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  • Karen Mcphail

To the Bath we go! How to Best Approach Bathing for Those With Dementia

Bathing and hygiene often become a significant challenge for those with dementia. Sadly, the more that family members worry and begin to push the worse things tend to unfold and a vicious cycle begins. So this bring us to the most common question of the week....

How is it best to approach bathing for those with dementia?

Of course, every person is different in terms of how their dementia unfolds so there is no one prescription or cookie cutter approach to apply to all challenging behaviors. However, there are definitely approaches that can be tried and things that should be avoided.

First, it helps to approach bathing after a person has experienced something enjoyable and at a time of the day when they are generally in a good mood and not fatigued. A bath at the end of the day when they are fatigued or perhaps over stimulated is therefore not generally a terrific time. Try to set the right tone from the start. The mood should be light, relaxed and on their terms as much as possible. Soft music, scented bath products, or scented candles out of reach, and relaxed lighting can be helpful. Lavender and peppermint can be very calming, but you can try other seats that evoke positive emotions and spark a connection! .

Try guiding the individual on their terms... " I see the bathroom, let's go in."

"What a pretty room" "It's a great time for bath"

Try using soft music or even coming up with a bath time song and routine as you walk to the bathroom. Those with dementia do not lose their sense of rhythm so music can be a useful tool! I have lead many clients happily to the bath by offering them my hand to hold and then leading them gently to the bathroom while singing the William Tell Overture or Lone Ranger tune with the following words:

To the bath to the bath to the bath we go!

To the bath to the bath to the bath we go!

To the bath to the bath to the bath we go!

OOOOH to the bath we go!

Connecting at their level in a meaningful way is key as all behavior is purposeful even resistance and agitation. The individual should be encouraged to participate as much as possible and be given some control over bath time. Verbal and process cueing along with simple guidance is often helpful throughout. Give simple choices, using short phrases when possible:

"What a nice wash cloth," offering it to them.

Those with dementia are very sensitive and any stress and pressure is sensed quickly and reacted to. A gentle, slow, and patient approach should be taken at all times. Rushing cannot happen.

Skin sensitivity is common in those with dementia! Water temperature should therefore be checked frequently and rubbing the skin should be avoided when cleansing.

Moisturizing, nonrinsing disposable dry wash cloths with water can be best for sponge bathing. These can be purchased at most drug stores and on amazon.

After baths a soft towel should be used to softly pat skin dry. Skin should be assessed during bathing for any skin tears, bruising or other issues. Skin fold areas should be kept dry and cornstarch powder can be used to limit moisture.

Keeping bath time short and having everything set up and ready to go prior to starting is VERY helpful.

Be realistic at all times!!!! Sometimes the bath will not be complete at times due to behavioral issues and may need to be cut short as we want to ensure that it is a positive process. Never force!!

Again, sponge bathing is often best, as showers can be scary for those with dementia as many become afraid of water. As dementia progresses perceptions change and water becomes pretty much invisible for many. This is why sponge bathing is often best as during showers or when individuals are splashed it becomes scary as sometimes they perceive that they are being hit and then become defensive, combative.

Consistency and routine will be helpful in terms of behavior management and for successful outcomes. Having consistent processes and people involved and tapping into what will make the experience positive is key. What past memories can be tapped into to make the bath positive or less stressful? What has triggered the individual to become upset in past that can be prevented or avoided? All these areas are important to consider.

Again, be realistic with expectations! The only intention should be for bath time to be completed in a positive way; the rest will come overtime.

If bath time is producing anxiety or anger for your loved one simply stop and redirect their behavior in a positive way. NEVER push through or force the task. Most people are not that dirty that a bath needs to be done urgently. Avoid conflict and stress for all by keeping it slow, being realistic, and moving forward in a positive way based on cues from your loved one.

If you need assistance on how to manage bath time or other challenging behaviors please reach out via our contacts tab.

#bathing #bathinganddementia

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