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Bathing a Person With Dementia

 REGINA D. Posvar LPN,RNA
REGINA D. Posvar LPN,RNA

Q: Dear Nurse Posvar, I am recently hired to care for an older person with Alzheimer’s. My granny had Alzheimer’s so I know about it. Sometimes when she hit my mom when giving her a bath, my mom knew was not her fault and continued with the bath. I know it this can be a hard job. I have already experienced getting blows during bath time with the person I care for. I do not like getting hit. The family have reduced the baths to four times when I come. They say she needs to be clean because she was always a person who dressed well and looked good. I understand. How can I keep from getting hit so much? I am thinking of quitting the job but I need the job. Please help.

A: I am sad to hear your distress. There are a few things I can recommend that will help your situation.
1: Learn the person’s personal history of likes and dislikes;
2: Find something in their history that you can use to connect with your person with Alzheimers.
3: Make sure everything you need to complete a bath is in the bathroom before you bring the person there.
4: Pay attention to your own body language – is it anxious or calm (love or fear?) The person you care for will know which emotion and energy you are presenting and will respond to how it makes them feel.
5: Learn a song they like and sing it when you are in the bathroom;
6: Allow them to do as much as they can with their own bath – you are there to help, not take over.
7: Before you even start the bath, reflect on what you do and what they do with the process and determine what you can do to make it more pleasant. Understand that you have the healthy brain and can make changes.
8: Make eye contact when you tell them what you want to do.
9: If they pull away from you or tell you “no”, back off and try a different approach.
10: Pay attention to the environment. Is it soothing or does it aggravate the person you are caring for? Did they watch something on TV that was stressful or a family argument?

Those emotions contribute to the person with Alzheimer’s and they may not be in the mood for a bath. Change the environment to a happy calming mood.

If the person goes too long without a bath try having them wash their important parts with soap and water over the sink. Many times this is so helpful, and make it a routine and actual baths/showers can be twice a week instead of every day.

Have a talk with the family and help them understand that a happy loved one is more important than that bath at that particular time. Now of course, if someone has soiled themselves you want to spend some time getting that person comfortable so they will cooperate with a bath, as in the long run their agitation could be from them feeling uncomfortable about being in soiled clothes. Fighting them to do so is not helpful to you or them.

Q: Dear Regina, I have recently moved back to Saint. Lucia to help my siblings with the care of my mum. She has not been properly diagnosed with dementia but we all know that she suffers from it. She can no longer care for herself on her own. My youngest sister lives with her and does most of the daily care. My other siblings and I want to help more but our younger sister is troubling us and says we do not care. How can we help my sister with my mum’s care?

A: Your younger sister may have burn-out syndrome. She is beyond asking for help and is not able to rationally ask for help or appreciate any help. You are going to have to have a meeting with her to express your love and gratitude for all she is doing for your mum. She needs a regular break. When you all meet, you need to outline the care needs of your mum and what your sister is providing. Once you know what is needed and what she has been supplying, then you can see where you all can plug in to help each other. You may have to chip together and pay for hired help to give her a regular break so she can enjoy a social life without the worries of who is with your mum. If you all are able to be the break she needs I also suggest you do sibling outings away from care duties. Be patient with her as she is very stressed and may not admit to it. I am sure she feels she can do it on her own or no one can do it better than she can. Her love for your mum is real and she wants what is best for her She will push others away because she has ignored her own self care and cannot see that others do care. Many times a professional in the field may help during a family meeting.

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