Self-neglect is a common problem with people with dementia. As a reminder, dementia of memory impairment can be caused by a number of diseases. Alzheimer’s disease is the most frequent, but certainly not the only cause. We do not understand how the unhealthy brain manifests the symptoms of dementia, but we do know that some things are more distressing than others. No desire to bath, meet hygiene needs and wash their hair often becomes an issue.
One of the interventions for bathing issues is that the senior may be chilled when bathing. As we age, our body’s ability to maintain its temperature changes. We often lose the body fat layer that we had a younger person. The skin becomes more fragile, thinner and drier. Hormone changes occur and circulation may be reduced by hardening of the arteries. All of these and more, have an impact on the senior’s ability to manage their body temperature. Have you ever walked into a senior’s home and felt like you were in a sauna? This exemplifies the changes.
There are a number of simple solutions that can help. The first is to warm the bathroom up with a space heater or turn on the shower to steam and warm the area. Keep the bathroom door shut to retain the heat. Use care when turning up the temperature of the water because the senior’s skin is fragile and thermal injury and burns can occur without notice.
Other solutions are to wrap the senior in towels or a robe and only shower parts of the body at a time. Dry the body parts as they are bathed. Evaporating water causes chilling and drying the water away quickly keeps the senior warmer.
Making the bathroom a spa may redirect the senior from the bathing experience. You do not need to install a spa tub to do this. Decorate the room with spa like accessories. Hide the toilet behind a screen to minimize the appearance of a bathroom. Use a shower instead of a bath for fall safety and for prevention of urinary tract infections from sitting in a tub of water. Have a chair in the spa area for the senior to sit down and undress. Do not undress the senior until you are in the spa and ready to shower. Soft music, running water or the sound of rain in the background may be soothing.
Recognize fears that the senior may have had for their whole life. They may be afraid of water and water spraying them in their face may frighten them. They may be modest and having someone see them without their clothes may be problematic. The gender of the person who is doing the bathing may be a problem. Look for patterns of behavior to give you clues about what works and does not work. If the person enjoyed swimming, let them bath in a bathing suit and make it seem like a dip in the pool.
Bathing a senior on a daily basis is not necessary. Often two to three times a week is adequate. They do not perspire like young adults and they are usually not as physically active requiring odor management. Their skin is also less well lubricated and natural oil secretion from the skin is lessened with age. This makes the skin drier and more fragile. Cracks can occur in the skin which is a natural infection barrier.
Are you having difficulties getting your loved one to bathe? Try one of the above suggestions or contact me to discuss your specific situation.