Avoiding the Bath

What a wonderful week! Last Sunday I felt honored to be able to volunteer with my business partner, Ginny, at the Memory Walk in Tower City, Cleveland with the Alzheimer's Association Cleveland Area Chapter. There is something so rich when everyone comes together for a cause. There was fun and food and Moondog and smiles everywhere. The dream of the Alzheimer's Association is a world without Alzheimer's disease. What a great reason for banning together.

Well, that started the week. Then, besides the opportunity to do a short segment about our Brainy Day Program on the local news and shoot a video through a very gifted college senior, my partner and I had the opportunity to spend some joy-filled moments with seniors who were laughing and having fun. I also had another chance to do a presentation on behaviors and activities. The subject of concern for the week seemed to be bathing.

Bathing can be tough to tackle. There is not only the issue of hygiene, which can be hard to live with in and of itself, but there is also the health factor of skin breakdown, urinary tract infection or other possible infection. So what do you do to convince someone who does not think they need a bath or shower to take one? I've been in households where the battle was loud and strong.

Let's look first at some of the possible issues for their resistance. We touched a little in a previous post about the privacy issue. To undress and have someone bathe you is an affront to dignity. In the majority of folks I have met, this is a humiliating experience, especially the first time they have to go through it. For the person with dementia it can be the first time every time.

Another issue is that the person is going back in time. If they were fearful of water, hated bathing as a child or couldn't swim, the past could be contributing to the present refusal. Other things that are factors: Being cold, not being able to stand or sit for long periods, fear of falling, the sound of the running water or even the inability to understand what is happening to them or expected of them. (We'll address this next week)

So what can we do? There are several things that might be helpful. Of course, your approach is vital. No one wants to be told what to do. This is a perfect time to think of those words "help" and "invite". Invite the person to help you with something pertaining to the bath. Maybe you need help because "I can't decide if this soap works better or that one." or "I have two sponges. Can you help me? Which one is soapier?" or "Does this feel warm?"

There are several products on the market that are helpful. There is a video called "Bathing Without a Battle" that shares a method of bathing while the person is still in bed. They show how to keep the majority of the person covered while bathing just one part at a time. That helps the cold and dignity issues. There is also Soapless Body Wash which helps to eliminate rinsing and is better for the older person because soaps can be drying to the skin. Blotting with a towel instead of rubbing is also protective to older skin. Both can be found in the Alzheimer's Store Catalogue. www.alzstore.com

Care providers can use the soapless body wash in a basin of hot water, soak 12 washcloths in the basin and then wring them out and put into a ziplock bag to keep warm. Have one or two large bath towels. The idea is to use each washcloth on one area of the body and eliminate the need for the person to get into water. The parts not being washed can stay covered. If they can, let them have a washcloth for face or neck or arm. Using soothing music and aromas like lavender can help to create an atmosphere of calm. Use comforting words and quiet tones or hum softly to the music.

As with everything, there are no guarentees that this will work, but when it does, it can provide an experience of less stress for both the individual with dementia and the care provider. Mary Ann