Bathing is often a behavior stimuli for those with dementia. We don't understand why, but if it is an issue for the individual you are working with, the following are some examples of problems and potential interventions.
1. Pain
Many seniors have arthritis and after sitting or lying they have joint pain with movement. Giving them a Tylenol 45 to 60 minutes prior may help to minimize the pain. The person with dementia may demonstrate pain by moaning when moved, show facial grimacing, grab joints that are painful or may say that they hurt.
2. Fear of water
The senior with dementia may be afraid of water running onto their face and into their eyes and ears, even though they haven't been afraid of water before. Bathe them from the feet up and use a handheld shower head. Use caution when washing their hair to make sure water does not run over the head and bending the head backward. Be careful with this intervention because there maybe arthritis in the neck and movement may be painful.
3. Getting chilled when bathing
Outer body temperature mechanism does not work as well as we age. We tend to get chilled more easily. Having a wet body worsens the chilling and is uncomfortable. Interventions include keeping the body covered during bathing. Bathe and dry the body in segments. Heat the bathroom before bathing. Turn the water on before bathing time to help warm the space.
4. Fear of the unknown
The senior may not understand what the bathroom is for. The shower is a dark box that is fear inducing. Make the bathing area bright so the senior can see. Eyeglasses and hearing aids are removed at bath time which means sensory deprivation. Make the shower into a spa. Have a warm temperature, a chair covered with a towel, cover the commode with a towel, use aromatherapy for easing tension, have everything prepared so that the bathing experience is not disjointed.
5. Fear of falling
This is a real issue for seniors regardless of any memory issues. Falling as an adult is fear inducing especially if the senior has had an injury from a subsequent fall. Use showers that are handicapped accessible. Having the person step into a tub can be scary for them. Use a bath bench that slides across the tube edge. Make sure that there is a bath mat on the bottom of the bathing area. Use a handheld shower to prevent the need to stand on the wet surface. Mask the step into the shower with a bath mat or towel, so the senior does not realize that there is a step that is a trip hazard.
6. Privacy fears
Even if the individual bathing the senior is a well-known family member, they may not recognize them. Or, they may not recognize them in the role of personal care provider. Husbands, wives, and children do not bathe their loved ones. Privacy and intimacy are deep seeded needs of each of us. Interventions may be to leave underwear on the person as they move into the shower. Covering the trunk and perineum with a towel or wrap will ensure modesty. Once the underwear or towel is wet, the person may let you remove it. If it becomes an issue, consider getting a non-familiar person to help with bathing.
The critical point is to observe, try different interventions and not despair. It can be a significant challenge, but not one that is insurmountable. If the senior is odor free and not as risk, step back and wait. Even if the wait is several hours or days, it does not make a real difference in their wellbeing. Re-approach at a later time, and you might be successful then. Dementia is a disease that manifests with peaks and valleys. Wait until the person is calmer and in a valley and try again. If you have tried the above suggestions and they don't work for you, contact me to discuss other options.