A man sprays dry shampoo and combs it into a woman's hair. The woman is wearing a robe and is seated in front of a table that also features a bowl of water and a soapy sponge.

To B(ath)e or Not to B(ath)e?

The showerhead drenched my shirt as tried to coax my wife Barbara to stay under the water long enough to rinse out the shampoo.

A recent AlzheimersDisease.net article about bathing reminded me of my struggles as my late wife’s cognitive function declined as a consequence of the early-onset Alzheimer’s variant of the disease.1

As her disease progressed, Barbara started to resist taking a bath or shower more often. As I compared notes with other caregivers and researched online sources, I found that she was not alone in her dislike of bathing among those suffering from Alzheimer’s.

Why is bathing such a challenge?

A number of reasons have been given as to why people with later-stage Alzheimer’s really hate bathing. In addition to the reasons given in the earlier article (modesty around caregivers, discomfort), I personally think it may have to do more with their inability to regulate temperature (Barbara was constantly either too hot or too cold).1 In any case, it seems to be a continuing problem for caregivers.

Here are some strategies that helped me encourage Barbara to bathe.

Addressing safety concerns

Most importantly, there are many safety concerns that must be addressed. Alzheimer’s patients are more subject to scalding as they struggle with their loss of sense of touch and declining communication skills. Balance problems also arise, which make traditional one-person shower stalls more difficult to use to bathe Alzheimer’s patients. (I would have to hold the door open to help Barbara, getting soaked in the process.) Thankfully, our long-term care insurance paid for a remodeling of our fiberglass shower into a two-person tiled shower with both fixed and hand-held nozzles and, more importantly, guard rails. These improvements made bathing Barbara easier for both of us.

Give an important reason to bathe

I heard one story about an obstinate veteran soldier with Alzheimer’s who refused to take a regular shower. At its wits’ end, the staff at his skilled nursing facility finally told him that “the General was visiting today and everyone needed to be prepared for inspection.” He dutifully marched into the bathroom and took a shower in preparation for the “inspection.”  When preparing to celebrate our 25th anniversary at a brunch with friends (about two months before her death from Alzheimer’s-related complications), I told Barbara that it was important for us to dress up for the occasion. Without any urging from me, she too marched in to take a shower, although she hated every minute and was sobbing throughout.

Sponge baths in lieu of showers

I saw an enlightening video of an elderly Alzheimer’s patient who dreaded being wheeled into the shower room for her periodic shower. Instead, her innovative caregiver gave her a sponge bath underneath her covers. She had such an angelic smile as she received her sponge bath and was overheard telling her caregiver that she “had no money to pay her for such wonderful treatment.”

Explore water-free alternatives

There are products on the market, such as no-rinse shampoos, that can alleviate the need to rinse the patient with water. Simply apply the product and comb through.

As a caregiver, every day I confronted the question of “To Bathe or Not to Bathe?” I learned about these ideas from experience, but I wish I’d known them sooner.

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