The 5 steps to showering someone living with Dementia

One of the most common complaints/frustrations/comments I get when speaking with our caregivers and loved ones caring for people living with Alzheimers or other diseases causing dementia is:

"How do I get them to shower???  They REFUSE to shower".

This situation presents a challenge.  On the one hand we don't want to force anyone that we are caring for to do something they don't want to do, but on the other hand we need to ensure that their skin condition is maintained.  Skin is our largest organ and our first line of defence against infection so keeping our skin clean and intact is paramount in ensuring overall health.

Here are 5 steps to help you deal with daily "shower battle".

1.  STOP REASONING AND EXPLAINING!!!
One of the most common mistakes people make when communicating with people living with dementia is USING TOO MANY WORDS.  Remembering 3 words after 10 minutes can be challenging or impossible for someone living with dementia, so a wordy explanation regarding personal hygiene, feeling fresher etc although well meaning are really quite useless.  Instead - try this.  Slowly walk up to them and get their attention and smile.  When they smile back, put out your hand - palm up, and wait for them to take it.  Your role is to be a GUIDE.  The goal in this initial step is to get your loved one moving and in the right direction.  If your loved one asks - "where are we going?" respond with something banal and SHORT (less than 5 words).  "To have fun" is a good option.

2.  GET THE BATHROOM WARM.

Particularly on these cold winter mornings, trying to convince someone that stripping down naked in a cold bathroom is a good idea is really an exercise in futility.  If the bathroom has a heating function in the light and ventilation unit then make sure this has been on for a few minutes to warm up the bathroom.  If you don't have one of these then you can try the following tip.  Turn the water on in the shower - to the temperature that you'd have a comfortable shower.  Shut the door.  This will turn the bathroom toasty warm and inviting after a few moments.  Revert to step one and proceed in.

3.  THE HOOK (aka bribery!)

As you are leading the person living with dementia to the shower, start layering on the positive reinforcement.  Remember keep it simple.  Something like "ok mum/dad - lets have a nice wash and then I'll get you a (insert favourite food here - piece of cake, packet of chips, chocolate bar etc) and a cup of tea and then we will go out and have some fun".  Now at this point your loved one may argue "I don't want to have fun" or ask "what fun".  Either way - the focus is now on the fun and NOT on the shower.  Shift the focus back to the food bribery.

When using the hook don't forget to use the word "we".  "We will have a wash and then we will have some fun".  Not only does this reassure your loved one that you are with them every step of the way it also develops your own positive attitude to accomplishing your goal!

4.  AVOID THE WATER!

Well obviously this defeats the purpose of a shower but in our experience a lot of clients living with dementia really don't like water or are afraid.  Imagine feeling something hitting you on the head from above that you can't see.  Scary huh?  For this reason, guide your loved one into the shower from the side so water isn't hitting their head and hold their hand out to feel the water and adjust to the temperature.

Now hand them soap and a wash cloth and encourage them to start washing themselves,  At this stage often the long term memory of having a shower kicks in and they start washing themselves.  Encourage them and don't take over until you have no choice.

5.  AND NOW THE UNSPEAKABLE BITS

There are 2 parts (front and back) that NEED TO BE WASHED.  You can often encourage your loved one to do the front but you may have to do the back (or even the front).  Either way they need to be done.  There are no tricks here.  Just get them washed to avoid infections.

For more information please visit us at www.thecareside.com.au