Education and Care - Bathing

Alzheimer's Foundation of America

The bathing habits of an individual with dementia ideally should follow the same pattern as prior to the onset of the disease. If someone showered every day in the morning, aim for that; if they bathed every other evening, stick with that routine. The rule of thumb: Bathing should occur as frequently as before unless specific hygiene needs or behavioral changes arise. For example, adjustments may be necessary if an individual is severely agitated, wakes up soiled in the morning, or experiences behavioral problems, or "sundowning", as evening approaches.

Bathing is a complex activity of daily living composed of several phases: undressing, introduction into the shower or tub, washing, drying and re-dressing. Recognizing a person's abilities and preparing ahead of time can help simplify the process.

Possible Problems:
  • Most older individuals retain a sense of modesty and resist undressing; this is a normal response.
  • Frightened, disoriented individuals may not recognize the family or professional caregiver.
  • They may have forgotten how to undress, wash or dry themselves, or redress.
  • Individuals, especially those who are visually or hearing impaired, recovering from recent medical problems or on certain medications, are at risk of falling.
  • Shower and bathtub surfaces can be dangerous - cold, hot or slippery.
  • An individual, especially in the middle to late stages, may forget how to pick up their legs or sit in a bathtub.
  • Someone can become alarmed during any part of the process and attempt to flee.
  • Give one-step instructions in short, simple terms, and go slowly.
  • Communicate with non-verbal cues to help the individual understand.
  • Remember to provide privacy, and ensure dignity.
  • Be reassuring since concern over modesty also may increase agitation.
  • Approach the individual from the front whenever possible.
  • Make sure the room temperature is appropriate for disrobing.
  • Smile, speak calmly and do not express any frustration.
  • Remove the bathroom door lock for safety.
  • Do not leave the individual unattended in the bath area.
  • Minimize safety risks by installing a no-skid surface and grab bars.
  • Try the shower instead of the tub, or vice versa, if someone becomes afraid of either.
  • Keep the individual in a bathrobe until they are in the bathing area.
  • Make sure the individual uses the toilet prior to bathing to prevent accidents during or after the bathing process.
  • Secure soap, towels and other bathing items in advance.
  • Ensure appropriate water temperature, especially to prevent scalding.
  • Keep the individual in a warm room until they are completely dry and clothed.
  • Lay out clothing in advance to proceed quickly from drying to dressing.

Be flexible. Bathing does not have to occur daily. If the regular routine stops working, try sponge baths, switch to every other day or change the time of day.

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