fact Sheet and is not explicitly medically licensed