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Personal Care and Alzheimer’s Disease: How to Avoid the Struggle

Bathing can be difficult for someone with Alzheimer’s or Dementia and also then often becomes a daily struggle for their caregivers.

Here are some suggestions that might help if you are providing bathing assistance for your loved one:

Have all items ready for bathing ready in advance (soap, water temperature, towels). You do not want to add stress to the situation by not having ready access to what you need for the bathing.

The bathroom and shower area should be warm, well lit and have safety features like non skid bath mats and outside the tub mats along with grab bars a shower seat and a hand held shower. These are not always needed for everyone, but the idea of safety is.

Soothing music in the bathing area can be calming for many people with Alzheimer’s.

Curtains pulled, doors closed give safety and security as well as privacy.

Establish a routine based on history of your loved ones bathing habits. Did they shower every AM before work or like a leisurely tub bath once a week? Bath tubs are difficult to get in and out of as a person ages. It needs to be assessed on a case by case basis. Some people prefer a sponge bath with shampoo in the sink. The idea is to maintain some semblance of past routine whenever possible.

Sequence the steps and involve the loved one with the help of verbal cues and gestures. “Here is the facecloth, you can wash your face”, is simple and direct which can be combined with demonstration to get the loved one to imitate the caregiver. This method may ease the tension and encourages doing what they can for themselves.

Sometimes water on the face or head can be anxiety provoking for some people. If you know this to be true, separate the bathing activity with a hairdresser or barber and/or an occasional use of dry shampoo.

Avoid a lot of discussion about the reason why they need to be bathed. Reasoning is altered by the disease. Instead, be sure to gain your loved one’s confidence with a kind, patient, matter of fact approach to bathing.

Refocus the loved ones attention, if they become restless , give them something to hold so they can be focused on that rather than the task at hand. Examples might be a loofah or a soft washcloth, colorful if possible.

Respect privacy by avoiding unnecessary exposure to private areas. Cover with towels to maintain dignity.

Bathing can be accomplished creatively in several different ways: sponge, shower or tub.

Early on with higher function maintained, the MD could write on a prescription pad the suggestion: “Bathe 2-3 times a week” and sometimes if the directive comes from the MD it is taken out of the caregivers hands.

Sometimes a calendar to indicate when baths were given can be used with stickers or a note. This also can be used for bowel movements if the consumer is still relatively independent with toileting, just to keep track to avoid constipation..

This calendar should not be used as reward/punishment or by any means confrontation.

It might serve as a visual for the consumer to provide some orientation to see when the task was last accomplished.

Additionally consider hiring a home health aide from a health care agency.  Home health aides specifically trained in dementia care are very good at maintaining privacy and yet still accomplishing what needs to be done for personal care. If incontinence is involved it is very important to make sure that the skin is clean, dry and protected with a barrier cream or the probability of skin break down increases.

As always, please seek out support from the Alzheimer Association, www.alz.org/MANH, 1-800-272-3900 or call us at 1-800-892-0890 to inquire about services.

Care giving is the most difficult job and probably the most important as well. Be well and take care of yourself.