No one likes the idea of being bathed by someone else. Yet when people are older, the bath and shower present the danger of falling and the inability to take care of personal hygiene because of normal debilitation. The flexibility needed to soap and rinse the body, often in an imbalanced position, such as when lifting a foot to wash it,) is often not within a senior's ability anymore. Beyond that, the steam from a shower may cause the senior to feel faint. Bathing and showering for the elderly can be a risky proposition.
Home care aides, home health aides, Certified Nursing Assistants, and other professionals provide bathing services to the elderly. Yet a stranger bathing a stranger potentially creates embarrassing and trying situations. Bathing by a family caregiver may be even more embarrassing and trying. For example, what if the only person available to bathe grandma is her adult son? What if the only person available to bathe grandpa is his adult granddaughter?
These situations have a potential for humiliation and shame. If possible, it may be best to hire a caregiver for just this task. If not, a family caregiver of the same gender should bathe the senior.
Here are hints from experts on how to make bathing an elderly person less uncomfortable:
- Talking helps. Some bathers continually chatter to keep everyone distracted. One CNA tells her elderly bath patients about her own surgical scars so they feel less self-conscious about their own imperfect bodies. Others turn on the radio to a soothing station. It is possible with some patients to sing songs together. Dementia patients may respond particularly well to singing together. This introduces a note of camaraderie that engages the dementia patients in the bathing.
- Being prepared helps. Have soap, towels, shampoo, and lotions available. Having to gather things while handling a slippery, elderly, wet person is not a good idea. Make sure towels are large, even beach-sized. This way the person can be wrapped in warmth and privacy promptly when the cleansing and rinsing are done.
- Preparing the environment helps. Showers should be equipped with handheld showerheads, plastic chairs at a comfortable height, handrails, and non-slip floor surfaces. There should be ample light without making the person feel he or she is on stage. Glaring light may upset a person with dementia. A pleasant, well-lighted, decorated bathing area, with pleasant scents and soothing music have a salutary effect on the elderly person.
- Reminders may help. Some bathers may delay bathing or showering as long as possible out of fear of falling and embarrassment. A reminder note may help the person get into the right frame of mind. An older person may respond well to being told by a loving relative that they have grown a little odiferous. If the elderly person is holding back because of modesty, he or she will choose to bathe rather than offending others. Don't force the issue. Sponge baths may be taken in between full baths or showers if the elderly person is intractable.
- Keeping the person physically comfortable helps. Make sure the room is warm. Test the water temperature. Don't rely on the elderly person to tell you it is too hot or too cold, although you may ask. If the person prefers to stay partially covered while other parts of the body are washed, is acceptable if he or she covers part of the body with towels or clothing and reveals only parts at a time. Reducing the time the person is nude to a minimum helps.
- Show respect. Put yourself in the elderly person's position. Only help as much as necessary. Don't plunge in, soap the person from top to bottom, rinse in a deluge, and place them in a towel or robe. Maybe the person just needs you to stand by or only needs help with feet and legs. Dementia patients like to be able to have something to control, so allowing the person to hold a towel or washcloth as a principal responsibility empowers the senior.
Bathing involves several points of stress and emotional triggers. The University of Iowa College of Nursing and John A. Hartford Foundation of Geriatric Nursing Excellence have developed guidelines for bathing persons with dementia. The authors of the guidelines state that 90% of dementia patients become agitated when told it is time to bathe. Bathing or showering is the time when an elderly patient is most likely to lash out at the caregiver. Many elderly persons, even those without dementia, feel fear, shame, anger, and even violation when others bathe them. It is assuredly a time when additional sensitivity, patience, and consideration are required.
Alzheimer's Association. Bathing. Alz.org. Available at http://www.alz.org/care/alzheimers-dementia-bathing.asp. Available at http://www.guideline.gov/content.aspx?id=44984. Retrieved 1/20/2016.
Hall, G.R., Gallagher, M., and Hoffmann-Snyder, C. Bathing persons with dementia. (2013). Iowa City (IA): University of Iowa College of Nursing, John A. Hartford Foundation Center of Geriatric Nursing Excellence; U.S. Department of Health and Human Services. Agency for Healthcare Research and Quality. National Guideline Clearinghouse.