Alzheimer's and Bathing: Tips for Bathing and Personal Hygiene

As your loved one's Alzheimer's progresses, you may find that certain tasks become more challenging for them to accomplish. Bathing or showering with Alzheimer's is an area where you may come up against resistance, anger, or hostility.¹

But there are ways to help you and your loved one accomplish the necessity of bathing and reduce the stress it can create. In fact, the AlzheimersDisease.net Facebook community was very vocal with tips and suggestions from their own personal experiences caring for a loved one with Alzheimer's. Continue reading to discover what worked (and what did not) for them.

Why is bathing with Alzheimer's a struggle?

Proper cleanliness as an adult is a societal norm and expectation. A resistance to bathing can feel confusing. You may find yourself frustrated and perplexed. There can be a few things that cause your loved one agitation toward the task of bathing:^1,2

• They might feel embarrassed that they can no longer do this task themselves.
• They may feel a loss of control or independence at being forced to do something when they are not ready.
• They may not understand what is happening or what is being asked of them.
• They might feel cold or frightened at being exposed.

All of these emotions can play into a hostile attitude toward getting clean. Multiple community members shared that their loved ones find bathing to be physically painful:

• "My husband would say 'needles, needles' when I would have him in the shower. I used the handheld sprayer as he wouldn't like water on his head or face. His head was shaved so I would use a wash cloth on his head and face."
• "Bath/shower time is now a very real struggle for my relative. It's literally a life and death danger from his viewpoint, he's so very scared of it and fights accordingly. Seeing your 'needles needles' comment makes me think the shower is literally painful on his skin. Such a mystery, all of it."

Another community member responded with this helpful advice:

• "Put a sock on the shower, it helps the flow not feel like needles to their skin."

Getting to yes

The process of bathing a loved one with Alzheimer's can go more smoothly if you can get your loved one to agree to the process willingly rather than by force.

Honor their preferences and try to maintain what they have always done. Did your mom use to bathe before bed? If so, do not ask her to bathe in the morning. Keep to the routine she preferred and was most comfortable with. Did your dad always take showers? Do not require him to now take a bath. Use a shower chair and keep the process as familiar as possible.

Try your best to make bath time fun and comfortable. Are there certain scented soaps or lotions your loved one likes? Do they like a particular kind of washcloth or sponge? Does certain music help them feel calmer and relaxed? Make these things part of the process so bathing is something they will enjoy rather than resist.^1,2

Because bathing can be so draining on both the patient and caregiver, be strategic when you initiate bath time:

• "He can get overwhelmed, so I try to keep him calm. Don’t do it when they are too tired."

The time of day can also make a huge difference, as this community member suggests:

• "Bathing earlier in the day is better."

Offer choices and clear communication

Whenever possible, offer your loved one choices so they feel they have control over the process. Some questions and options you can present include:^1,2

• "Today is bath day! Are you ready to do that now, or would you like to do it at another time?"
• "Which towels would you like to use, the blue or the white?"
• "What would you like to wear once we are done?"
• "Would you like me or [another trusted person] to help you?"

Your loved one may prefer someone of the same sex to help bathe them. For example, a father may prefer his son or son-in-law to assist him rather than his daughter.²

Be flexible

Then there are days when a shower or bath just will not happen. That is okay. Sometimes, putting showering or bathing off another day is the only option when your loved one gets upset by it. A sponge bath using a wash cloth in between regular baths could be an option. Or, you could wash 1 body part each day of the week to make it less overwhelming.^1,2

According to an Alzheimer's caregiver in our community, going with the flow is key:

• "LO resists showering. It's a struggle. We try and do it once a week, but if it upsets her too much we just put it off for another day. She used to wash up in the sink but has lost the understanding of how... When she is in the shower she always says how good it feels... Every day is the same yet different, so we go with the flow."

Talk them through each step before engaging

In order to help your loved one feel as comfortable as possible, communicate each step clearly before engaging in the task. Here are some helpful cues you can use:^1,2

Getting started

• "It is time for your bath! First, we are going to walk to the bathroom."
• "Now it is time to take off your clothes and put on your bathrobe. Can I help you unbutton your shirt? Now I am going to take off your socks and shoes."

Check the temperature

• "I am running the water. I think this feels like a good temperature. Do you agree?" Allow them to feel the water and change it to be warmer or cooler, depending on their response.
• "Are you cold? Would you like a towel over your shoulders?"

The activity of washing

• "Now I would like to help you into the tub. I am going to place a towel/washcloth over your lap once you are sitting."
• "I am putting soap on the washcloth. I am going to start by washing your back. I am done with your back now. Would you like to wash your arms, or would you like me to do that?" Keep naming the area and asking "me or you?" as you go.
• "Now it is time to wash your hair. I am going to rub in some shampoo. Could you lean your head back so we can rinse it out?"

Finishing up

• "All done! Can I help you stand up and get out?"
• "Can I help dry you off with the blue towel or do you want to start?"
• "Time to put on your bathrobe and go back to the bedroom to put on your clothes."
• "Great job! You look so nice and fresh!"

Keep your loved one safe

Safety when bathing someone with Alzheimer's is very important, especially to avoid a fall or accident. Never leave your loved one alone in the bath. Here are some things that may help keep your loved one safe and ease the process for you both:^1,2

• Install bars and grips to help them get in and out of the tub.
• Invest in a shower chair.
• Have rubber grips on the bottom of the shower or tub to prevent slipping.
• Use a handheld shower attachment to ease the process of washing and rinsing.

This community member has learned that a warm towel goes a long way:

• "We have a built-in shower seat that I cover with a warm towel. Even in the summer, I have the bathroom hot, because she is cold."

Another community member invested in a shower "hoodie:"

• "A hair shower hoodie works well with her long hair when washed. It's a wrap to use after washing the hair. Keeps it from dripping all over them."

Other personal hygiene tips for someone with Alzheimer's

Help maintain normalcy by encouraging and helping your loved one to do things that were always important to them.

If your mother always wore makeup, help her apply some or encourage her to put it on. If your dad was always clean-shaven, invest in an electric razor and help or encourage him to shave.^1,3

Dressing can be challenging for your loved one as well. After having them choose what they want to wear, lay out clothes in the order they should be put on to help minimize confusion.^1,3

Your loved one may need help remembering how to brush their teeth. Show them how, explaining step by step what to do. Brush your own teeth at the same time so they can watch. If a manual toothbrush is hard for them to use, consider investing in an electric toothbrush. Encourage them to do as much as they can for themselves.^1,4

Personal hygiene definitely changes as Alzheimer's progresses. What tips have you utilized to assist a loved one? Share what has and has not work so well with the community!