Dealing with Bathing Challenges

How would you feel if you were hurriedly told to complete a task you can’t remember or understand how to do? If you were made to stand naked and vulnerable in a cold bathroom with lots of slippery surfaces, afraid you may fall and get hurt? Imagine being coaxed into a small space behind a dark curtain as loud sounds pound in your ears, and an invisible liquid stings your eyes, fills your mouth and hits your skin like needles. For someone with dementia, this is how showering can feel – like a terrifying and humiliating experience to avoid at all costs.

Bathing often presents a challenge for individuals withmid- to late-stagedementia who may find the experience frightening or overwhelming. To keep your loved one healthy with good hygiene and to make the experience pleasant instead of a stressful battle, consider these suggestions:

  • Unless they’re very physically active, older adults don’t need to bathe every day. Washing once or twice a week is generally sufficient to keep skin healthy, so don’t create unnecessary challenges by insisting on bathing more. If body odor is an issue within a day or two of bathing, wet wipes are usually good enough to quickly cleanse areas where sweat and dirt tend to accumulate.
  • Incorporate bathing into your loved one’s routine by sticking to two or three consistent days and times for the activity each week. Choose the time of day when your loved one is typically at their “best” and allow plenty of time so you can both avoid the stress of being rushed. (For many folks with dementia, particularly those who experience sundowning, mornings are ideal.)
  • Place towels in the same prominent place at the same time every “bathe day” as a symbolic reminder. This can help gently correct the mistaken belief that “I bathed already.”
  • Begin by kindly telling your loved one it’s time to bathe, stating it as a given that it will happen. “It’s Monday morning, time to wash.” Don’t offer a choice of whether or not to wash.
  • Speak in soft, gentle tones with very simple directions of one or two steps at a time. (Example: “Get ready for your shower” leaves out a ton of details that can make the task overwhelming. Depending upon your loved one’s abilities, you may need to tell them to take off their shoes, go to the bathroom, take off shirt, pants, etc.)
  • If opting for a bath, understand that visual changes and a loss of depth perception may make your loved one unable to see the water. A colorful non-skid tub mat or bright bubbles can be useful in helping your loved one feel more confident stepping into the tub.
  • When it’s time to wash and rinse hair, give your loved one a folded washcloth to hold on their eyes while they tip their head back. (The kitchen sink can also be a great spot for a “mini salon.”)
  • Honor your loved one’s dignity by allowing them discretion and privacy. Close the blinds and doors. Allow them to undress under a warm robe or behind the shower curtain. Allow your loved one to wear a swimsuit if they want. You can help bathe the uncovered parts of their body, then give them the soapy rag to wash under their swimsuit behind a closed curtain.

More Suggestions

Create a pleasant environment for a familiar, relaxing, spa-like experience:

  • Make sure the bathroom is very well lit, including the shower. (Light-colored shower curtains are ideal.)
  • Get the bathroom and dressing area really warm, but don’t allow the water to get too hot. Folks with dementia can find temperature changes jarring and are often very averse to being cold.
  • Lay out everything your loved one will need in order of use (washcloth, soap, towel, clothes, deodorant). Keep things simple by removing all other products.
  • Minimize distractions by turning off the TV, putting pets away, and silencing phones.
  • Supply your loved one with familiar toiletries they’re accustomed to.
  • Provide washcloths and towels in colors that contrast with the room and shower so they’re easier to see.

Make the bathroom a safe space for your loved one:

  • Install convenient handrails or grab bars.
  • Place a non-skid rubber mat in the bottom of the tub or shower.
  • Provide a detachable shower head so the water doesn’t hit their face.
  • Consider a shower chair for extra safety.
  • Cover up mirrors if they cause confusion or distress.

Allow your loved one to feel a sense of control by giving them simple choices with inconsequential outcomes:

  • “Do you want to use the red or the purple towel?”
  • “Does this water temperature feel nice?”
  • “Would you rather take a shower or a bath?”
  • “Is this music too loud?”

Use positive language to counter objections, such as:

  • Tell your loved one a trusted authority (doctor, pastor, friend) has said they need to take a bath. A written note or pre-recorded voicemail/video can be useful for repeated use.

Tap into the power of flattery:

  • “Mom, you look so beautiful when your hair is clean and styled. Let’s wash it so I can help you fix it for XYZ (friend or activity).”
  • “Honey, you look so dashing in ABC (a clean garment). I’d love for you to wear it after you get cleaned up.”

Associate bathing with a positive feeling

  • “It was so fun when we did XYZ activity earlier, and now we need to clean up.”
  • “We always feel best when we start the day clean after an energizing bath.”
  • “Nothing feels better than getting into a freshly made bed after a nice shower.”

Have some fun with it:

  • Give your loved one something to use as a microphone for a shower concert.
  • Offer a rubber ducky for bath time.
  • Playfully sing along to “Splish Splash” to signal bath time.
  • Sneak in a bath by putting your loved one in a plastic yard pool with the grandkids.

Finally, on those days where you’re exhausted and bath time isn’t a battle worth choosing, allow yourself some grace — get out the wet wipes and dry shampoo for a quick “bird bath.”

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